Page last updated at 23:36 GMT, Monday, 18 May 2009 00:36 UK

Tories propose dentistry overhaul

Patient being treated by dentist
A new contract for NHS dentists was introduced in 2006

NHS dentistry in England needs to be completely overhauled to improve access, the Conservatives have said.

They have proposed a series of steps, including school check-ups, missed appointment fees, NHS work quotas and reform of the way dentists are paid.

A new contract introduced in England and Wales in 2006 aimed to attract more dentists to the NHS, but latest figures show fewer patients are being treated.

But the government says access to NHS dentistry is already improving.

Dentists are fed up with the flawed system of perverse incentives that Labour have introduced
Andrew Lansley, shadow health secretary

A Department of Health spokesman said: "We aim to ensure that everyone who wants to see an NHS dentist can by March 2011.

"We have invested over £2bn in NHS dentistry - the result is more NHS dental practices expanding and opening all the time.

The tide is turning and we are now seeing access to NHS dentistry starting to increase."


The 2006 deal effectively scrapped the system of registration whereby dentists had a list of patients.

Instead, they have been paid to carry out a set number of courses of treatment.

It was hoped this would allow dentists to spend more time with patients by creating a more structured and less onerous workload.

But the changes have received heavy criticism in recent years from dentists and patient groups as well as opposition parties as one million fewer patients are now being treated.

The Tories said they would make changes to the contract to restore registration so that dentists were paid to provide treatment to a set number of patients with incentives in place to encourage good care as happens under the current GP contract.

Their proposals also include a return to school screening for five-year-olds - they say two thirds of NHS trusts no longer run the check-ups since the rules were relaxed in 2007.

The party said it also wanted to see quotas introduced to ensure newly qualified dentists worked a set amount in the health service for five years.

The amount of private work being done by dentists has increased dramatically over the past 20 years.

The Tories also said they wanted to see a tough stance taken against people who consistently miss appointments by giving dentists the power to charge them.

'Significant difficulties'

Shadow health secretary Andrew Lansley said: "Dentists are fed up with the flawed system of perverse incentives that Labour have introduced.

"We will make preventative treatment a real priority because we urgently need to improve our nation's dental health."

Susie Sanderson, of the British Dental Association, said the 2006 changes had created "significant difficulties" for the profession and patients.

She said the union needed more time to assess the merits of the Tory proposals.

But she added: "In seeking to reform the system it is important that all patients are able to access dentistry and that dentists are able to provide the kind of modern, preventive care they are trained to give."

Lib Dem health spokesman Norman Lamb said: "The government's new contract is not working, but I am not sure what the Tories are suggesting will work. It could create turmoil in the health service.

"We are looking into this issue as we feel it is a priority."

The government is also considering the changes. Ministers announced a review of dentistry last year after accepting many people were still struggling to get access care. A report is expected in the summer.

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