Half of Blackpool either forced to go private - or go without - vital dental care

PLUS: The biggest changes to the bins since they got wheels

Hello and welcome to The Blackpool Lead.

Today we focus on an issue felt keenly - all-too-often felt too much - across Blackpool. That is the issues in finding a dentist.

Private dentistry can be prohibitively expensive and that means that, when an NHS dentist isn’t available, people either go without or even try doing it themselves. Bob Mortimer might be alright with that, but the reality is more than a little Victorian.

We have not forgotten the vote on welfare reform - with Chris Webb and Lorraine Beavers both advocating strongly for residents already - but it comes too late in the day for us to respond in-depth today. Expect a report on the fallout in the weekend edition.

What we can tell you is that both the MP for Blackpool South and Blackpool North and Fleetwood voted against even the watered down welfare bill.

Special report: Tens of thousands without a dentist in Blackpool

A not-especially well-attended debate on dentistry

By Michael Holmes

Tens of thousands of adults and children in Blackpool still do not have access to an NHS dentist - with the problem getting worse over the past five years, it can today be revealed.

In 2020, some 52% of adults and 56% of children in the town had been able to access care in the past 24 months and 12 months respectively, according to NHS figures scrutinised by The Blackpool Lead.

But by April this year, those numbers had fallen to 42% and 51%, leaving roughly half the resort’s population with no choice but to pay for private treatment - or forgo it altogether.

Dentist Stuart Johnson, who is also a member of the Lancashire and South Cumbria Local Dental Committee, told The Blackpool Lead: “In essence we have a universally criticised national contract which leaves the NHS dental service ‘broken’.

“The contract was imposed on the profession by Labour in 2006 but has subsequently been underfunded to the point that many treatments now cost more to provide than our practices are paid to provide them.

“For some practices, the final straw has been the national insurance increase in April, which can mean practices are making a loss and have to either close altogether or cease providing NHS services.”

Johnson said the committee has asked to meet with Blackpool South MP Chris Webb and Blackpool North and Cleveleys MP Lorraine Beavers “to discuss what is needed” but it has yet to happen.

Webb told an almost-deserted parliament during a recent debate on dentistry that a four-year-old has been left in agony for months because of waiting times.

He said: “Anyone who has had severe toothache knows the unbearable agony. In those moments, it feels like there’s nothing worse. But imagine watching your four-year-old child suffer that same pain. And imagine being told that he can’t be helped.

“That was the reality for my constituent Louise. A single mother, Louise got in touch with me at breaking point. She had watched her son suffer through constant distress - crying in agony, unable to sleep, refusing food.

“When she managed to see an emergency dentist, she was told he would need between four and eight teeth extracted under local anaesthetic. But the wait time for that procedure was up to two years.

“Louise was left with no choice but to manage her son’s pain daily with Calpol and ibuprofen.

“That’s not healthcare - that’s abandonment.”

Labour MP Webb said Louise’s story is “not rare”, with people turning up to A&E at Blackpool Victoria hospital “because they can’t get a dental appointment”.

He added: “Some are even resorting to pulling out their own teeth at home. DIY dentistry - in 21st century Britain.

“This is the shameful legacy of years of underinvestment and neglect. NHS dentistry was left to decay under the previous (Conservative) government.”

Beavers did not respond to a request for comment.

The NHS website, which allows users to search for dentists in their area, revealed 14 practices in Blackpool (plus several farther afield in nearby Fylde coast towns and villages).

Of those 14, half were listed as “not accepting new NHS patients”.

Another six were listed as “only taking new NHS patients for specialist dental care by referral”.

Only one - mydentist in Leamington Road near the town centre, said it was routinely accepting new NHS patients.

Poor dental health is not merely cosmetic, according to health chiefs.

“A person’s oral health can act like a window into what is occurring in the rest of the body,” according to one NHS dental service elsewhere in the country.

Oral inflammation and bacteria associated with advanced gum disease can be linked to heart disease and blood clots, while poor oral health “can affect appetite and the ability to eat, result in malnutrition and hence compromise general health and well-being”, it says.

Poor oral health also puts people at greater risk of developing pneumonia or diabetes, while there is also evidence linking tooth and gum issues to strokes and bowel cancer.

Webb, the Blackpool South MP, said: “People living in poverty are most at risk of poor dental health and in my constituency, poverty is a daily reality for so many.

“Families who live hand-to-mouth do not have the luxury of going private. For them, NHS dentistry is not a bonus - it is their only hope. And bit by bit, it’s being chipped away.

“Children’s tooth decay is one of the clearest signs of how deep this crisis runs. In Blackpool, one in five three-year-olds - and nearly one in three five-year-olds - has visible dental decay, among the highest in the country.”

He continued: “Oral health is a key market of wider health. We are failing children before they’ve started school.”

Webb cited figures from the British Dental Association showing that more than six in 10 dentists are considering leaving the NHS completely and that, despite the number of dentists registered to practise in the UK being at an all-time high, the number working in the NHS is falling annually.

“Dentists are not to blame,” Webb said. “The current NHS contract is simply unworkable. The system doesn’t value them - and it doesn’t allow them to care for patients the way they want to.”

Webb said he is “pleased that the government’s rollout of 700,000 more urgent dental appointments has begun” but Johnson from the Lancashire and South Cumbria Local Dental Committee criticised the move locally.

He said: “In our area, due to the hard work and collaboration between the ICB (integrated care board) commissioners and the profession, we already had really good provision of urgent and emergency care.

“So unfortunately the instruction from government to provide extra urgent appointments has actually taken money away from routine care; there was no additional funding for these appointments, just an instruction on how to use the existing budget.”

The Lancashire and South Cumbria ICB, which is responsible for planning and managing NHS services in the region, said there are “several factors currently impacting NHS dental services”, including people’s worsening oral health, funding, dissatisfaction with the national contract and “workforce challenges”.

The ICB has been tasked by the government with boosting dental care to pre-Covid levels, with access a problem nationally and not unique to Lancashire.

But access rates on the Fylde coast, including Blackpool, are “dropping as opposed to improving”, papers seen by The Blackpool Lead acknowledge.

The ICB’s associate director of primary care Amy Lepiorz said: “The ICB is currently undertaking a piece of work to understand why dental access is taking longer to recover in Blackpool and the Fylde coast area than other areas, and identify what targeted improvements may be needed.

“Earlier this year, we published our dental commission plan which details all the different initiatives and strategies that we are implementing to improve safety, clinical outcomes, patient experience and dental access across Lancashire and South Cumbria, as well as what investment is required.

“Some of these initiatives include upskilling the entire dental team with the aim of better equipping practices to manage the ageing population, and to work with stakeholders to deliver population-level prevention schemes across Lancashire and South Cumbria.”

In April, MPs said measures introduced nationally last year to boost access to NHS dentists appeared to have “resulted in worsening the picture”.

The dental recovery plan has “comprehensively failed”, the Public Accounts Committee (PAC) said, amid concerns that vulnerable people “continue to suffer the most”.

A PAC report said the dental contract “remains unfit for purpose”, with current arrangements only enough for about half of England’s population to see an NHS dentist over a two-year period.

The blueprint to bolster NHS dentistry was unveiled in early 2024, with a pledge it would fund more than 1.5m additional NHS treatments or 2.5m appointments.

This included a new patient premium (NPP), with practices getting credits for each eligible new patient they saw, a “golden hello” recruitment scheme introducing £20,000 incentive payments for dentists, and mobile dental vans.

But the PAC discovered that the NPP – which has cost at least £88m since being introduced in March last year – has resulted in 3% fewer new patients seeing an NHS dentist.

The “golden hello” scheme had appointed fewer than 20% of the expected 240 dentists by February 2025, the report also said, while the mobile dental vans have already been taken off the road.

PAC chairman Sir Geoffrey Clifton-Brown said: “This country is now years deep in an avalanche of harrowing stories of the impact of dentistry’s system failure.

“It is utterly disgraceful that, in the 21st century, some Britons have been forced to remove their own teeth.

“Last year’s dental recovery plan was supposed to address these problems, something our report has found it has signally failed to do.

“Almost unbelievably, the government’s initiatives appear to have actually resulted in worsening the picture, with fewer new patients seen since the plan’s introduction.”

Current funding and contractual arrangements would only cover about half of England’s population to see an NHS dentist over a two-year period “at best”, the PAC report said.

It said 40% of adults had seen an NHS dentist in the two years to March 2024, compared with 49% in the two years before the Covid pandemic.

There was also a “discrepancy” between what a dentist can earn doing NHS work and private work, which the PAC said is a “fundamental issue for improving access”.

There were 34,520 dentists registered to provide services in England in April 2023, with 24,193 delivering some NHS care in 2023/24, the report said.

The PAC said that, without proper pay, more dentists will move exclusively to the private sector.

The report said “it does not appear” that NHS England or the Department of Health and Social Care “have a sense of what level of funding would provide a realistic incentive for dentists to prioritise NHS work”.

Sir Geoffrey said: “NHS dentistry is broken. The government could hardly fail to agree on this point, and indeed I am glad that it is not in denial that the time for tinkering at the edges is over.

“It is time for big decisions.”

Shiv Pabary, chair of the British Dental Association’s general dental practice committee, added: “MPs have arrived at an inescapable conclusion, that tweaks at the margins have not and will not save NHS dentistry.

“We’ve never budged from our view that governments past and present have needed to go further and faster.

“We’re ready to roll up our sleeves and start on the fundamental reform required to give this service a future.”

A Department of Health and Social Care spokesperson said the Labour government “inherited a broken NHS dental sector” and was fixing it through its Plan For Change.

In February, they said, it delivered on a manifesto pledge by rolling out 700,000 extra urgent appointments and pledged to introduce a new supervised toothbrushing scheme for three to five-year-olds.

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