In Stormont debate, members of the legislative assembly have unanimously agreed on the need for a new oral health strategy to reform dental services. 

Members of the legislative assembly (MLAs) in Northern Ireland have unanimously passed an assembly motion which calls on the minister of health to develop a new oral health strategy to reform dental services, address workforce challenges and expedite dental payment reform. 

The crisis unfolding in health service dentistry was the focus of a second debate on dentistry in as many weeks, the latest being a full assembly debate at Stormont brought forward by Diane Dodds and Alan Robinson from the Democratic Unionist Party (DUP), and amended by the Alliance Party.

Members from across all parties were united in expressing alarm at the widespread access issues arising from the scale of the disappearance of health service dentistry, quoting the massive reductions in registered patients and NHS dental activity.

MLAs acknowledged that this is entirely the outworking of a dental payment model, which they say bears no resemblance to the true cost of providing care. They also recognised that it has become unviable for practices to deliver, and is resulting in the most rapid decline of NHS dentistry anywhere in the UK.

They also stressed the urgency of having the cost-of-service review published without delay, emphasising the need to make rapid progress in the weeks and months ahead if dentistry in Northern Ireland is to have any chance of being put on a stable footing.

Broken system

Politicians spoke about how dental access is a major issue impacting constituents right across Northern Ireland. MLAs contributing to the debate quoted official statistics which showed registration lapses in the region of the 20,000s and 30,000s in their constituencies in the year 2024-25 alone. 

Mark Durkan (Social Democratic and Labour Party) was clear that this crisis was not created by dentists. “It was created by a system that no longer works. It is a broken model designed, funded, albeit inadequately and overseen by the Department of Health… the issue is not a lack of willingness to care for patients, but the fact that the current model is no longer financially viable,” he said.

Timothy Gaston (Traditional Unionist Voice) warned of “the slow collapse of NHS dentistry in Northern Ireland”, and said that ”no amount of warm words about access will change that reality” while Gerry Carroll (People Before Profit Alliance) said this was “a crisis that the minister and successive governments have allowed to fester year-on-year without getting a grip on the crisis” culminating in “just half of the population” now registered with a health service dentist, “and almost 400,000 people have been lost since 2023”.

Projected deficit

Responding to the debate, health minister Mike Nesbitt acknowledged the general dental services contract “has been in place largely unchanged since 1990 and was not designed for the cost-based workforce reality or patient demand that exist today”. 

He continued, “I am determined to look at that in the remainder of this mandate”, while adding that he expected to have the final version of cost-of-service review with him, “in a matter of weeks”.

The minister warned again that his department faces a projected deficit of £800 million in this financial year, and is operating without an agreed budget. “That places a very real and unavoidable constraint on my ability to do all the things that I want to do or to move at the pace at which I would like to move,” he said.

Winding up the debate, deputy chair of the health committee Danny Donnelly (Alliance Party) said: “There has been clear recognition during the debate that it is not a short-term pressure nor a localised difficulty; it is a deep structural problem that now requires a serious and strategic response”.