Dentists 'should get NHS quota'

By Nick Triggle
Health reporter, BBC News

New contracts for NHS dentists were introduced in 2006

Dentists should have a limit on the amount of private work they can do, a think-tank says.

The New Local Government Network, which specialises in public service reform, said imposing a quota would help improve access to NHS dentistry.

It said such a move was justified as it cost £175,000 to train a dentist.

But dental leaders said they were against the idea of quotas, pointing out that there were dentists who wanted to do more NHS work but could not.

The call comes as the government is reviewing NHS dentistry after heavy criticism of the new contract.

Dental patients continue to struggle to find NHS practices with capacity to take them Nigel Keohane, of the New Local Government Network

The deal was introduced in 2006 in England - and subsequently adopted in Wales - in a bid to improve access.

But one million fewer patients are actually using NHS services now, compared with when the arrangement started.

Income for dentists is roughly evenly split between private and public patients, but there are signs that younger dentists are more likely to turn their backs on the health service.

In total, there is believed to be 3,000 dentists working solely on private patients, while another 4,000 are spending less than 25% of their time on NHS patients.

To remedy the situation, the think-tank said dentists could be compelled to spend half of their time on NHS patients in return for their training.

'Limits choice'

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Nigel Keohane, from the think-tank, said the government had to adopt a more "nuanced" approach to commissioning dentistry services.

"Dental patients continue to struggle to find NHS practices with capacity to take them," he claimed.

"This limits choice and creates inconvenience for the customer and insufficient supply to meet demand."

It is not the first time the idea of a quota has been floated.

Kevin Barron, chairman of the House of Commons Health Committee, has also supported the move in the past, saying dentists had a "moral obligation" to treat NHS patients.

But Susie Sanderson, of the British Dental Association, said the profession was against quotas and that problems with the new contract meant that some dentists were being prevented from taking on more NHS patients.

"In some instances dentists have either not been awarded NHS contracts at all or been awarded NHS contracts that are for smaller NHS commitments than they would have liked," she said.

The government said it was also against a quota, saying it was looking to build on the new contract instead.

Dr Barry Cockcroft, England's chief dental officer, said: "The NHS is now under a legal obligation to provide dental services for their local population.

"We have also appointed an independent review team to help us understand what more needs to be done to ensure that every person who wants to visit an NHS dentist can do so and all NHS dental services meet the highest standards of care.

"We feel that the measures we have taken are a better approach than a quota system for NHS dentists."