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水曜日、2008年7月2日
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によって レベッカスミス | NHSの歯科医療へのアクセスを改善するかわりに改良はそれを、レポート見つけられる健康の選り抜き委員会英国下院によってより悪くさせた。

保健業務ではたらいている歯科医の数は落ちた、遂行されるNHSの処置の数は落ち、多くの地域で患者はまだそれらを扱うと歯科医が見つけることの厳しい難しさを経験している。

Worryingly、半分によってNHSで遂行される病院および歯の抽出への紹介が両方増加する間、複雑な処置は落ちた。

これは提案し歯科医が単に取除いていることを提供してがuneconomicalなったので複雑な処置で取るよりもむしろ歯を。

レポートは2006年4月の新しい契約の導入に続く2年に900,000人の数人が前のシステムの最後の2年のよりNHSの歯科医に会ったと言った。 これはunderestimateであることができると言った。

大臣は心配へのアクセスを改善しない広まった心配にもかかわらず歯科契約に改良をもたらした。 契約は10人の歯科医に付き1人以上それに署名することを断り、三番目より多く論争のそれに署名したほど不評だった。

但し、歯科医療Rosie Wintertonのそして健康の総長は主張した: 「改良アクセスを改善し、予防の歯科医療を励まし、そして歯科医に提供する安定した収入を」。は

政府は新しい契約がより多くの患者にNHSの歯科医と登録し、予防の仕事を励まし、「ドリルを減らし、」文化を満たすチャンスを与えることを望んだ。

彼らはまた処置ごとに支払済であることの代りに、歯科医が歯科活動(UDAs)の単位として知られていた仕事の一致した量の遂行に対して平らな年間収入を与えられたのは支払システムを簡単にするように設計されていたからである。

但し、選り抜き委員会は変更、歯科医の結果としてそれをもはや持っていた適切な処置を与える財政の刺激を見つけなかった。

王冠、橋および総義歯のような複雑な仕事の容積は57%落ちたと、言った。

MPsは健康の部門がイギリスことをを渡ってそれをもたらす前にシステムの試験調査を遂行しなかったことそれが「異常」だったことを言った。

ケビンBarron、健康委員会の議長は、言った: “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 News 

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