One of the most significant challenges of my 20-year dental career was coming to terms with the differences between NHS and Private dental care in the UK.

As a private dentist, I often felt guilty about how expensive private dental care was compared to NHS (National Health Service) dentistry. I also worried about those with more limited means accessing good services if the high costs made them unobtainable. Eventually, I had to resolve the argument with myself, in that my mission was to provide the best care possible. I was doing a disservice to myself and my patients if I compromised my skills to fit into a system that I perceived as dysfunctional. Therefore, the private sector won the dispute, and I felt justified in continuing to focus my efforts on that sector.

I entered dental school in 1992, just as the UK government significantly cut the fees paid to dentists for their services through the NHS. So began the migration of UK dentists into the private sector as the government attempted to subdue the profession to keep the costs of providing dental services reasonable.

The increasing crisis in NHS dentistry is now becoming a frequent news item in the UK. For many years the UK government has struggled with the profession to keep their expectations within reasonable limits. When dentists have previously threatened a mass exodus from their NHS contracts, the government and corporate response was to recruit within Europe to keep the NHS alive and avoid the collective power of the disgruntled professionals. Brexit disrupted this strategy, and with the additional pressures endured during the recent pandemic, the proverbial straw has now broken the camel’s back. Dentists are leaving the NHS in droves. Finally, the power dynamic may be shifting, but many humble dentists have had their self-esteem shattered by the manoeuvrings of government, and the battle of wills fought over the last 30 years.