Spilling the Teath UK: Rebuilding from the Roots – Neil Carmichael Calls Time on the Current NHS Model
This week on Spilling the Teath UK, I sat down with Neil Carmichael, Executive Chair of the Association of Dental Groups (ADG), for a timely and thoughtful conversation on the future of UK dentistry.
Neil, a former MP and now honorary professor at UCL, brings a policy-led perspective to the table - one that’s rooted in pragmatism and long-term thinking. While he doesn’t come from a clinical background, his insight into how systems function (or don’t) made for a sharp and nuanced discussion.
“The system doesn’t work. It needs to be rethought, not patched.”
A System in Need of Structural Review
Neil didn’t frame his argument as radical overhaul - but rather as overdue, measured reform. He acknowledged the pressures dental professionals face and pointed to the core issue: the current NHS contract doesn’t support the outcomes it’s meant to deliver.
“We’ve reached a point where continuing as we are won’t solve the underlying problems. There needs to be a strategic rethink about what we want NHS dentistry to achieve.”
From recruitment challenges to patient access, Neil made the case for rebalancing the system, not just repairing it.
The Case for a Broader Talent Pipeline
Neil also addressed one of the sector’s biggest concerns: workforce sustainability. He argued that international recruitment must be part of the solution - and that the UK should modernise its approach to recognising overseas qualifications.
“We won’t meet the demand through domestic training alone. We need to be more confident and efficient in how we bring talent into the system.”
Education as a Long-Term Lever
With a deep personal connection to education, Neil made a compelling case for improving the pipeline into dentistry through earlier and more targeted interventions.
“Dentistry should be seen as a mission-driven career. That starts with how we talk about it in schools and how we train people across their careers.”
He also spoke about the need for investment in professional development to ensure dental teams are equipped for the sector’s evolving demands.
The Takeaway: Reform with Purpose
Neil’s tone throughout was calm but clear: dentistry is at a point where meaningful reform is needed - and it should be approached thoughtfully, with cross-sector collaboration.
“It’s not about short-term headlines. It’s about building something more sustainable for dentists, patients, and the wider health system.”
This episode is a must-listen for anyone thinking about the long-term direction of NHS dentistry. Whether you're in policy, practice, or education, the message is the same: we have to start asking better questions - and planning for a system that works.
