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Woensdag, 2 Juli, 2008
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Door Rebecca Smith | In plaats van het verbeteren van toegang tot tandheelkunde NHS hebben de hervormingen het slechter, het rapport door de Gezondheid gemaakt van het Lagerhuis het Uitgezochte Comité vond.

Het aantal tandartsen die in de gezondheidsdienst werken is gedaald, is het aantal uitgevoerde behandelingen NHS gedaald en op vele gebieden ervaren de patiënten nog strenge moeilijkheden in het vinden van een tandarts om hen te behandelen.

Bezorgd, zijn de complexe behandelingen die op NHS worden uitgevoerd door de helft gedaald terwijl zowel de verwijzingen aan het ziekenhuis als tandextracties zijn gestegen.

Dit stelt voor de tandartsen eenvoudig tanden eerder dan het overnemen van ingewikkelde behandelingen verwijderen omdat zij onekonomisch zijn geworden te verstrekken.

Het rapport zei dat in de twee jaar na de introductie van het nieuwe contract in April 2006, 900.000 minder mensen een tandarts NHS dan in de laatste twee jaar van het vorige systeem zagen. Zelfs kunnen dit zijn onderschat, zei het.

De ministers introduceerden de hervormingen aan het tandcontract ondanks wijdverspreide zorg zij geen toegang tot zorg zouden verbeteren. Het contract was zo impopulair dat meer dan één in tien tandartsen weigerden om het te ondertekenen en meer dan ten derde ondertekend het in geschil.

Nochtans, drong de toenmalige gezondheidsminister verantwoordelijk voor tandheelkunde Rosie Winterton aan: De „hervormingen zullen toegang verbeteren, zullen meer preventieve tandheelkunde aanmoedigen en zullen een stabiel inkomen voor tandartsen.“ verstrekken

De overheid hoopte de nieuwe contracten meer patiënten de kans om met een tandarts zouden geven te registreren NHS, meer preventief werk aan te moedigen en de „boor te verminderen en“ cultuur te vullen.

Zij werden ook ontworpen om het betalingensysteem te vereenvoudigen, zodat in plaats van wordt betaald per behandeling, de tandartsen een vlak jaarlijks salaris in ruil daarvoor voor het uitvoeren van een goedgekeurde hoeveelheid werk gegeven werden die als eenheden van tandactiviteit wordt bekend (UDAs).

Nochtans, vond de uitgezochte commissie dat als resultaat van de veranderingen, de tandartsen niet meer om het even welke financiële aansporing hadden om aangewezen behandeling te geven.

Het volume van het complexe werk zoals kronen, bruggen en gebitten was door 57 percenten gevallen, zei het.

Afgevaardigden zeiden het „buitengewoon“ was dat het Ministerie van Gezondheid geen pilootstudies op het systeem alvorens het over Engeland uitvoerde te introduceren.

Kevin Barron, voorzitter van het Comité van de Gezondheid, zei: “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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