The practice owner said that the current NHS dentistry contract is ‘no longer fit for purpose’
Deborah McGovern, practice owner at Healthy Smiles, Maghull(Image: Deborah McGovern)
People in Maghull are being left in pain with dental issues that could affect them for years to come as they sit among the thousands waiting to access NHS treatment, a local dentist has said as she argued that the current system is “no longer fit for purpose”.
Deborah McGovern, who is the practice owner at Healthy Smiles in Maghull, told the ECHO that there are 2,000 people on their waiting list at the moment, with “demand continuing to grow”, while “capacity available under the current NHS dental contract simply cannot keep pace”.
Maghull has several NHS dental practices, including Oak Dental Care, Healthy Smiles and Northway Dental. Maghull Health Centre also offers some dental treatments, but normally only on referral from another dentist.
None of the practices are currently accepting new NHS patients, according to Healthwatch Sefton, a situation that is mirrored across dentist surgeries in Merseyside.
NHS patients still have to pay for their care, but prices are capped within fixed bands, with a check-up currently costing around £28 while procedures such as crowns cost around £330. Private check-ups normally cost more than £50 and a crown can range from £650 to £1,000.
The amount of money an NHS dentist is paid per patient is assessed based on the type of treatment and not the number of treatments, meaning that a practice would get the same payment for carrying out three fillings as it would for 10.
This means that a practice can often find itself out of pocket, and so has to take on private work to remain viable.
Healthy Smiles in Maghull(Image: Emma Morgan)
Dental therapist Ms McGovern said: “Every day, we speak to people who are desperately trying to find an NHS dentist. Parents are worried about their children, elderly patients are struggling to access routine care, and many people are left waiting until they are in pain before they seek help.
“It’s frustrating because a lot of dental disease is very preventable. But, especially in Liverpool, there is such a high need for dental care, especially with children. It’s soul-destroying, some of the things that we see.”
She said that she and her colleagues see children with issues that will affect them going forward into their lives, which is “heartbreaking”.
Ms McGovern said: “There’s a lot of dental neglect, but most disease is preventable with good oral hygiene, good diet, and increased education and investment into the NHS.”
She said that patients’ “frustration is understandable, but the reality is that NHS dentistry is operating within a system that is no longer fit for purpose”.
She said: “One of the biggest misconceptions is that dental practices choose not to see NHS patients. Nothing could be further from the truth. The current NHS dental contract is outdated, target-driven and financially unsustainable. It does not reflect the true cost of delivering modern dentistry and makes it increasingly difficult to recruit and retain dentists within the NHS.
“Many talented clinicians are leaving NHS dentistry because the pressures have become too great.”
The ECHO previously visited Maghull and spoke with local people about dental services, with several saying they could not get onto an NHS list despite months or years of trying. One man said: “There’s nothing anywhere around here, nothing for miles around.” Another woman added: “You’ve got no chance.”
Ms McGovern said that in Maghull, the challenge has intensified as a result of population growth from several new housing developments. She added: “New homes are, of course, welcome, but there appears to have been little consideration of the impact on local healthcare services.
“Existing practices are expected to absorb the additional demand despite already operating at full capacity. Healthcare infrastructure should be planned alongside housing growth, not as an afterthought.
“It is also worth highlighting that, in real terms, the NHS dental budget has fallen significantly over recent years while demand has continued to increase. Practices are being expected to deliver more care with fewer resources, making the current system increasingly difficult to sustain.”
Ms McGovern added that the situation is also made worse by the number of missed appointments, 600 of which have been recorded in the past seven months at Healthy Smiles.
She said: “You could have a family of six, which is an hour of appointments, and they just don’t turn up. And then there’s a small NHS business sitting there with staff that need to be paid for those hours.
“Every missed appointment is a lost opportunity for another patient waiting for treatment.”
She said that this also makes it harder for practices to achieve the activity targets in their contracts, which can mean that they lose income, “despite having the staff, facilities and willingness to provide care”.
Healthy Smiles now removes patients from its NHS list and offers their place to someone else if they fail to attend two appointments without giving appropriate notice.
Another issue affecting dentists across the country is the rise in employer National Insurance contributions which took effect in 2025. Ms McGovern added: “How do you pay for staff when there’s no extra money coming in?
“We’re a very small NHS practice, we’re only two surgeries, but we’re looking to maybe take on more dentists. But there’s no extra funding, so even if we had two more dentists, there would be no more funding.”
Ms McGovern added: “We want to treat more patients. We want to expand NHS services. But without meaningful reform, practices simply cannot continue absorbing increasing costs while working within a contract that no longer reflects reality.
“The dental contract needs tearing up and completely reforming.”
She said she is disappointed that there has been no announcement of additional investment from the government to help improve NHS dentistry access.
She said: “We need a modern NHS dental contract that properly funds patient care, supports recruitment and retention of NHS dentists, recognises the pressures created by growing communities, and allows practices to invest in expanding services where they are most needed.
“The public deserve better. Patients deserve better. The dedicated professionals who continue to provide NHS dentistry deserve better too.”
The parliamentary debate on NHS dentistry on June 15(Image: Parliament TV)
Ms McGovern said that the British Dental Association, which represents dentists across the country, has been “working tirelessly” and had many meetings with the government to push for reform, but she said: “They get so far and things look like they could be ready for change, and then there’s a change of position in parliament.
“We were making headway with the last health secretary [Wes Streeting], and now that’s changed and there’s a new person.”
She said that it was also noticeable that a recent parliamentary debate on NHS dentistry took place in the week of the Makerfield by-election, when many MPs were out campaigning, and was very poorly attended.
Official data by Ipsos for the government has shown that nationally, the unmet need for NHS dentistry sits at more than 13 million, or in excess of one in four of the adult population.
A spokesperson for NHS Cheshire and Merseyside previously told the ECHO: “We’re working with dental providers and partners to improve access to NHS dentistry. We’ve introduced local measures such as our Access and Quality Scheme, which focuses on improving access for vulnerable patients and those with the greatest need.
“As practice capacity can change frequently, patients are encouraged to check the NHS website regularly, as availability may change.”
People who are experiencing pain or need emergency support, advice or treatment can access urgent dental care seven days a week. NHS Cheshire and Merseyside has a dental helpline for these cases, which can be reached on 0161 476 9651.
It comes as research carried out by private provider Smart Dental Care found that 44% of Liverpool residents had previously avoided going to the dentist because of the cost, and that 22% could not find an NHS dentist.
A Department of Health and Social Care spokesperson said: “Too many people are struggling to access the dental care they need, but after years of decline, this government has taken swift action to rebuild NHS dentistry, delivering 1.8 million additional courses of treatment and a £4.2bn ringfenced budget for NHS dentistry this year alone.
“There is much more to do, but we are making progress to tackle inequalities across the country, including rolling out more dentistry school training places in underserved areas and cutting red tape to allow qualified dentists to practise.
“Our reforms to dentistry prioritise patients with the greatest need, while our prevention programme is building healthy dental habits in around 600,000 children, tackling tooth decay from an early age.”
The department said it was committed to fundamentally reforming the dental contract by the end of this parliament.