Debate contribution: NHS Dentistry

Debate contribution by Ms Claire Sugden on 28 April 2026.

MLA

Ms Claire Sugden

Party at the time

Independent

Date

28 April 2026

Type

Debate contribution

Business

Private Members' Business

Heading

NHS Dentistry

Assembly identifier

Official Report component 5510160

Read the official Assembly record

Text

This is an issue that has been raised consistently in the House over a number of years, across various mandates and throughout the tenure of successive Ministers. I agree with Deborah Erskine that the situation on the ground continues to get worse. For a growing number of people across Northern Ireland, NHS dentistry is no longer something that they can access. To all intents and purposes, it is becoming privatised. Only around half of adults are now registered with a dentist, and registrations have dropped sharply in the past year. We need to ask why. Is it down to poor public health messaging, or are people simply fed up trying to get an appointment that does not exist? Treatment levels remain well below where they were before the pandemic. That is a system in decline. I appreciate the proposer of the motion's arguments, because they reflect exactly what people on the ground are telling us, which is that they cannot get registered, cannot get appointments and, more often than not, are told that their only option is to go private. We need to be clear about from where the pressure comes. It is not from the dentists, who have held the service together for longer than they should have been expected to. What I hear from dentists on the ground is that the current model is neither financially viable nor sustainable. It is not about profit but about existence. Dental practices are businesses, and if they cannot afford to cover their costs, they cannot continue. When that happens, people lose access entirely. There is a huge gap between what the Department is paying and what it costs to deliver that type of healthcare. As the gap grows, dentists are being forced to reduce their NHS work and move towards providing private care. I have seen it happen locally. Practices that would have preferred to remain within the NHS are stepping back from it because they simply cannot afford to make NHS dentistry work. The pandemic accelerated the situation, but it did not create it. Rather, it exposed a system that was already under strain, while the cost of delivering care increased through higher clinical standards and longer treatment times. At the same time, the issue is not necessarily about the number of dentists but about how much NHS care dentists can realistically provide under the current model. Right now, the amount of care that they can provide is falling. The Department will point to the funding from schemes and recent investment, but that does not change people's experience when they try to access a dentist. It is one of the issues raised most frequently in my constituency office. Every MLA in Northern Ireland will have an example of when someone has come in and asked, "Do you know of any NHS dentists?", and the answer is no. We are still awaiting the publication of the cost-of-service review, which is meant to inform the reform. That delay matters, because, without it, there is no clear path to fixing the problem at the centre. I accept that the situation is not unique to Northern Ireland, but we are a devolved Administration and therefore have the ability to act. Over a number of years, that action has not come at the pace or scale that is needed. Dentistry is not optional. It is part of our health system. When people cannot access routine care, problems are delayed and become more serious, and that places further pressure on a system that is already struggling.

We spend a lot of time dealing with the consequences of poor health, and dentistry is one area in which, if we intervene earlier to prevent problems, we can reduce that pressure. It is about investing to save, which is a phrase that the Executive would do well to consider, because, when access drops, we lose opportunity. As with so many issues, as others have said, the pressure is not felt equally. Those in the most deprived areas experience worse outcomes, so it is an equality issue. We have a First Minister who talks about being the Minister for equality, but her Government do not demonstrate that. I support the amendment, because we need a longer-term approach and to look at the workforce and how services are structured. However, unfortunately, strategy cannot come at the expense of urgency, and, sadly, the issue in front of us is now urgent: can NHS dentistry remain viable? If the payment model does not work, the service will continue to shrink regardless of what our strategy says. I will therefore support the amendment, but, Minister, the strategy must be matched by immediate action rather than saying, "Let's leave it until the next mandate", because we know what will happen then. That means publishing the cost-of-service review without delay; putting in place a sustainable payment model; and taking steps to protect access for NHS patients. If we continue on the current path, we will not just have a system that is under pressure; large parts of it will be lost to our population. Once it is gone, it will be very difficult to rebuild. That is why we need action now.

866 words. Text as published by the Northern Ireland Assembly.

Assessment

Not flagged

Jev’s structured answers

Assessed 21 October 2026 at 15:28 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

Disagree with this assessment?

Classifications can be challenged. A person reads every challenge, and any change is recorded publicly above with its reason.

Challenge this classification