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Domingo 13 de julio de 2008
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Un millón pierde hacia fuera en reformas dentales de NHS
Miércoles 2 de julio de 2008 Discuta este informe en los foros de RINF > Por Rebecca Smith | En vez de mejorar el acceso a la odontología de NHS las reformas han hecho peor, el informe por la Cámara de los Comunes el comité selecto de la salud encontrado. El número de los dentistas que trabajaban en el servicio médico ha caído, el número de los tratamientos de NHS realizados ha caído y en muchas áreas los pacientes todavía están experimentando dificultades severas en encontrar a un dentista para tratarlas. De forma preocupante, los tratamientos complejos realizados en el NHS han caído por mitad mientras que las remisiones a las extracciones del hospital y del diente han aumentado. Esto sugiere que los dentistas estén quitando simplemente los dientes más bien que que estén adquiriendo tratamientos complicados porque han hecho poco económicos de proporcionar. El informe dijo que en los dos años que seguían la introducción del nuevo contrato en abril de 2006, 900.000 pocas personas vieron a dentista de NHS que en los dos años pasados del sistema anterior. Incluso esto podría ser una subestimación, dijo. Los ministros introdujeron las reformas al contrato dental a pesar de la preocupación extensa que no mejorarían el acceso al cuidado. El contrato era tan impopular que más de uno en diez dentistas rechazados para firmar lo y más que un tercero lo firmó en conflicto. Sin embargo, el ministro de entonces de la salud a cargo de la odontología Rosie Winterton insistió: “Las reformas mejorarán el acceso, animarán una odontología más preventiva y proporcionarán una renta estable para los dentistas.” El gobierno esperaba que los nuevos contratos dieran a más pacientes la ocasión de colocarse con un dentista de NHS, de animar un trabajo más preventivo y de reducir el “taladro y de llenar” la cultura. También fueron diseñados para simplificar el sistema de los pagos, de modo que en vez de ser pagados por el tratamiento, dieran los dentistas un sueldo anual plano a cambio de realizar una cantidad convenida de trabajo conocida como unidades de la actividad dental (UDAs). Sin embargo, el comité selecto encontró eso como resultado de los cambios, dentistas tenía no más cualquier incentivo financiero da el tratamiento apropiado. El volumen de trabajo complejo como las coronas, los puentes y las dentaduras había caído por 57 por ciento, dijo. El MPs dijo que era “extraordinario” que el departamento de la salud no realizó los estudios experimentales en el sistema antes de introducirlo a través de Inglaterra. Kevin Barron, presidente del comité de la salud, dijo: “It is disappointing that so far the new dental contract has failed to improve the patient’s experience of dental services. “While we readily accept that in some areas of the country provision of NHS dentistry is good, overall provision is patchy. “Fewer patients are visiting an NHS dentist than before the contracts were introduced in April 2006, we heard little evidence that preventive care has increased, and patients seem less likely to receive complex treatments they might require within the NHS. “The Department did not test through a pilot the new remuneration system and we were astonished that in such a crucial area of reform the Department chose not to undertake rigorous testing prior to its introduction.” As a result of the changes, dental work is now split into three bands, with band 1 being a simple course of treatment such as a check-up or X-ray, costing the patient £16.20. Band 2 treatment costs £44.60 and covers everything in band 1 plus fillings, root canal work or extraction. Band 3 costs £198 and also covers crowns, dentures or bridges. However, the MPs heard expert evidence suggesting the contracts provided dentists with a “financial incentive to persuade a patient to have a decayed tooth extracted rather than undergo the more complex procedure of restoring it”. Dentists now had no financial incentive to treat complex cases and patients were being pushed unnecessarily into the hospital system, the MPs heard. Another impact has been that patients now pay the same amount - and dentists receive the same amount - for one filling as for three. As a result, people are delaying seeing the dentist until they need multiple fillings so they get their money’s worth. The report said unrealistic targets were set for dentists and were applied too rigidly, encouraging them to simply race through as many patients as they could. There were reports that dentists were forced to close for the last three months of the financial year as they had completed all their allocated treatments while others were forced to pay back money for failing to reach their target. Susie Sanderson, Chair of the British Dental Association’s Executive Board, said: “This is a damning report which highlights the failure of a farcical contract that has alienated the profession and caused uncertainty to patients. “For the past two years, dentists and patients have told the Department of Health that it got it wrong. Now MPs have agreed with the BDA. “The committee has said unrealistic targets have been set for many dentists and urged an improvement in local commissioning. “The Department must listen to this condemnatory report and act swiftly, looking seriously at these recommendations, for the sake of patients and the profession.” Shadow Health Minister, Mike Penning added: “The Government has consistently refused to acknowledge the shambolic current state of NHS dentistry. This report gives a scathing assessment of the true scale of the problems. “Labour must take responsibility for the failure of their dental contract. It has vastly reduced the number of people able to gain access to an NHS dentist. The situation is simply unacceptable, as the Select Committee has now made clear.” As a result of the changes, private dentistry appears to have expanded. While there are no reliable figures, estimates suggest it could now make up half of all dentistry provided in England. Liberal Democrat health spokeswoman Sandra Gidley, a member of the select committee, said: “This is another example of the Government meddling and rushing through changes without thinking about the consequences. “The facts speak for themselves. The number of patients seen by NHS dentists between December 2005 and December 2007 has fallen by a million. “The scandal for patients is that many are receiving less sophisticated treatment and are paying more for the privilege. “The Government has plunged us headlong into a dark age of dentistry.” A spokesman for the Department of Health said: “The focus and funding is already starting to show results - patients are starting to see the benefits with new NHS practices opening all over the country, and we are working with the NHS to ensure that, as the committee recommends, the quality of dental commissioning by PCTs improves. “It takes time for the extra services now being commissioned to feed through into the access figures that currently do not provide an up to date picture. More and more patients are benefiting from increases in services and we are confident that this will start to show through in the figures later this year.” See More:Health News UK NewsDiscuss this report in the RINF forums > Have Your Say: One million lose out in NHS dental reforms This entry was posted on Wednesday, July 2nd, 2008 at 6:08 am and is filed under Breaking News . You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site. |
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