NHS dentist reforms 'failing to achieve aims'

The Government's reforms of NHS dentistry have failed to achieve their stated aims, the British Dental Association (BDA) said today.

The biggest shake-up of dentistry in 50 years was intended to remove dentists from the "drill and fill" treadmill, improve patient access and lead to a greater focus on preventative work.

But one year after a controversial new dental contract was introduced, the BDA said the anticipated benefits have failed to materialise.

Its research found that 85% of 394 dentists surveyed believe the new contract has not improved patient access to NHS dentistry.

Almost all (97%) think it has not removed dentists from the work "treadmill" and 93% feel the new system does not encourage a more preventative approach.

Furthermore, 95% of dentists questioned felt less confident about the future of NHS dentistry than they did two years ago.

The findings come on the same day as the charity Citizens Advice demanded Government action to help the two million people who cannot find a dentist.

Susie Sanderson, chair of the BDA's executive board, said: "When the Government is failing to meet even its own success criteria for the new contract, then it's time for urgent action.

"We now have a reductive, target-driven system that is failing both patients and dentists.

"The future of NHS dentistry is becoming increasingly fragile and we need action now before it shatters altogether."

Under the new contract introduced last April, dentists are paid for carrying out a set number of units of dental activity (UDAs) over the course of the year.

But last month, a Department of Health memo, reported in the Health Service Journal, suggested patients may have to resort to emergency care or find an alternative practice because their dentists have fulfilled their annual contracts too soon.

At a BDA conference today Dr Sanderson will call on the Government to scrap the UDA as being the only way of measuring performance.

She will say: "Contractual performance has to be monitored but UDAs are only a single and very crude method.

"We need a more sophisticated approach which is sensitive to the reality of delivering dental care to patients and which supports preventive care, rather than works against it."

Citizens Advice said the Government needed to take urgent action to deal with "dentistry deserts" in some parts of England and Wales.

It said the two million figure comes from the Government's own estimate in April 2006 of people in England who want access to an NHS dentist but are unable to find one.

Its report, called Gaps To Fill, published today, said there was still "huge inequality in access to NHS dentistry".

It said areas like Hartlepool and Hornchurch, Essex were spoilt for choice while others, such as Blackburn and Petersfield, Hampshire, had very poor access.

More than 4,000 people completed a survey on its website, with two-thirds saying they have gone without treatment due to problems accessing care.

The Tories said the Government's dental contract had "blown a black hole in NHS finances of over £120 million this year".

Shadow health secretary Andrew Lansley said: "We told the Government one year ago that their new contract would be a costly disaster for NHS dentistry.

"The National Audit Office warned that the NHS did not have the necessary expertise to operate the contract.

"Dentists walked out of the negotiations, but the arrogance and complacency of the Department of Health led them to press on regardless.

"Once again, the Government's abject failure to estimate the cost of a new contract has punched a black hole in NHS finances of tens of millions."

Health minister Rosie Winterton said: "We are pleased the CAB have welcomed the reforms and that they believe the reforms provide a good foundation on which to rebuild NHS dentistry.

"We have made a significant extra investment over the last three years - with annual budgets increasing by £400 million (in real terms).

"The overall picture is that, despite the speculation, the number of dentists is growing and rather than leaving they are actually keen to expand their work for the NHS - hardly indicative of a failing system."

A spokesman for the Department of Health added: "Speculation about levels of charge income misses the key point that dental services are growing.

"As services grow, so too will the patient charge revenue."

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