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星期三， 2008年7月2日
谈论这个报告在RINF论坛 >

由 丽贝卡·史密斯 | 而不是改进对NHS牙科的通入改革使它坏，报告由下议院找到的健康精选的委员会。

工作在卫生业务的牙医的数量下落了， NHS治疗的数量被执行的下降了，并且在许多区域患者在找到牙医仍然经历严厉困难对待他们。

忧虑地，当提及对医院和牙提取增加了时，在NHS执行的复杂治疗下降了由一半。

这建议牙医简单地去除牙而不是承担复杂的治疗，因为他们变得浪费提供。

报告认为在跟随新的合同的介绍的二年在2006年4月， 900,000很少人看见了一位NHS牙医比在早先系统的最近二年。 这可能是低估，它认为。

他们不会改进对关心的通入的大臣介绍了改革给牙齿合同尽管普遍关心。 合同是很不得人心的超过一个在十位牙医拒绝签署它，并且更多比三签署了它在争执。

然而，健康部长负责牙科Rosie Winterton坚持了： “改革将改进通入，鼓励更加预防的牙科并且为牙医提供稳定的收入”。

政府希望新的合同将给更多患者机会向NHS牙医登记，鼓励更加预防的工作和减少“钻子和填装”文化。

他们也被设计简化付款系统，因此而不是有偿的每种治疗，牙医被给了平的年薪以换取执行一个议定数量工作以单位牙齿活动著名(UDAs)。

然而，精选的委员会发现了那由于变动，牙医不再有所有财政刺激给适当的治疗。

复杂工作的容量象冠、桥梁和假牙由57%下落了，它认为。

MPs说它是“非凡的”健康的部门没有在介绍它之前执行关于系统的中间试验横跨英国。

凯文Barron，健康委员会的主席，说： “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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