Debate contribution: Dental Services: Fermanagh and South Tyrone

Debate contribution by Mrs Deborah Erskine on 25 February 2025.

MLA

Mrs Deborah Erskine

Party at the time

Democratic Unionist Party

Date

25 February 2025

Type

Debate contribution

Business

Adjournment

Heading

Dental Services: Fermanagh and South Tyrone

Assembly identifier

Official Report component 4815533

Read the official Assembly record

Text

Thank you, Mr Deputy Speaker. I rise to address a matter of great concern to my constituents in Fermanagh and South Tyrone, and I welcome the fact that my constituency colleagues and the Health Minister are in the Chamber to consider the issue. We have seen a significant shift from NHS dental services to private provision. It has created a lack of NHS dentists in my constituency and, more worryingly, a difficulty in accessing services. The issue has been escalating for some time and now threatens to deepen the existing health inequalities in our area and across the region. As many know, the transition of dental practices from NHS to private care has led to a growing number of people being unable to access basic dental services. In Fermanagh and South Tyrone, we have seen multiple practices reduce or completely withdraw their NHS services, leaving families and individuals with limited or no access to affordable dental care. Coincidentally, I attended my dental practice just last week and heard that it is switching to a private model. That change does not just place a financial burden on individuals and families but risks further marginalising the most vulnerable in our society, including those on low incomes, the elderly and people living with chronic health conditions. "People will simply not show up" was the message from my dentist, who, sadly, anticipates that being the case, because the practice has had no option but to switch to private dentistry. My dentist knows that, in an area of deprivation, hard-pressed families are experiencing difficulties as a result of the financial impacts that they face at this time. The publication 'General Dental Services Statistics for Northern Ireland: Annual Statistics 2023-2024' shows that, in urban local government districts such as Belfast, Antrim and Newtownabbey, Lisburn and Castlereagh, and Ards and North Down:

"at least 88% of the population is within three miles of a dental practice".

In the Fermanagh and Omagh District Council area, the percentage drops to only 53% living within that distance. When the rural nature of our area and the fact that public transport is lacking are taken into consideration, we can see how the inequalities stack up. Intervention is needed now. Furthermore, in the same publication, the figures paint a grim picture. The Fermanagh and Omagh District Council area had the lowest adult registration rate, at 49%. That is 17 percentage points below the Northern Ireland average. We are a dental desert in Fermanagh and South Tyrone. I am aware that the Minister is committed to ensuring access for all to NHS services. The reality faced by constituents, however, tells a different story. Access to dental services is becoming more of a luxury than a public health provision. I therefore must challenge the Minister on that. He knows that socio-economic determinants are a key factor leading to poor oral health. Given the increase in private dental practices, what specific action are you taking, Minister, to address the critical issues that affect the affordability and availability of NHS dental care in our community? What steps will you take to ensure that NHS dentists are properly reimbursed for their services so that their practices can remain viable and continue to serve our citizens? Without adequate financial support and incentives for dental professionals, the trend towards private dental practices will only increase, leaving more of our constituents and more of the residents of Northern Ireland behind. The cost of running a dental practice must not be ignored. I argue that the underfunding of dental services is one of the main factors that is pushing dental practices in my constituency and other constituencies towards switching to private practice or closing. I recently spoke to a hard-working, dedicated dentist in my constituency who told me that, compared with when they first opened their doors, their operating costs alone had increased by over 40%. That is before even touching on the increase in employers' National Insurance contributions that is hurtling down the track. There are ways in which we can try to stem the flow. Other jurisdictions have dealt with the issue. In Scotland, changes were made in 2023 in the form of the dental payment uplift in the NHS. The short time that it took to do that proves that things can be done. Scotland has similar levels of deprivation to us, yet it has got to grips with the issue. I know, Minister, that you will point to the need for a cost-of-service review. The British Dental Association (BDA) has called for that for years.

We need to see a third-party review of how much dentistry costs so that dentists can get a fair rate of return. We also need to look ahead to the key questions of where we want to be in 2027. The space between now and 2027 is key. We need urgent action to top up the fees now and to give the all-important signals to dentists to stop the mass exodus from NHS dentistry. By dealing with the funding issues, you will support dentists to stay in the system.

Minister, what further steps are you taking to ensure that we increase the number of NHS dentists? Dentists are literally waiting to make the call on what they will do. We need more practitioners; we need to see them in areas that are currently underserved, like Fermanagh and South Tyrone. Therefore, I ask the Minister to consider incentives like reinstating the commitment payments given to NHS dentists to stay in the system. Those were done away with in 2016, and we perhaps need to look at them again. That brings me to another point that affects my constituency: the out-of-hours dental service run by 13 practices. At the weekend, one dentist is responsible for over 65,000 patients. They are only obliged to see registered patients, but there is no way of checking whether patients are registered. Essentially, patients rely on the goodwill of that dentist to provide dental treatment to them over a weekend. I want the Department to support the trust and my local dentists in finding a site and paying a sessional rate per patient that is the same as elsewhere in Northern Ireland. We need to address the growing health inequalities that are exacerbated by the switch to privatisation. You cannot blame dentists, who have seen no change in their contract and lost faith in the system, nor can you blame patients, who are worried about the decreasing service and frustrated at the fact that they now have to pay for that service. It is clear that access to dental care is not equal across Northern Ireland; in fact, it is becoming increasingly determined by one's ability to pay. That will only deepen existing disparities in health outcomes, particularly in rural areas like mine. It is essential that we take urgent action to ensure that dental care is universally acceptable and affordable for all our citizens, regardless of where they live or their income level. Dentists obviously also play a crucial role in identifying cancers such as oral cancers, incidences of which look set to double in the UK by 2035. I do not want my area of Fermanagh and South Tyrone or, in fact, any area in Northern Ireland to be a statistic for oral cancer. It is as stark as that. We need to rebuild confidence in the system. One dentist put it like this: "Dentists do not go on strike; they leave". Do not let anybody else leave. Let us stop creating more health inequalities. Let us save NHS dentistry. I urge you, Minister, to take immediate and meaningful action to support NHS dentists, to increase the number of available services and to address the inequalities in access to dental care. The people of Fermanagh and South Tyrone deserve nothing less.

1,304 words. Text as published by the Northern Ireland Assembly.

Assessment

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Assessed 21 October 2026 at 12:02 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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