Spring statement: Will Rachel Reeves end decades of NHS dentistry neglect—or continue the stealth cuts?

26 March 2025, 07:48

Don’t expect to hear the word ‘dentistry’ slip off Rachel Reeves tongue as she delivers her Spring Statement later today.

However, the treatment of this service by the Treasury neatly encapsulates the position the government finds itself in.

Having made many worthy promises, the Government - critics say - looks set to deliver a rerun of austerity.

Is that so? Well, a few weeks ago a charge hike for dental patients was quietly slipped out without fanfare. At about 2.3% it’s below inflation and will kick in on 1 April. Fair enough, really?

Well no. Because the new Chancellor appears to be borrowing from the playbook of her Conservative predecessors - using these charges as cover for cuts.

Back in 2015 the George Osborne’s Spending Review committed the government to five years of 5% annual hikes in dental charges.

More investment year on year then? No. The budget didn’t move - it’s been effectively static for a decade and a half. Patients simply paid more, and all that changed was ministers paid less.

We’ve looked at the numbers and had governments past and present actually shared the burden, followed the old mantra about being “in it together” and increased state spending by the same rate they hiked charges we’d have an extra £1.5bn in the pot - enough to underpin an effectively universal service.

But that wasn’t on the agenda. What was were easy stealth cuts, in a part of the NHS that simply wasn’t valued at the Treasury.

Well, at least some things have changed.

Dentistry is now a top political issue, and the crisis isn’t letting up. Recent polls show 1 in 4 people who fail to secure NHS care are trying their hand as DIY dentists. A fifth are heading abroad for care that should be available on their high street.

The sad truth is this crisis was made at the Treasury. Underfunding is a political choice, and with a long pedigree.

The new government has made the right promises to save this service. The challenge now is squaring worthy pledges with an hostility to dentistry that’s been hard wired into HMT for generations.

The task ahead requires reform, but that must go hand in hand with sustainable funding. At present a typical practice loses over £40 doing a set of NHS dentures. That might suit Treasury accountants but it’s not going to keep this service afloat.

Almost since the birth of the NHS, dentistry and austerity have gone hand in hand.

Charges were rolled out in 1951 explicitly to reduce the demand for care, something they still achieve with aplomb for those on modest incomes. But now they have evolved into a substitute for decent state investment.

The Chancellor is considering her long-term plan, in her coming Spending Review.

Her choices will either sink or save this service.

Shiv Pabary is the Chair of the British Dental Association's General Dental Practice Committee

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