Debate contribution: NHS Dentistry

Debate contribution by Mr Alan Robinson on 28 April 2026.

MLA

Mr Alan Robinson

Party at the time

Democratic Unionist Party

Date

28 April 2026

Type

Debate contribution

Business

Private Members' Business

Heading

NHS Dentistry

Assembly identifier

Official Report component 5510202

Read the official Assembly record

Text

Thanks very much, Madam Principal Deputy Speaker. Hopefully, today, we will achieve a record. Earlier, we had a couple of hours' debate on the Sign Language Bill and achieved unanimity, and, hopefully, we will get unanimity on this matter of such significant importance. I will say some words that my constituents will very much expect me to say. I do not think that it is an exaggeration to say that getting a NHS dentist feels close to impossible for many people in Northern Ireland. Half the population is not registered with a dentist, compared with over two million who are registered with a GP practice, and it is getting worse, not better. As others have said, registrations have dropped by 17% in the past year, and all future projections point one way: downwards. At the same time, the number of health service treatments being carried out is nowhere near what it was before the pandemic. People might hear that things are recovering, but that is not what the public are experiencing. Every Member can vouch for the fact that our constituents — I say "our", so the constituents of every one of us — are ringing practice after practice and being told, "We're not taking NHS patients". Their experience is putting them off treatment until the pain becomes unbearable, and they are experiencing a growing sense that unless you can afford to go private, sadly, you are on your own. That is not how our health service is supposed to work. People are, rightly, asking why they are paying National Insurance. We said all of this just a year ago: it is a case of rinse and repeat. I have to be honest and say that I do not get job satisfaction from saying the same things but nothing changing. I can understand it when the public say that they are sick to the back teeth, if they have any teeth left. We need to be honest about why this is happening. It is not because dentists do not want to treat NHS patients. It is because health service dentistry is no longer viable. As has been said by multiple Members, material, energy and staffing costs — all costs — have gone up, but dentists say that the payments that they receive for NHS work has not kept pace. Therefore practices are being squeezed from both sides, and the result is entirely predictable: they are reducing the NHS work or stopping it all together. Unless there is a fix, nothing that we say here today will make any difference, and, sadly, following the debate, nobody will be able to ring their local dentist and have the door flung open to them. If I am fed up, how do the public feel? There are also smaller decisions that are having big consequences. Take the issue of registrations lapsing due to non-attendance, for instance. On paper, that might seem reasonable, but, in reality, it can mean that someone misses an appointment because they, perhaps, could not get time off work or their childcare fell through, and then, suddenly, they can be out of the system. Once they are out, getting back in is incredibly difficult. Effectively locking people out for reasons that often have very little to do with choice is just not right.

As we have mentioned today and many times before, there is also a wider cost involved. When people cannot access dental care, that has a knock-on effect. What could have been a simple check-up turns into an emergency. What could have been prevention turns into intervention. We all know that patients sometimes end up in GP surgeries or in hospital settings, which are already bursting at the seams. That is why the continued wait for the publication of the Department of Health's cost-of-service review is so frustrating. We have been waiting, dentists have been waiting and patients have been waiting. Without that review's findings, we are trying to fix a huge crisis without having the full picture. We therefore really need that review to be published. I appreciate that the Minister said today that he is expecting to receive a rewrite and that he wants that within weeks. I hope that, once he receives that rewrite, the review will be published. As I say, we need that review to be published and for there to be an overhaul of the current practice system. Dentists want a payment model that reflects the true cost of providing care. NHS dentistry needs to be stabilised before more practices walk away from it, because if the Department does not get to grips with the situation, we in the Province will drift quietly but steadily towards yet another two-tier system: one in which those who can pay get seen quickly, while those who cannot are left waiting or simply go without. Once that line is crossed, if it has not been already, it will be very hard to come back from. I will end by referring to the words of a local dentist in my constituency of East Londonderry. I received this correspondence recently:

"Our practice is the only dental service in a rural town, providing NHS care to both feepaying and exempt patients since 1986. We are deeply committed to serving our community, however, the future of NHS dentistry feels increasingly uncertain. We face financial concerns, staff shortages, and personally, growing pressure as the sole practice owner. When another practice leaves the Health Service, those patients then turn to us. Recruiting and retaining staff has become nearly impossible as we can't compete with private practices offering higher salaries and better working conditions. Adverts for dentists do not attract a single enquiry. Our team often faces verbal abuse from patients struggling to access NHS care, and we are unfairly blamed for the wider decline in NHS dental services. The rising cost of running a regulated service is a significant challenge, and the current NHS contract doesn't reflect these realities. Patients rely on us as their only access to routine dental care, but as demand increases, the situation worsens. We cannot increase NHS registrations without diluting the care to our current patients, risking the wellbeing of my staff, or affecting our ability to cover costs. I have no option but to increase my private provision, or close the doors altogether. Without better support, the cost to society will grow, and we already see more people turning to dental tourism which brings further costs to the public purse where remedial treatment is needed."

That dentist concluded by saying:

"The system needs urgent overhaul before there is total collapse. Once practitioners leave, they are unlikely to return."

1,111 words. Text as published by the Northern Ireland Assembly.

Assessment

Not qualifying

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Assessed 21 October 2026 at 15:30 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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