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RUPTURE DES NOUVELLES |
Un million perdent dehors dans des réformes dentaires de NHS
Mercredi 2 juillet 2008 Discutez ce rapport dans les forum de RINF > Par Rebecca Smith | Au lieu d'améliorer l'accès à l'art dentaire de NHS les réformes l'ont rendu plus mauvais, le rapport par la Chambre des Communes le Comité choisi de santé trouvé. Le nombre de dentistes travaillant dans le service de santé est tombé, le nombre de traitements de NHS effectués a chuté et dans beaucoup de secteurs les patients ont toujours des difficultés graves à trouver un dentiste pour les traiter. Importunément, les traitements complexes effectués sur le NHS ont chuté par moitié tandis que les références aux extractions d'hôpital et de dent ont augmenté. Ceci suggère que les dentistes enlèvent simplement des dents plutôt que de prennent des traitements compliqués parce qu'il est devenu peu économique les fournir. Le rapport a indiqué qu'en deux années suivant l'introduction du nouveau contrat en avril 2006, 900.000 peu de personnes ont vu un dentiste de NHS qu'en deux dernières années du système précédent. Même ceci pourrait être une sous-estimation, il a indiqué. Les ministres ont présenté les réformes au contrat dentaire en dépit du souci répandu qu'ils n'amélioreraient pas l'accès au soin. Le contrat était si inpopulaire que plus d'un dans dix dentistes ait refusé de le signer et plus qu'un tiers l'a signé dans le conflit. Cependant, le ministre puis de santé responsable de l'art dentaire Rosie Winterton a exigé : « Les réformes amélioreront l'accès, encourageront un art dentaire plus préventif et fourniront un revenu stable pour des dentistes. » Le gouvernement a espéré que les nouveaux contrats donneraient à plus de patients la chance de s'inscrire à un dentiste de NHS, d'encourager un travail plus préventif et de réduire le « foret et de remplir » culture. Ils ont été également conçus pour simplifier le système de paiements, de sorte qu'au lieu d'être payés par traitement, des dentistes aient été donnés un salaire annuel plat en échange pour effectuer une quantité convenue de travail connue sous le nom d'unités d'activité dentaire (UDAs). Cependant, le comité choisi a trouvé cela en raison des changements, dentistes n'a plus eu n'importe quelle incitation financière donnent le traitement approprié. Le volume de travail complexe comme des couronnes, des ponts et des dentiers était tombé par 57 pour cent, il a indiqué. Le MPs a indiqué qu'il était « extraordinaire » que le département de la santé n'ait pas effectué les études préliminaires sur le système avant de le présenter à travers l'Angleterre. Kevin Barron, Président du Comité de santé, a indiqué : “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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