NHS reforms risk exodus of dentists
New reforms to the NHS dental system could lead to a reduction in the level of dental work done by NHS dentists, according to a report from the National Audit Office (NAO).
Though the NAO agrees there is a “strong rationale” for modernising the system, it warns of “significant risks” that will need to be managed if the new system is to be both effective and value for money.
In 2003, the Government announced that responsibility for providing dental care would be handed over to Primary Care Trusts, which would be responsible for commissioning dental services. It hoped that this would allow dentists to be paid for preventative work, not just money per action taken, and so encourage more dentists to stay within the health service.
This transfer is currently scheduled for October 2005, but the NAO warns that not only do PCTs have little experience in high street dentistry, the new system might not offer enough incentives for dentists to stay.
It warns there is a shortage of dentists across the country, with many dentists choosing not to set up in deprived areas, and dentists in affluent areas deciding to take on no new NHS patients or reduce the services they offer.
A 2002 governmental review found a shortage of 1850 dentists, and the Government has promised to recruit 1000 new dentists by October 2005. This recruitment is expected to come from abroad, new trainees and existing dentists increasing their NHS commitments.
The head of the NAO, Sir John Bourn, said: “The Department of Health is pursuing an ambitious programme to reform NHS dentistry. There are good reasons to modernise the system but it is vital that the Department gets it right. I have identified significant risks that will need to be carefully managed.
“In the light of concerns by dentists and the NHS, the Department’s decision to postpone the introduction of the new arrangements to October of next year is welcome. It now needs to be more transparent about its plans and its timetable for managing the change process to achieve the new date – and ensure that these are conveyed to dentists and their patients.”
The report was welcomed by the British Dental Association, which said that now was “make or break” time for NHS dentistry.
Its chief executive, Ian Wylie, said: “This report will not make easy reading for the Department of Health. The BDA has consistently warned the Government that it needs to get these changes right first time if it is not to lose what little confidence the dental profession has left in NHS dentistry. Our own research earlier this year found that only one in ten dentists believed their PCT could cope with their new responsibilities. With less than a year to go until implementation, and still without a draft contract, it’s no wonder that many dentists are seriously considering whether or not their future lies within the NHS.”
