Page last updated at 11:27 GMT, Wednesday, 28 March 2007 12:27 UK

Q&A: NHS dentistry

NHS dentistry were recently overhauled in a bid to solve the long-running problem of accessing services.

But dentists and patients are still reporting problems.

Dental equipment
There are over 20,000 dentists working in the NHS

What is happening?

Dentists are reporting they are having to turn away NHS patients because local health chiefs have run out of money to pay them.

Some practices are even having to force dentists to take holidays - despite having patients waiting to see them.

Critics say this means the new contract has not increased access at all.

A poll by the British Dental Association found that 85% of dentists did not believe access had improved since the new deal came in last April.

And the latest data seems to support this.

The NHS Information Centre said the same proportion of people are being treated by NHS dentists this year as were being seen before the new contract, meaning an estimated 2m people who want a dentist cannot get one.

Why has the new contract not solved the situation?

Local health chiefs, working for primary care trusts, were given responsibility for ensuring dental services are in place under the new arrangements.

They were given a budget of 2.3bn for 2006-7 to make sure services were in place.

But a quarter of this was expected to come from patients charges - many adults contribute towards the cost of their care.

However, not as much as expected has been made in charges, leaving PCTs with no money to pay dentists at the end of the financial year.

The government has agreed that the new system has taken a while to be in, but ministers say they are confident there will be increased provision in the coming months.

What can patients do?

If a patient does need treatment but cannot find an NHS dentist they can ring their local primary care trust to go on a waiting list.

In some areas it has only taken a few days for a place to be found, although long waits have been reported in other areas, particularly in rural places.

If it is an emergency, the PCT can direct patients to emergency dental clinics which should be able to see people straight away.

Alternatively, if there are not NHS places available, there is always the option of going private, which, depending on the sort of treatment is needed, may not necessarily be much more than the cost of NHS treatment.

However, at this stage of the financial year, dentists say it may be worth waiting until next month.

From April, PCTs will have access to their new budgets for 2007-8, meaning in theory dentists should be able to start treating patients again.

Who is to blame for all this?

Dentists, and privately PCT officials, have pointed the finger at the government.

The Department of Health used data from nearly three years ago to work out the budget for 2006-7.

Dentists say provision has since changed and in many areas - particularly where traditionally there has been a lack of services or practices are expanding quickly.

This means that the money PCTs have been given is not enough to meet the demand.

Ministers counter this by saying they are putting more money into dentistry than before.

They also point out that NHS services needed to be reformed.

Before the contract came in, if a dentist left the NHS to do private work they would not automatically be replaced.

Whereas now the money that dentist would have got goes back to the PCT which can then pay for more services.


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