Labour will end NHS ‘custom’ of raiding dental budgets, says minister

Stephen Kinnock said the current situation, in which the budget was underspent by close to half a billion pounds, was “absurd” and “dysfunctional”.

“If we do [reform] right and it’s structured properly, you will not see a single underspend, a single penny of underspend in NHS dentistry going forward,” he said.

Mr Kinnock made the remarks at a Labour Party autumn conference fringe event.

The minister, whose responsibilities include primary care as well as social and community care, said: “The fundamental reason for the underspend is the contract has not been attractive enough to ensure take-up.

“We’ve got to make NHS dentistry pay, and until you make it pay, you’re not going to get the take-up on that budget line. So it’s not so much about the quantity [of the budget]… it’s the way in which the NHS contract is structured that is leading to low take-up. We are looking at those long-term contractual issues.”

On the same panel session in Liverpool, Nuffield Trust chief executive Thea Stein said it had become “custom and practice” to use the dental budget to plug financial gaps in other services.

Shawn Charlwood, chair of the British Dental Association’s General Dental Practice Committee, told the session that some integrated care boards, which commission primary care, needed to “up their game”.

In some areas of England, close to a third of the dentistry budget is unspent. NHS England has flexed rules to allow ICBs to commission more activity; although it also told systems last year they could use the funding to balance pressures elsewhere.

In the worst-performing ICB, Lincolnshire, 30 per cent of dental allocations were unused in 2023-24, HSJ reported previously, while Greater Manchester ICB managed to spend 99 per cent.

This year, NHS trusts and ICBs are forecasting a £2.2bn deficit, leading to concerns that budgets could again be raided.

Mr Charlwood said: “Some ICBs are very, very proactive, very imaginative about using funds to deliver care to specific groups, but there are many ICBs who are actually not doing that, and there is a lack of consistency of approach with ICBs.”

Ms Stein said: “I worked in the NHS as a commissioner, as a chief exec for many years… The custom and practice is to know the money’s there and to use it as a balancing figure.

“Nobody is stopping a commissioner looking at solving the problem… I’m sure there are dentists, even at the moment, who would step forward… [but] fundamentally, the NHS has always looked at that figure for that for many years now and used it to balance off other deficits.”