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'Standards drop' in NHS dentistry | 'Standards drop' in NHS dentistry |
(about 8 hours later) | |
Reforms of NHS dentistry mean some patients are receiving substandard care, critics claim. | Reforms of NHS dentistry mean some patients are receiving substandard care, critics claim. |
Dental Laboratories Association figures show a drop in the number of complex treatments, like dentures, carried out since the new contract began in April. | Dental Laboratories Association figures show a drop in the number of complex treatments, like dentures, carried out since the new contract began in April. |
The DLA says financial rather than clinical concerns are driving decisions - to the detriment of patients. | The DLA says financial rather than clinical concerns are driving decisions - to the detriment of patients. |
But the government says the new contract was designed to cut unnecessary complex treatments. | But the government says the new contract was designed to cut unnecessary complex treatments. |
'Dark Ages of dentistry' | |
The chief dental officer, Barry Cockcroft, said dentists will still act "ethically and clinically" in the best interests of the patient. | |
Speaking on BBC Radio 4's Today programme he refuted suggestions by DLA chief executive Richard Daniels that the service was "going back to the Dark Ages of dentistry". | |
Mr Daniels argued that his association had comments from "some of the most vulnerable" patients who had required dentures and instead were given tooth extraction. | |
He blamed the new contract, which does not record the specific treatment carried out. | |
"For example, if you had a tooth missing under the old contract very regularly you would have received a single crown. | |
"Under the new contract you'll be finding you'll get a one tooth denture and the cost of those are significantly different yet the dentist's income will still be the same," he told the programme. | |
Mr Cockcroft said the DLA's evidence was "anecdotal" and said the government's pilot project found patients were pleased with the new system. | |
It found a drop in intervention, with no impact on patients, he said. | |
"The vast majority of dentists will actually still do what is completely right for their patients," he added. | |
He said the old contract was designed to deal with a completely different climate and that the oral health of the nation had "vastly improved". | |
Earlier he said the new contract was designed to give dentists more stability - and the same money for treating fewer patients. | |
It meant they did not have to rely on a "drill and fill" culture to maximise their income. | It meant they did not have to rely on a "drill and fill" culture to maximise their income. |
However, if dentists do not fulfil their work quota, their employer, the Primary Care Trust, can ask for some of their wages back. | However, if dentists do not fulfil their work quota, their employer, the Primary Care Trust, can ask for some of their wages back. |
There is no incentive to carry out complex work that might be best for the patient Anthony Halperin, chairman of the Patients Association | There is no incentive to carry out complex work that might be best for the patient Anthony Halperin, chairman of the Patients Association |
The DLA, a professional body for dental laboratory owners, says this pressure may be affecting the treatments dentists are providing, with some doing fewer time-consuming, complex procedures. | The DLA, a professional body for dental laboratory owners, says this pressure may be affecting the treatments dentists are providing, with some doing fewer time-consuming, complex procedures. |
It revealed exclusively to BBC Breakfast that it had seen a 57% reduction in complex "Band 3" dental treatments - such as crowns and dentures - on the NHS compared with the old dental contract. | It revealed exclusively to BBC Breakfast that it had seen a 57% reduction in complex "Band 3" dental treatments - such as crowns and dentures - on the NHS compared with the old dental contract. |
Yet on Denplan, where dentists do not pay for laboratory work but patients do, the rate of Band 3 work has remained unchanged over the same 12-month period. | Yet on Denplan, where dentists do not pay for laboratory work but patients do, the rate of Band 3 work has remained unchanged over the same 12-month period. |
The figures show that the private market is not growing at the same rate at which the NHS is decreasing. | The figures show that the private market is not growing at the same rate at which the NHS is decreasing. |
It could be that patients are missing out on treatments altogether. | It could be that patients are missing out on treatments altogether. |
The DLA believes 3%-5% of the dental work is being shipped abroad. | The DLA believes 3%-5% of the dental work is being shipped abroad. |
Compromised care | Compromised care |
Richard Daniels, DLA chief executive, said: "The current contract is forcing dentists to make prescription decisions based on financial resources rather than clinical need. | Richard Daniels, DLA chief executive, said: "The current contract is forcing dentists to make prescription decisions based on financial resources rather than clinical need. |
"My concern is that, with such a dramatic reduction in complex treatments, some of the most vulnerable people in society are suffering. | "My concern is that, with such a dramatic reduction in complex treatments, some of the most vulnerable people in society are suffering. |
DENTAL TREATMENT BANDINGS Band 1 - simple scaling, examination, repairsBand 2 - tooth extraction, root canal workBand 3 - veneers, dentures | DENTAL TREATMENT BANDINGS Band 1 - simple scaling, examination, repairsBand 2 - tooth extraction, root canal workBand 3 - veneers, dentures |
"The Department of Health must act now to stop the decay of our dental service." | "The Department of Health must act now to stop the decay of our dental service." |
Peter Ward, chief executive of the British Dental Association, said it was too early to say if there had been a change in the amount of complex treatments being performed by NHS dentists. | Peter Ward, chief executive of the British Dental Association, said it was too early to say if there had been a change in the amount of complex treatments being performed by NHS dentists. |
But he said: "What we do know, is that the crude, target-driven contract introduced in April 2006 is creating problems for dentists and patients across England and Wales. | But he said: "What we do know, is that the crude, target-driven contract introduced in April 2006 is creating problems for dentists and patients across England and Wales. |
"Dentists are highly-trained healthcare professionals and should be treated as such, rather than being left chasing targets." | "Dentists are highly-trained healthcare professionals and should be treated as such, rather than being left chasing targets." |
"Appropriate" trend | "Appropriate" trend |
Anthony Halperin, chairman of the Patients Association and a private dentist, said: "I am convinced that this contract is not to patients' advantage. | Anthony Halperin, chairman of the Patients Association and a private dentist, said: "I am convinced that this contract is not to patients' advantage. |
"They are not being treated as efficiently as they were under the old system and they are paying more for it. | "They are not being treated as efficiently as they were under the old system and they are paying more for it. |
"Dentists are so driven by hitting targets that there is no incentive to carry out complex work that might be best for the patient." | "Dentists are so driven by hitting targets that there is no incentive to carry out complex work that might be best for the patient." |
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