Conservatives unveil proposals to overhaul NHS dentistry

The shadow health secretary, Andrew Lansley, has said that NHS dentistry need s to be completely overhauled in order to give patients’ better access to treatment.

The Conservatives have proposed a number of key reforms, including school check-ups, missed appointment fees, NHS work quotas and reform of the way dentists are paid.

The reforms are set to challenge the current NHS dentistry contract, which has been dogged with criticism since its introduction in 2006.

The 2006 deal effectively scrapped the system of registration whereby dentists had a list of patients.
Instead, they have been paid to carry out a set number of courses of treatment.

It was hoped this would allow dentists to spend more time with patients by creating a more structured and less onerous workload.

However, since the introduction of the contract, more than one million people have been unable to register with an NHS dentist.

Lansley said: “Over a million people have lost their NHS dentist in just three years and dentists are fed up with the flawed, system of perverse incentives that Labour have introduced.

“A Conservative government will … restore access to an NHS dentist to the million who have lost one under Labour. We will make preventative treatment a real priority because we urgently need to improve our nation’s dental health.”

Lansley also intends to restore dental screening for all five-year-olds at school. The extra cost will be paid for by scrapping £17m of past incentives that encouraged unnecessary treatment and by allowing dentists to charge patients who frequently miss appointments.

Dentists trained at taxpayers’ expense will also be required to work for the NHS for at least five years, instead of the current three year minimum.

The Tories have also said they would make changes to the contract to restore registration so that dentists were paid to provide treatment to a set number of patients with incentives in place to encourage good care as happens under the current GP contract.

The Tories claim that previous targets distorted the service, making it more profitable to call back patients repeatedly for extra repair work spread over several visits rather than expanding their surgery’s list of patients.

“Dentists are playing the system,” a Tory spokesman added. “We will move to a new registration system.”

Last year figures revealed that as many as 800,000 fewer patients were being seen by dentists. The Tories believe that is an underestimate and the real figures may be as high as three million.

The government’s chief dental officer, Barry Cockcroft, disputed the significance of the figures and said that new services were opening all the time.

The government are also adamant that NHS dental services are improving.

A Department of Health spokesman said: “We aim to ensure that everyone who wants to see an NHS dentist can by March 2011.

“We have invested over £2bn in NHS dentistry - the result is more NHS dental practices expanding and opening all the time.

The tide is turning and we are now seeing access to NHS dentistry starting to increase.”

Susie Sanderson, of the British Dental Association, said the 2006 changes had created “significant difficulties” for the profession and patients.

She said the union needed more time to assess the merits of the Tory proposals.

But she added: “In seeking to reform the system it is important that all patients are able to access dentistry and that dentists are able to provide the kind of modern, preventive care they are trained to give.”