NHS dental provision could be under threat in future years as newly qualified dentists with debt in excess of £50,000 will favour the private sector, government has been warned.
Soaring tuition fees may deter students from studying dentistry altogether, stopping investment in private practice and severely reducing the number of students from low income or black or minority ethnic families.
This, in turn, creates a lack of diversity in the workforce which could potential damage future patient access, the British Dental Association (BDA) claims.
While the BDA said it accepted the need for reform, not enough focus had been given to the impact it would have on longer courses.
In written evidence to the Commons Business Select Committee examining Government reforms of Higher Education, the BDA called for a full impact assessment based on ‘robust evidence’ to assess how changes in admissions and increasing fees for dental courses will impact long term.
Along with not investing in buying practices, engagement in postgraduate training and education could be hit, and more dentists would turn their back on their NHS.
It said: ‘Not only are there not enough salaried positions in the NHS, if debt is higher it is natural for students to seek to maximise their earning potential. With the potential decline in the number of practice owners the NHS may well suffer from a lack of dentists in the future.
‘This tendency was borne out by the BDA’s 2010 student debt survey where over one third of students said that debt would influence their career path and encourage them into private, rather than NHS, practice. This could be exacerbated if dentistry is included as a subject justifying the highest tier of fee charges.’
It added: ‘The Browne Review’s recommendations reflect the challenging economic climate. We are worried, however, about the impact the proposed reforms will have on students choosing to study dentistry. We would expect a full evidence-based analysis of the impact of raising fees for clinical courses, in particular as they are vital for the future of health provision.
‘Dentistry is a longer-than-average undergraduate course and so will result in higher-than-average levels of debt. Indeed, our preliminary projections suggest that debt could reach up to £57,600 for some dental students under the proposed reforms.’
At present dental students are graduating with an average £25,545 of debt compared to the average student with £16,614. The current level is already 128% up from 2000.
Students on non-clinical courses also have more time to find part-time work to minimise their levels of debt, the committee were told.
Furthermore, the BDA asked for a commitment from government dentistry would continue to be recognised as a clinical subject, therefore ensuring part of the cost of training is met by government.
Students whose parents did not live near one of the 12 dental schools could also be disadvantaged if wanting to live at home and study to keep down costs.
From September government is allowing universities in England to charge up to £9,000 per year for undergraduate courses, raising the cap from its 2011/12 level of £3,375.