Llyr Gruffydd MS Member of the Senedd for North Wales

One area of the NHS that is showing the greatest sign of stress and, if truth be told, collapse is dentistry.

Practices in Wrexham and Ruthin in the past weeks have announced that they are halting all NHS work and effectively forcing thousands of patients to go private if they want to continue to access a dentist. For a family of four the cost is estimated to be an additional £534 a year at a time when food, energy and fuel prices are also rocketing. This is yet another unwanted bill for hard-pressed families.

To make matters worse, the people who are able to get on the new private practices will be the lucky ones. The practice in Ruthin will only be able to accommodate 28% of existing patients - so almost three quarters of patients will be without a dentist whether private or NHS going forward.

This is not an overnight crisis and this is not a criticism of dentists, many of whom are desperately unhappy about having to make this decision. The problem is a long-standing failure to invest in training and recruiting sufficient dentists as well as the imposition of new contracts by the Welsh Government, which is denial about the impact this is having.

The British Dental Association's Welsh chair Russell Gidney, warned in January that the government's failure to examine the real-world impact of these new, untested targets will force many practices to withdraw partially or wholly from NHS dentistry. Yet the government pressed on and health minister Eluned Morgan said dentists who were complaining were in a very small minority. Perhaps she should try, as many of my constituents have, to register with an NHS dentist in north Wales. I think she'd find they are as rare as hen's teeth.

We have a three-tier system emerging - some still have access to an NHS dentist, some have opted to pay for a dentist but we now have a growing number of people who cannot access a dentist because there is no NHS service available in their area. This, of course, means that third group is left to rely on emergency care - further clogging up our A&E departments and missing out on preventative care that could reduce pain and suffering.

I fear that the BDA is right - the future of NHS dentistry is in the balance after 13 years of cuts by UK Tory Governments and mismanagement by Welsh Governments.

It also raises wider concerns about whether this is the shape of things to come elsewhere. Could GP practices, which are facing similar pressures as doctors retire early because of the strains and stresses of work, eventually go down the same route where we will be left with a growing number of people unable to get primary care?