NHS at 60- Labour’s dentistry reforms failing dental patients

NHS at 60- Labour’s dentistry changes designed to improve NHS dental services in England have not been successful, a report by MPs says.

The new contract, introduced in 2006, was intended to simplify charges and make it easier to find an NHS dentist.

But the Commons Health Committee said access remained “patchy” and there had been a sharp fall in the number of complex procedures.

The new contract, under which patients paid fixed charges for particular types of procedure, also gave local primary care trusts the power to commission and pay for dental services.

It has been rolled out to cover Wales, although the report only deals with progress in England.

The number of patients seen fell by 900,000 in the 18 months following the introduction of the new contract in April 2006, the report said.

In the first year of the contract, the number of complex treatments – including bridges and crowns – which involve laboratory work was halved, and the number of root canal treatments fell by 45%. Both of these attract higher fees under the new scheme.

The committee said there were concerns that some patients were not getting the complex treatment they needed.

Conversely, the number of tooth extractions rose.

The committee also heard fears that the changes had not stemmed the exodus of NHS dentists into private-only practices.

Committee chairman Kevin Barron MP said: “It is disappointing that so far the new contract has failed to improve the patient’s experience of dental services.

“While we readily accept that in some areas of the country, provision of NHS dentistry is good, overall provision is patchy.”

He criticised the Department of Health for not piloting the new contract on a smaller scale prior to introduction.

The committee called on the government to improve PCT commissioning and review the “units of activity” system to make sure it rewarded dentists for choosing the most appropriate treatment.

“It highlights the failure of a farcical contract that has alienated the profession and caused uncertainty to patients,” she said. “For the past two years, dentists and patients have told the Department of Health that it got it wrong.”

A Department of Health spokesman said it would “carefully consider” the recommendations but that the benefits of the reforms were already emerging.


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