The new NHS constitution outlined this week in the Darzi report promises an NHS accessible to all, free at the point of use, and provided on the basis of need, not ability to pay.

No aspect of the service falls short of this ideal by a bigger margin than dentistry. The Health Select Committee, with a majority of Labour members, did not set out to spoil the NHS’s 60th birthday. But its report certainly puts those promises into perspective.

For decades, most adults of working age have paid a substantial part of their dental costs – just the same kind of co-payment which, we are told, would undermine the whole ethos of the NHS if it were to be allowed in paying for cancer drugs.

Yet in spite of this, NHS dentistry has a terrible reputation. Americans are said to recognise British people at 100 yards by the poor quality of their teeth. The old “fee per item of service” contract rewarded NHS dentists for the amount of drilling and filling they did.

The new contract was supposed to put all this right. But its implementation was left to a succession of junior ministers who never carried enough clout to make it work. The British Dental Association pulled out of the negotiations, but the Department of Health did not take the hint. It remained convinced it was right and brought in the new contract regardless. This simplified the scale of charges, but in such a crude way that it further distorted dental practice. No pilots were carried out to see if it worked. It would be all right on the night, critics were told. It was not.

The department and the Chief Dental Officer remain convinced that these are, well, teething pains. Meanwhile, private dentistry has overtaken NHS dentistry in the number of patients treated, and millions who cannot afford to go private let their teeth deteriorate. Can NHS dentistry be rescued? It seems unlikely. But the attempt made by this Government has made a bad situation worse, at greater cost. Next time it should try listening to the dentists.

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