500,000 children set to lose NHS dental treatment in dentistry choas
Thousands of Dentistry 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 Bliar 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.
The new reforms are forcing dentists to leave the NHS and pushing patients into private practice. There always seems to be a crisis in NHS dentistry, but this time it might be the real thing. On April 1 a new system of health service dental funding will be introduced and, at best, things look chaotic. Many dentists are fuming, predicting a further exodus of dentists from NHS work, an end to preventive work, and higher charges for you and me.
The British Dental Association has called the situation a shambles. With just 14 days to go before the system comes into force, hundreds of NHS dentists who are meant to have signed up to the new agreements with the primary care trusts (PCTs) that will fund them from April 1 have failed to do so. Some have not even received draft contracts from PCTs which are struggling to get to grips with their new responsibilities, even though contracts were meant to be ready by the end of February.
Other dentists have simply decided that they cannot sign up to a system that they believe will give them less money for more work, and encourage patients to be under-treated. In Birmingham, 75 per cent of dentists are reported not to have returned their contracts. In Middleton, Manchester, every dental practice is refusing to sign the contract, and there are similar reports from elsewhere in the country.
Without revealing figures, the Labour Government says that the majority of NHS dentists have signed up. But then there are the dentists, such as John Ginty who have done so reluctantly, knowing that they have virtually no money to provide NHS treatment.
According to the Labour Government, the new arrangements will provide more flexibility in local dentistry, opening up more capacity for people to become registered with an NHS dentist and freeing time for preventive work. That is now seriously contested.
Why the change? The reforms started out with the best of intentions. Funding for NHS treatment is ridiculously complicated, with about 400 different types of treatment with different prices. The current system encourages over-treatment; drilling and filling as much as possible to bring in the money. The more elaborate the procedure, the more money a dentist receives.
About 30 million people in the country do not have an NHS dentist. And about 10,000 dentists are believed to have left the NHS in the past decade, complaining of a lack of government investment in dentistry, and a treadmill of routine drilling and filling with little emphasis on personalised preventive work. So the Labour Government had to do something.
What’s changing? NHS dentists will now be funded directly by their local health authority (primary care trust). The Government believes that this local control will mean that if a dentist opts out of NHS work, PCTs will be able to commission replacement services so capacity will not suffer. Effectively, there will be a local pot of money for NHS dentistry that can be used more flexibly.
Under the new arrangements, there will be a simpler pricing structure for NHS patients: just three bands of payments. This is meant to discourage over-treatment. The first band applies to all check-up and X-ray work; the second applies to simple treatment like extractions and fillings; the third to more complicated work such as crowns and dentures.
Now comes the complicated bit. Each of these treatments is worth a certain number of “units of dental activity”, UDAs, and it’s the number of UDAs a dentist performs in a year that determines how much money he or she gets.
What are UDAs? Dentists get one unit of dental activity for band-one treatments; three UDAs for band 2; and 12 UDAs for band three treatments. From April 1, if they tot up enough UDAs every year, they will be entitled to the same money they received for NHS treatment in the previous year.
http://www.timesonline.co.uk/article/0,,8122-2089458,00.html
The NHS has been losing dentists to the private sector since 1992 when it introduced changes to their payments. Tony Bliar 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.
The new reforms are forcing dentists to leave the NHS and pushing patients into private practice. There always seems to be a crisis in NHS dentistry, but this time it might be the real thing. On April 1 a new system of health service dental funding will be introduced and, at best, things look chaotic. Many dentists are fuming, predicting a further exodus of dentists from NHS work, an end to preventive work, and higher charges for you and me.
The British Dental Association has called the situation a shambles. With just 14 days to go before the system comes into force, hundreds of NHS dentists who are meant to have signed up to the new agreements with the primary care trusts (PCTs) that will fund them from April 1 have failed to do so. Some have not even received draft contracts from PCTs which are struggling to get to grips with their new responsibilities, even though contracts were meant to be ready by the end of February.
Other dentists have simply decided that they cannot sign up to a system that they believe will give them less money for more work, and encourage patients to be under-treated. In Birmingham, 75 per cent of dentists are reported not to have returned their contracts. In Middleton, Manchester, every dental practice is refusing to sign the contract, and there are similar reports from elsewhere in the country.
Without revealing figures, the Labour Government says that the majority of NHS dentists have signed up. But then there are the dentists, such as John Ginty who have done so reluctantly, knowing that they have virtually no money to provide NHS treatment.
According to the Labour Government, the new arrangements will provide more flexibility in local dentistry, opening up more capacity for people to become registered with an NHS dentist and freeing time for preventive work. That is now seriously contested.
Why the change? The reforms started out with the best of intentions. Funding for NHS treatment is ridiculously complicated, with about 400 different types of treatment with different prices. The current system encourages over-treatment; drilling and filling as much as possible to bring in the money. The more elaborate the procedure, the more money a dentist receives.
About 30 million people in the country do not have an NHS dentist. And about 10,000 dentists are believed to have left the NHS in the past decade, complaining of a lack of government investment in dentistry, and a treadmill of routine drilling and filling with little emphasis on personalised preventive work. So the Labour Government had to do something.
What’s changing? NHS dentists will now be funded directly by their local health authority (primary care trust). The Government believes that this local control will mean that if a dentist opts out of NHS work, PCTs will be able to commission replacement services so capacity will not suffer. Effectively, there will be a local pot of money for NHS dentistry that can be used more flexibly.
Under the new arrangements, there will be a simpler pricing structure for NHS patients: just three bands of payments. This is meant to discourage over-treatment. The first band applies to all check-up and X-ray work; the second applies to simple treatment like extractions and fillings; the third to more complicated work such as crowns and dentures.
Now comes the complicated bit. Each of these treatments is worth a certain number of “units of dental activity”, UDAs, and it’s the number of UDAs a dentist performs in a year that determines how much money he or she gets.
What are UDAs? Dentists get one unit of dental activity for band-one treatments; three UDAs for band 2; and 12 UDAs for band three treatments. From April 1, if they tot up enough UDAs every year, they will be entitled to the same money they received for NHS treatment in the previous year.
http://www.timesonline.co.uk/article/0,,8122-2089458,00.html
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