NCPA - National Center for Policy Analysis


July 3, 2008

A new contract for dentists in Great Britain's government-run health care system is failing to improve services for patients, Members of Parliament have warned.

Changes in the way dentists are paid means they effectively have no financial incentive to give appropriate treatment, the Commons Health Select Committee said.

  • Under the new contract, dentists receive an agreed annual sum rather than being paid for each individual treatment.
  • The committee found the number of dentists extracting a decaying tooth rather than carrying out a more complicated procedure had increased.
  • As a result, the volume of more complex work like crowns, bridges and dentures has fallen by 57 percent.

Evidence also suggested that patients were being pushed unnecessarily into the hospital system.  A survey carried out by the British Dental Association in 2007 found 78 percent of clinical directors had seen an increase in referrals from general dentists.

The report said it was "extraordinary" that the Department of Health did not carry out pilot studies on the new system before introducing it across England.

And it said that, despite assurances from the Government that the new arrangements would work if Primary Care Trusts and dentists acted more flexibly and used common sense and goodwill, the Committee "saw little evidence this will happen."

Figures released last month showed that almost a million fewer people are now seeing an NHS dentist than before the Government's reforms.

Source: "Dental System 'Failing Patients,' " Sky News, UK, July 2, 2008.


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