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Last Updated: Friday, 17 February 2006, 15:26 GMT
West: Dentists' despair
Paul Barltrop
Paul Barltrop
The Politics Show West

Dentist queue
Queue for dental registration

It was not meant to be this way. For years it has been hard to find an NHS dentist. Within weeks it may get even harder.

The Prime Minister could not have been clearer. "Everyone within the next two years will be able once again to see an NHS dentist," declared Tony Blair in 1999.

But seven years on, the reality across the West is very different.

Take Bath and North East Somerset: there are 42 dental practices - not one is presently accepting new NHS patients.

It is not much better in Swindon where only one of the town's 38 practices has spaces.

It is just as hard in parts of Gloucestershire; so when a practice in the town of Wootton-under-Edge last month announced it had space for 1000 new NHS patients, it had them queuing round the block.

In April 2006 a new contract for dentists comes into effect. It has prompted warnings that even more will now quit the NHS altogether.

Tony Blair
Tony Blair promised NHS dentistry for all

David Houston runs the largest practice in Weston-super-Mare: 17 dentists look after the teeth of 25,000 patients.

Yet he says the new arrangements will mean they are only funded for 19,000.

"My profession is not keen on this contract," he says.

"It is under funded, ill-considered, and has not had the time to be consulted through with the profession.

"It is being forced upon us."

From April points will be awarded for the number of "units of dental activity" - or UDAs - carried out by dentists.

But the system will not recognise multiple work. So the dentist will get the same points for doing one filling as three.

The British Dental Association warns that so many targets and conditions are squeezed into the contracts that dentists cannot focus on improving prevention or quality of care.

But such criticism is firmly rebutted by the Primary Care Trusts (PCTs) who from April 2006 will control dental budgets, instead of central government.

"Certainly we can guarantee that people will get treatment on the NHS," says Chris Born, the Chief Executive of Bristol North PCT - though he concedes it may not be ideal:

"It is a question of how easy that treatment is to access, how far people have to go."

dental student Jennifer Moorcroft
Jennifer Moorcroft faces student debt

What of the future? If students at Bristol University's Dental School are anything to go by, it does not look good.

"We are coming out of dental school with massive debts," says Jennifer Moorcroft, who is in her fourth year.

"I certainly think the private sector is very alluring and it is a better option for a lot of people than the NHS."

The Department of Health insist the new contracts will make matters better.

It has been seven years since the Prime Minister's pledge; the verdict on this latest change will be made within months.

The Politics Show

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