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Last Updated: Friday, 2 June 2006, 16:22 GMT 17:22 UK
Dentist's view
Spiralling debts and job cuts are plaguing the NHS in England, bringing a new focus to how it operates in the 21st century.

Health workers in a variety of sectors - plus the BBC's Home Editor, Mark Easton - offer their views on what is wrong with the National Health Service and prescribe their own remedies.

Susie Sanderson, a dentist in Sheffield and Chair of the British Dental Association's Executive Board, gives her assessment.

DIAGNOSIS

Susie Sanderson

NHS dentistry has recently undergone its most fundamental change since its inception in 1948.

A new contract for dentists, local commissioning of dentistry and a new system of patient charges were all introduced on 1 April.

The BDA's main concerns about these changes are that the system is untested, target driven, that it does not support a more preventive approach to oral health care and that it won't achieve the government's aim of improving access.

As a result of what has been described as a reckless experiment with the nation's oral health, around 2,000 dentists, concerned about the quality of care they feel their patients deserve, decided to leave the NHS.

Their departure exacerbates the chronic shortage of dentists that the UK is already facing.

In July 2004 the Government's own figures estimated that England alone was 1,850 dentists short of the number required.

A number of practitioners who have signed a contract and remain in the NHS have done so 'in dispute', and they have yet to make decisions about their future commitment to the service.

PROGNOSIS

It's difficult to predict where NHS dentistry is heading.

It's only six weeks since the service underwent major reform and it is too early to gauge accurately the effect on patients and dentists.

What must happen now is that developments should be monitored closely and the government must listen properly to patients and dentists and commit thoroughly to change what are major flaws in the new system.

The BDA will continue to make it clear that a full and transparent review by the government is essential.

Funding for NHS dental contracts is guaranteed only until 2009, which adds further to uncertainty about the future.

The shortage of dentists also remains an issue.

The number of training places for dentists has been increased but it will be six years before the effect of this increased training complement will be seen.

The future of NHS dentistry must also be seen in the wider context of the growth of the private dental market, the arrival of exciting new treatments and patients' changing expectations.





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