1,400 dental patients told they will soon lose NHS care

In a letter sent to the patients who will be affected, Nicky McWilliams, Practice Manager of Bupa Dental Care explained that although the practice remains “committed to providing NHS care”, they’ve been unable to find a permanent replacement for Dr. Kerri Burke who is leaving in January 2024, due to a “critical national shortage of dentists delivering NHS care in Northern Ireland”.

Ms. McWilliams assured recipients of the letter that, if they are currently having NHS treatment with the practice, they can complete it as arranged and that Bupa will be in touch with them to let them know about the next steps.

However, recipients of the letter who will no longer receive NHS care at Bupa Dental Care Enniskillen have been offered the option to stay at the practice as a private patient.

When asked how many patients at the practice will be affected, a spokesperson for Bupa Dental Care Enniskillen responded: “We have six NHS dentists treating NHS patients in our Bupa Dental Care Enniskillen practice, who will continue to treat up to 8,500 NHS patients in the local community.

“The practice offers emergency appointments to current NHS patients, prioritising children and high needs patients in line with NHS guidelines.

“For more than two years we have been actively recruiting for an NHS dentist to join the practice, however the national shortage of dentists to deliver NHS care means that we have sadly struggled. As a result, less than 14 per cent of patients at our Bupa Dental Care Enniskillen practice have been informed that they will need to seek a new dentist. We want to reassure patients that we’re doing all we can to seek dentists to deliver NHS care for this community.”

Dominic Kerrigan from Belcoo is one of the patients of Bupa Dental Care Enniskillen who was informed this week that he will no longer be offered NHS care at the practice.

Mr. Kerrigan explained that since receiving the letter, he has called every dentist in Fermanagh and none of them are accepting new NHS patients.

“The problem is there is actually no NHS availability in Fermanagh,” he said, adding that it is against his “policy to go private”: “It seems like it’s just pushing everybody into a private healthcare, despite paying your taxes which is supposed to cover the NHS and dental treatment.

“I took a look at the [private] prices [at Bupa] and quite frankly I think they are extortionate. It’s certainly a very expensive option.

“How does it work if you can’t afford that?” he questioned.

Commenting that he is most concerned about his children’s dental health, Mr. Kerrigan said: “We’ve been left in limbo. I’m not overly concerned about myself but I’ve a young family, I want to make sure that they do have a dentist of some sort so it will be a case of looking around.

“We’ll either go private or potentially cross the Border and see what the rates are like there. They’re possibly more attractive than private rates in [all of] the six counties.”

Dr. Ciara Gallagher (pictured), the chair of the British Dental Association (BDA) Northern Ireland Dental Practice Committee and board member of the College of General Dentistry in Northern Ireland, explained why the dental sector in Co. Fermanagh and Northern Ireland in general, is finding it difficult to recruit NHS dentists at present.

Dr. Ciara Gallagher, chair of the BDA Northern Ireland Dental Practice Committee.

“At the heart of the problem is the dental contract, it was written more than 30 years ago. Dentistry has moved on hugely from then but the contract has not. Fees paid for treatments have not kept up with the new technology available for treatments with the result that NHS dentistry is chronically underfunded,” she said, explaining that the fees paid by the Department of Health (DoH) for the majority of treatments now no longer cover the costs of providing these treatments and so practices all over Northern Ireland are having difficulties recruiting NHS dentists.

She added: “It is a fact that NHS focussed dentists in Northern Ireland are the lowest paid of all dentists in the UK and this makes attracting and recruiting young graduates incredibly difficult.”

When asked what the BDA is doing to tackle this issue, Dr. Gallagher said: “The BDA have relentlessly lobbied the Department of Health on behalf of both patients and dentists to reform the contract so that the fees paid reflect the enhanced costs of running a modern dental practice. Our work to highlight this has gone on for decades and has gone largely unheeded by the department of health until recently.

“There is now a realisation within the department that something must change, as highlighted by the BBC in conjunction with the BDA last year, when it was discovered that nine out of 10 practices were no longer taking on NHS patients. This access crisis has now got worse.

“The BDA continues to petition for change which would bring about improved access for patients, however with no government and a dire budgetary situation, we cannot predict with any certainty when this change will happen.

“What we can predict is that we will continue to fight for care for those patients who need it most.”

According to the website of Bupa Dental Care Enniskillen, a root canal treatment of a back tooth for NHS patients at the practice starts from £91.74 whereas private patients will pay £729. When asked why there is such a difference in the price of NHS care and private dental care, Dr. Gallagher responded: “I cannot comment on the fee charged by any one practice for a treatment, I can however say that when treatment is carried out privately, what is charged is more reflective of the cost of care.

“I can also say that what the NHS pays does not cover the cost of care for the vast majority of treatments,” she added, going on to explain that the running costs per hour of a dental practice are huge.

“For example there are eight types of insurance that must be in place before you open your doors, it costs upwards of £100,000 to equip a practice, for every dentist there must also be a nurse and a receptionist each of whom needs a decent salary, utilities are through the roof, dental materials are incredibly costly as are the costs for sterilising equipment and buying consumable dental products.

“The list of costs are huge and £91.74 for a complex procedure such as a root canal treatment will not cover these,” said Dr. Gallagher, adding: “If costs are not covered the practice will go out of business and close.

“Looking at extractions for example, this is a surgical treatment requiring considerable skill and the NHS fee for assessment, diagnosis, consent, numbing up, extracting the tooth and caring for the patient afterwards until they are fit for discharge is just over £16, when you look at this you can understand why this service can neither cover its costs nor attract dentists.”

Noting that she is “really concerned” about children who cannot get their teeth checked, Dr. Gallagher said: “Having a regular check-up means small problems can be picked up and treated before they become much larger and more painful problems such as abscesses requiring a general anaesthetic for extractions. I am concerned about adults who will not get their mouths checked for cancers and other oral illnesses.

“I am concerned for elderly patients with poorly fitting dentures who are not able to eat properly,” said Dr. Gallagher, in an interview with The Impartial Reporter.