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수요일, 2008년 7월 2일
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에 의하여 Rebecca 스미스 | NHS 치과에 접근 개량 대신에 개혁은, 보고 찾아낸 건강 추려낸 위원회 공동 주택에 의하여 더 나빠던 만들었다.

공공 의료에서 일해 치과의사의 수는 떨어졌다, 실행된 NHS 처리의 수는 떨어지고 많은 지역에서 환자는 아직도 그들을 대우하기 위하여 치과의사를 찾아내기에 있는 가혹한 어려움을 경험하고 있다.

걱정스레, 반에 의해 NHS에 실행된 병원과 이 적출에 소개가 둘 다 증가하는 동안 복잡한 처리는 떨어졌다.

이것은 제공하기 비경제적 되었기 때문에 치과의사가 간단하게 이를 제거하고 보다는 오히려 복잡한 처리를 취하고 있다는 것을 건의한다.

보고는 2006년 4월에 있는 새로운 계약의 소개를 따르는 2 년에서, 900,000명의 몇몇 사람이 이전 체계의 마지막 2 년에서 보다는 NHS 치과의사를 보았다는 것을 밝혔다. 이것 조차 과소평가일 수 있었다, 밝혔다.

성직자는 배려에 접근을 개량하지 않을 것입니다 대폭적인 관심사에도 불구하고 치과 계약에 개혁을 소개했다. 계약은 세 번째 보다는 더 많은 것을 그것 그리고 서명하기 위하여 사절된 10명의 치과의사에 대하여 이상의 것이 논박에서 그것을 서명했다 때문에 이렇게 인기가 없었다.

그러나, 치과 Rosie Winterton에게 맡겨져 있는 그 후에 건강 성직자는 주장했다: "개혁 접근을 개량하고, 예방 치과를 격려하고 치과의사에게 제공할 것이다 안정되어 있는 소득을."는

정부는 새로운 계약이 환자에게 더 NHS 치과의사에 등록하고, 예방 일을 격려하고 "교련을 감소시키고" 문화를 채우는 기회를 줄 것이라는 점을 희망했다.

그들은 또한 처리 당 급여받는 대신에, 치과의사가 치과 활동 (UDAs)의 단위로 알려져 있는 일 동의한 양 실행의 답례로 편평한 연봉을 주어졌다 그래야, 지불 시스템을 간단하게 하기 위하여 디자인되었다.

그러나, 추려낸 위원회는 변화, 치과의사 결과로 저것을 더 이상 있었다 어떤 재정적인 동기유발든지 준다 적합한 처리를 찾아내지 않았다.

크라운, 교량 및 틀이 같이 복잡한 일의 양은 57% 떨어졌었다, 밝혔다.

MPs는 밝혔다 건강의 부가 영국의 맞은편에 그것을 소개하기 전에 체계에 안내하는 학문을 실행하지 않았다 "특별했다는 것을".

Kevin Barron, 건강 위원회의 의장은, 말했다: “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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