Thousands of practitioners are likely to reject the contract offered by the government and quit the National Health Service to treat only patients prepared to pay, according to a survey of NHS primary care trusts.

The trusts, which provide GP and dental care locally, have admitted that thousands of children will be hit. Some have already written to patients warning them that from April 1 both adults and children will be obliged to find another dentist unless they are prepared to pay for treatment or buy insurance.

The NHS has been losing dentists to the private sector since 1992 when it introduced changes to their payments. Tony Blair pledged in 1999 that everybody would be able to see an NHS dentist within two years, but the exodus has continued.

It is expected to accelerate when the new employment contract for dentists takes effect and children will be removed en masse from dentists’ lists for the first time.

A Sunday Times survey of 29 primary care trusts found that 133,000 patients, about 40% of them children, have been told they will no longer be able to get NHS treatment from their current dentist after the end of the month.

There are 302 primary care trusts in England and, if the pattern is reflected across the country, about 830,000 adults and 550,000 children will be dropped by their dentists.

The Dental Practitioners Association said the figures were a “reasonable estimate”.

Among those who have already received a warning is Adette Lodge, 34, from Gloucester, who was told that her three children, aged 12, nine and five, would no longer be offered NHS treatment.

She said: “I was shocked, upset and angry. It is important that children’s teeth are formed properly in their early years. If their parents can’t pay, care is being taken away from them.”

Among those leaving the NHS is John Renshaw, who was chairman of the British Dental Association until last month. He said he regretted that some parents would not be able to afford dental fees and that children would be left without care.

“I have been committed to the NHS for the last 37 years but the new contract has forced me to make this decision,” he said.

“It was not an easy decision but it had got to the point where the NHS was not supporting the kind of service we wanted to offer our patients.

“There will be some patients who will not pay. I expect the number of children who are not getting dental care will increase.”

Graham Barnby, honorary vice-president of the British Dental Health Foundation, runs two dental practices in north Dorset. One has told 1,000 patients, including children, that they will no longer be offered NHS treatment.

Barnby said: “We have put in place low-cost insurance for children. The reaction from parents has been mixed. Just the other day we had one parent who paid the fees for their children for a year.

“Other patients have said, ‘I know my rights under the health service and I have a right to NHS treatment’. I feel sorry for those who cannot afford to go private.”

The new system pays dentists a fixed rate for a series of treatments. Some dentists argue that the fees are not high enough to pay for high-quality care.

The Department of Health insists that patients thrown off practice lists will be able to find another NHS dentist in the area. Rosie Winterton, the health minister responsible for dentistry, said: “The early signs are that the vast majority of dentists will sign up to the new contracts.”

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