NHS dentistry reforms 'failing'

Health Select Committee chairman Kevin Barron on the report

Changes designed to improve NHS dental services in England have not been successful, a report by MPs says.

The new contract, introduced in 2006, was intended to simplify charges and make it easier to find an NHS dentist.

But the Commons Health Committee said access remained "patchy" and there had been a sharp fall in the number of complex procedures.

The Department of Health insisted the reforms - which were later adopted in Wales - were starting to work.

While we readily accept that in some areas of the country, provision of NHS dentistry is good, overall provision is patchy Kevin Barron MP House of Commons Health Committee Q&A: Dental reforms

The new contract, under which patients paid fixed charges for particular types of procedure, also gave local primary care trusts the power to commission and pay for dental services.

It has been rolled out to cover Wales, although the report only deals with progress in England.

The number of patients seen fell by 900,000 in the 18 months following the introduction of the new contract in April 2006, the report said.

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In the first year of the contract, the number of complex treatments - including bridges and crowns - which involve laboratory work was halved, and the number of root canal treatments fell by 45%. Both of these attract higher fees under the new scheme.

The committee said there were concerns that some patients were not getting the complex treatment they needed.

Conversely, the number of tooth extractions rose.

In Scotland and Northern Ireland, not covered by the changes, the number of complex treatments rose.

No pilots

The committee also heard fears that the changes had not stemmed the exodus of NHS dentists into private-only practices, although the Department of Health said that was unlikely.

It highlights the failure of a farcical contract that has alienated the profession and caused uncertainty to patients Susie Sanderson British Dental Association

Committee chairman Kevin Barron MP said: "It is disappointing that so far the new 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."

He criticised the Department of Health for not piloting the new contract on a smaller scale prior to introduction.

The committee called on the government to improve PCT commissioning and review the "units of activity" system to make sure it rewarded dentists for choosing the most appropriate treatment.

'Farcical'

Susie Sanderson, from the British Dental Association, described it as a "damning report".

The focus and funding is already starting to show results Department of Health

"It highlights the failure of a farcical contract that has alienated the profession and caused uncertainty to patients," she said.

"For the past two years, dentists and patients have told the Department of Health that it got it wrong."

A Department of Health spokesman said it would "carefully consider" the recommendations but that the benefits of the reforms were already emerging.

"We have invested over £200m in NHS dentistry this year, over and above increases in the last three years. This takes our total investment to over £2bn.

"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."