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星期三， 2008年7月2日
談論這個報告在RINF論壇 >

由 麗貝卡・史密斯 | 而不是改進對NHS牙科的通入改革使它壞，報告由下議院找到的健康精選的委員會。

工作在衛生業務的牙醫的數量下落了， NHS治療的數量被執行的下降了，并且在許多區域患者在找到牙醫仍然經歷嚴厲困難對待他們。

憂慮地，當提及對醫院和牙提取增加了時，在NHS執行的複雜治療下降了由一半。

這建議牙醫簡單地去除牙而不是承擔複雜的治療，因為他們變得浪費提供。

報告認為在跟隨新的合同的介紹的二年在2006年4月， 900,000很少人看見了一位NHS牙醫比在早先系統的最近二年。 這可能是低估，它認為。

他們不會改進對關心的通入的大臣介紹了改革給牙齒合同儘管普遍關心。 合同是很不得人心的超過一个在十位牙醫拒绝簽署它，并且更多比三簽署了它在爭執。

然而，健康部長負責牙科Rosie Winterton堅持了： 「改革將改進通入，鼓勵更加預防的牙科并且為牙醫提供穩定的收入」。

政府希望新的合同將給更多患者機會向NHS牙醫登記，鼓勵更加預防的工作和減少「鑽子和填裝」文化。

他們也被設計簡化付款系統，因此而不是有償的每種治療，牙醫被給了平的年薪以換取執行一個議定數量工作以單位牙齒活動著名(UDAs)。

然而，精選的委員會發現了那由於變動，牙醫不再有所有財政刺激給適當的治療。

複雜工作的容量像冠、橋梁和假牙由57%下落了，它認為。

MPs說它是「非凡的」健康的部門沒有在介紹它之前執行關於系統的中間試驗橫跨英國。

凱文Barron，健康委員會的主席，說： “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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