How NHS Dentistry Became a Two-Tier System

For 20 years, NHS dentistry in the UK has been collapsing. What began in 2006 with the overhaul of how dentists are paid and contracted has spiralled into a full-blown access to dental care crisis. One that disproportionately harms the poor, the vulnerable and those with the greatest dental needs.

The cause of this crisis, is the Units of Dental Activity (UDA) system, introduced under the Tony Blair Labour government. It was supposed to simplify payments and contain costs, instead it created financial incentives that reward easy, low-need treatments while penalising dentists for taking on complex treatment cases. The result has been widespread dentist withdrawal from the NHS, and a dramatic drop in access to dental care for those who cannot afford private treatment.

In England in 2024, only about 40% of adults had seen an NHS dentist in the previous two years, down from over 50% in 2006. This means millions more people have routine or urgent dental needs going without treatment. (1)

An estimated 13 million adults now are going without treatment in NHS dentistry, with more than 5.6 million adults in recent years failing to get an appointment at all, and a similar number not even attempting to seek treatment because they think it’s futile. (2)

For many, there simply is no NHS dentist to go to. Among people without a regular dentist, up to 97% of them were unable to access NHS dental care even after trying, forcing many to pay for private treatment or go without. (3)

One dangerous consequence of this shambles has been people resorting to unsafe alternatives, with people attempting DIY dental work on themselves, because NHS appointments either don’t exist or are so scarce. (4)

Children are also suffering. Almost half of children in some parts of the UK have not seen an NHS dentist in a full year, a dramatic reversal from earlier decades. (5)

This isn’t a minor access problem but a systemic failure. The contractual model that was introduced has made many dentists reluctant or unable to take on NHS patients. Practices close their books to new NHS patient registrations, and in some regions NHS dental care has effectively ceased to exist for much of the local population. (6)

Two decades on from the UDA reforms, the promise that everyone needing a dentist would be able to find one under the NHS has vanished. Instead, dentistry has become a postcode lottery and a two-tier reality, where those with money get care and those without often go untreated.

Beyond the Threshold of Death

Recent research has raised questions about whether current medical definitions of death adequately take into account the possibility that conscious experience might persist briefly after after life-sustaining organ function ceases. This has been proposed by Anna Fowler, a student researcher at Arizona State University, whose work was presented at the annual meeting of the American Association for the Advancement of Science. Drawing on a meta-review of near-death experience (NDE) reports and clinical resuscitation studies, Fowler argued that death should be viewed not as a single moment, but as a “gradual, interruptible process”.

Her analysis cited reports from revived cardiac arrest patients who recalled conscious experiences during periods when their brains appeared “electrically inactive”. She noted that up to 20% of heart attack survivors described awareness during resuscitation, and referred to studies showing surges in brain activity near the point of death. On this basis, Fowler suggested that elements of consciousness might persist briefly beyond traditional clinical indicators of death.

At first glance, this appears to challenge conventional medical definitions. Yet the way the evidence is framed suggests a more conservative approach; one that avoids engaging with the most problematical elements of the data—that of out-of-body experiences (OBEs).

Fowler’s research emphasises auditory recollections: patients hearing voices, instructions or conversations among medical staff. These memories are presented as evidence that consciousness can persist into early stages of death. Hearing often remains functional longer than vision under hypoxia or anaesthesia, and fragmentary auditory functioning can occur without full awareness, and does not need a fully functional cortex. By focusing on auditory recall, Fowler’s argument remains within the bounds of materialist neuroscience, avoiding direct confrontation with the assumption that consciousness is produced by the brain—and sidestepping the radical implications raised by other NDE phenomena, namely OBEs.

Fowler’s hypothesis relies on the idea that the brain is profoundly compromised: starved of oxygen and functionally “dead”. Yet the clarity of the reported auditory experiences sits uneasily with this premise.

Severe cerebral hypoxia does not preserve lucid cognition. While rudimentary auditory processing may persist, semantic comprehension (understanding speech, recognising speakers and later recalling structured dialogue) depends on cortical networks that degrade early under oxygen deprivation. The more coherent and intelligible the reported experiences are, the less compatible they become with the physiological state being invoked to explain them.

Auditory recall is, therefore, being asked to do contradictory work: demonstrating profound physiological compromise while exhibiting cognitive clarity. This tension highlights a limitation in relying solely on auditory NDE reports.

OBEs present a different and more challenging type of evidence. Individuals report perceiving events from an external vantage point with visual and spatial detail. OBEs cannot be easily explained by residual brain activity or memory reconstruction, as they imply perception independent of the body’s sensory apparatus.

If OBEs are taken seriously, the hypoxia problem disappears. Consciousness would not require neural functioning, and both auditory and visual experiences could occur even under profound oxygen deprivation. Yet Fowler’s analysis excludes OBEs, possibly because they challenge the foundational materialist assumptions of her hypothesis.

By sidelining OBEs, her research retains credibility within mainstream neuroscience while gesturing towards the possibility of lingering awareness. OBEs are not dismissed for being weak, but because they are too strong, and require either direct falsification or acceptance of their non-material implications.

In this light, Fowler’s selective emphasis can be seen as an attempt to rationalise away the most problematical elements of the data. Death becomes “gradual” and “interruptible”, but consciousness is never shown to operate outside the brain.

Fowler’s research correctly highlights that death is a process: biological functions do not cease simultaneously, and the timing of consciousness near the point of death may be more complex than previously assumed. However, by emphasising auditory recall while excluding OBEs, her research appears to sidestep evidence that challenges materialist explanations, rather than confront it directly. For if consciousness can persist beyond the brain, OBEs are the clearest and most compelling evidence, and deserve attention in research.

Was Heathcliff Really a “Laskar”?

In Emily Brontë's Wuthering Heights, the character Heathcliff is called a “laskar” as an insult by members of the upper-class Linton household, representatives of refinement and gentility. In early nineteenth-century Britain, “laskar” was an imprecise term referring broadly to non-European sailors (often South Asian, Middle Eastern, or Malay), but in everyday usage it had already drifted toward pejorative generalisation. It connoted poverty, roughness, moral inferiority, and foreignness rather than a precise ethnicity. Like many insults of the time, its force lay less in accuracy than in social positioning. In the novel’s context, “laskar” functions not as a literal racial description but as a classed and xenophobic slur, marking Heathcliff as socially inferior and an outcast.

This mode of description is not unique to that term. Heathcliff is also described as a “gypsy lad”, a phrase which, like “laskar”, has sometimes been read as ethnically literal. Yet in early nineteenth-century usage, “gypsy” frequently functioned as a loose marker of social marginality, vagrancy, lawlessness and dark appearance rather than as a precise ethnic designation. Its use participates in the novel’s wider pattern of metaphorical othering rather than clarifying Heathcliff’s genealogy. Heathcliff is repeatedly described in terms that blur the human and the inhuman (“dog”, “imp”, “devil”, “brute”), none of which are intended literally. Together, these labels form a vocabulary of exclusion rather than a set of biographical clues.

In recent years, Brontë’s use of “laskar” has been read literally by some commentators, who infer that Heathcliff was of Asian heritage. Yet if Heathcliff were unmistakably of Asian descent, the novel’s silence on this point would be remarkable. The narrative voices (Lockwood and Nelly Dean) are observant, judgemental and unafraid of detail. When Victorian novels foreground racial difference as a defining trait, they tend to mark it unmistakably. Brontë, however, never provides a clear physical description that would settle the matter. Instead, she layers metaphor upon metaphor: darkness of hair, darkness of temperament, darkness of origin. This suggests deliberate indeterminacy rather than evasion. Heathcliff’s “darkness” is moral, emotional and symbolic long before it is possibly racial.

A socially degraded, non-Asian Heathcliff fits the novel’s logic more comfortably than a clearly racialised one. The central transgression of Wuthering Heights is class violation. Heathcliff’s eventual rise in social and economic status provokes the terror and revulsion of the Lintons. He offends them not because he is racially “other”, but because he refuses to remain in the place assigned to him by the British class system. This reading also explains how Heathcliff can accumulate wealth, enter drawing rooms and command legal authority. Such upward mobility would have been socially and legally constrained for most colonial subjects in early nineteenth-century Britain, and the novel gives no indication that Heathcliff overcame those specific barriers.

Brontë was not writing social realism; she was writing Gothic tragedy. Heathcliff is not a sociological case study. His origins are unknown and his background and identity remain mysterious. Describing him too clearly would diminish his symbolic force. By allowing terms like “laskar” to operate between description and insult, Brontë ensures that Heathcliff remains a projection screen for fear, prejudice and cruelty. The novel is less interested in what he is than in what others do to him once he is seen as an outcast.

It is entirely plausible, and arguably textually stronger, to read Heathcliff as non-Asian, with “laskar” functioning as a generalised insult rooted in class contempt and xenophobic psychology rather than literal ethnicity. Brontë’s genius lies in refusing to resolve the ambiguity, allowing Heathcliff to remain a mirror for both societal prejudice and the imagination of the reader.

The Unrealistic Promise of the Second Amendment

In American politics, the Second Amendment is venerated as a foundation for personal freedom. For many US citizens (mainly on the right-wing of the political divide), the right to bear arms isn't just about self-defence, but about safeguarding personal freedom. The idea is that an armed population is essential to protect against an overreaching government. But in today's world, where advanced technology and military strength have shifted the balance of power, this argument no longer holds water.

In theory, a well-armed population could act as a check on government power or tyranny. But that theory was born in an era when the United States had to rely on militias, not fighter jets or drones. Nowadays it’s impossible to take that argument seriously. No matter how many guns people own, they stand little chance against the overwhelming force of the modern US military.

The US military is one of the most powerful in the world, and has technology that is superior to anything a civilian could match. Tactical nuclear weapons, stealth bombers, drones and fighter jets would render any resistance movement powerless. A group of civilians armed with hunting rifles wouldn’t stand a chance against the precision and reach of military aircraft, able to take out targets from miles away.

Also, today’s military can shut down communications and disable power grids, cutting off access to the tools needed for any coordinated resistance. Without communication and electricity, the fight would be over before it began.

So, when we look at the Second Amendment today, we can’t help but wonder if the argument for its role as a safeguard against tyranny is more a fantasy than a feasible reality. In the age of modern warfare, where the power of the state is nearly limitless, the the idea of armed civilians standing up to the government is, for all practical purposes, an impossibility.