Debate contribution: Dental Care

Debate contribution by Mr Mike Nesbitt on 27 May 2025.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

27 May 2025

Type

Debate contribution (made as a minister)

Business

Private Members' Business

Heading

Dental Care

Assembly identifier

Official Report component 4972193

Read the official Assembly record

Text

Thank you, Madam Principal Deputy Speaker. I also thank the proposer of the motion, the proposer of the amendment and every other Member who has contributed to the debate. I met the British Dental Association in February. I am grateful to it for its briefing on the challenges that it faces. My officials have continued since then to engage with it on options for supporting the service. Last week, I announced a £7·36 million investment in general dental services for 2025-26, as well as £2·5 million to cover the hike in National Insurance contributions imposed by the UK Government. Alongside the money, there was the expansion of the Happy Smiles programme, which addresses health inequalities. That investment is not a panacea. There continue to be many challenges facing patients, particularly those who are not currently registered with a dental practice. As Members have pointed out, over the past five years, access to health service dentistry has been in decline here. One of the underlying reasons for that is that general dental practitioners spend less time treating health service patients and more time meeting the strong demand for private work. As they are independent contractors, how they allocate their time between their health service work and their private work is at each practitioner's discretion. Access to health service dentistry remains a major challenge, but I hope that that investment evidences my commitment to supporting the service and improving access for priority groups across Northern Ireland. The investment provides funding for a number of measures. First, there is the continuation of the enhanced child examination scheme, which provides children aged zero to 10 who have not been registered with a dentist with an examination, individualised oral health advice and age-specific fluoride application to their teeth, all to assist with preventing dental decay. From its reintroduction in June 2024 to April of this year, over 37,000 newly registered children have been seen under the scheme. Secondly, there is the continuation of the 30% enhancement in the fees paid to dentists for health service fillings, extractions and root canal treatment in financial year 2025-26, all to support public access to priority treatments. Thirdly, there is the allocation of £1·6 million to incentivise practitioners to maximise time spent providing health service care for their patients. The dental access scheme will also continue to provide access for unregistered patients with an urgent or pressing oral health need. Since it commenced on 1 August last year, the scheme has allowed nearly 18,400 high-need patients to receive treatment. It is funded until 2027. In addition to the investment being made directly into general dental services, funding is being provided to expand the Happy Smiles scheme, which was originally launched in 2016. The aim of the scheme was to improve the oral health of nursery-school children in the 20% most deprived areas of Northern Ireland. The programme is being expanded to include primary 1, primary 2 and primary 3 schoolchildren in the 20% most deprived wards, reflecting the recommendations in the children's oral health improvement plan's theme 1, 'Improving the Oral and Dental Health of Children'. It should be noted that the investment is being made in the face of a funding deficit of north of £500 million for my Department. That deficit severely limits my ability to implement the kinds of actions that we all desire to see and hampers my Department's ability to sustain and develop services across all areas of health in Northern Ireland. While the additional investment interventions are necessary to stabilise general dental services in the short term, I am clear that GDS, as with other services, require sustained effort to ensure sustained ability over the longer term. My Department is committed to advancing work on the long-term future of dental services, with an aim of ensuring that patients can continue to access care when they need it whilst taking measures to ensure that the service is sustainable. In keeping with my Department's long-term plans, I have approved the commissioning of a general dental services cost-of-service review that is to be completed in this financial year. That will provide a robust evidence base to inform how the service will develop. My officials are working at pace to identify the correct individual or team with the necessary skills and expertise to complete the review in the required time frame. General dental services play a key role in improving the general health of the population while reducing pressure on other areas of the health service. Improving oral health is an important aspect of the future sustainability of dental services and has a key part to play in ensuring the delivery of improved outcomes for patients. While I am aware that the Northern Ireland oral health strategy dates back to 2007, I believe that its evidence base and many of its recommendations are still valid. For example, one oral health strategy target was to improve the proportion of five-year-old children who were decay-free — then 39% — to at least 50% within 10 years.

In 2013, the data indicated that we had achieved 60%, and the 2018-19 data indicated that around 70% of our five-year-olds were decay-free. That was great progress, but I am aware of the fact that more can and should be done.

The development of a new oral health strategy, including a dedicated public dental health expert or expert group, would carry a significant resource cost due to the complex and extended nature of developing a new strategy and a prerequisite oral health needs assessment. That does not mean that oral health is not important to me. The children's and older person's oral health improvement plans were completed last year, and they made ambitious recommendations. However, funding those will be a significant challenge in the current financial climate. I am also very pleased that oral health has been included in my Live Better initiative. I have often stated that my vision for Health and Social Care is to see more care being delivered in primary and community care settings and a move towards a more preventative healthcare model. That approach is not only better for patients but more sustainable in the longer term. The challenges to general dental services and other HSC services are not limited to healthcare. The same challenges are evident in education, the economy and infrastructure, both built and otherwise. I have made it clear that, in my time as Minister, I will do everything that is in my power to drive for better outcomes for patients here. The actions that I outlined are evidence of that, as is my commitment to take a wider approach to reducing health inequalities through the Live Better programme. However, it is an unfortunate reality that the budget that has been allocated to me is not sufficient to meet the needs of the current service, let alone to introduce the kind of transformative change that I think that we all wish to see. It is also true that improving health outcomes is not solely within the purview of this Department. Addressing access to services, along with the other issues that were outlined today, will require the full weight of the Northern Ireland Executive.

1,198 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 12:35 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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