UK chief dentist blames rough-sleepers for NHS missing targets 

Mick Armstrong (pictured) suggested treating homeless people could mean missing targets 

The leader of the British Dental Association’s has branded homeless people ‘no-hopers’ and suggested treating them could cause targets to be missed.

Mick Armstrong made the remarks in an email to a colleague that Labour MP Stella Creasy was mistakenly copied into.

He was saying that many dentists are wary of taking on homeless people as patients in the email seen by the Guardian. 

‘These are difficult patients who rarely complete a course of treatment and attend irregularly if at all,’ he said. 

‘If we took in all the no-hopers who ring us … I suspect we’d miss our targets by a country mile.’

Armstrong has said he regrets the words he used and claimed to be frustrated with contracts that make it difficult for practioners to reach out to the vulnerable. 

He blamed the dental contract for punishing dentists who spend a lot of time with high-needs patients, missing annual activity targets and facing financial sanctions.

Creasy was in touch with the BDA prior to receiving the email, when she said the homeless had ‘hit a brick wall’ in terms of dental access.  

It came after a report found one in six homeless people had pulled out their own teeth due to not being able to secure services. 

After receiving the email, Creasy challenged Armstrong – but he stood by his remarks.

He said that the BDA have been fighting for a decade to direct resources to the most needy without fear of financial penalties.

But he said the majority of vulnerable patients require many appointments which he called ‘extremely time-consuming’ before adding that it was ‘frankly exhausting’ to treat them. 

In another email he said colleagues take on needy patients despite the financial implications but demanded ‘a positive incentive to provide such patients with treatment’ they deserve.

Creasy said she was ‘shocked’ to hear a dental professional describing a group of patients as ‘no-hopers’ and by suggestions their service could be restricted. 

The 2006 NHS dental contract funds treatment for just over half of the English population. 

A report found that one in six homeless people had been driven to pulling out their own teeth due to a lack of services 

A report found that one in six homeless people had been driven to pulling out their own teeth due to a lack of services 

Ninety-three per cent of NHS dentists who responded to BDA surveys said chasing government targets limits their ability to care for the neediest passengers.  

The association backs funding if appointment slots for homeless people and an end to punishments for trying to treat them. 

The BDA also wants NHS forms to be changed so that dentists can be paid even when patients don’t have an address. 

Charity Groundswell found last year that 15 per cent of homeless people had been forced to extract their own teeth. 

The study also found that 70 per cent reported losing teeth since becoming homeless, with 17 per cent citing acts of violence. Seven per cent had no teeth.  

The BDA head said that treating all of the 'no-hopers' would probably result in dentists missing their targets 

The BDA head said that treating all of the ‘no-hopers’ would probably result in dentists missing their targets 

Armstrong told the Guardian that his language was ‘inappropriate’ and blamed a failing contract.

‘I regret the intemperate wording I used in my exchange with Stella Creasy,’ he said. ‘The language was inappropriate but born of the frustration that all NHS dentists in England feel working under a contract that’s decisively failed both patients and practitioners.’

He said the NHS effectively caps the amount of patients that can be treated and says dentists are desperate for a system that puts patients first. But he said headway seems impossible under the current contract.  

At health questions in the Commons last month, Jackie Doyle-Price, the health minister for vulnerable groups, said: ‘Notwithstanding our expectations of GPs and dentists in this regard, it is quite clear that homeless people do not always have access to the treatment they should have.’

 



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