Introduction
The current dental contract is failing patients and driving dentists away from the NHS, according to Dr Susie Sanderson, chair of the BDA's executive committee.
Giving evidence to the House of Commons Health Select Committee last month (February) Dr Sanderson said: 'We have found the transition to the new contract very unsatisfactory indeed.' Provision of services by PCTs was 'patchy' and the scrapping of patient registration in 2006 threatened continuity of care, she added.
The contract favoured episodic, pain-relief oriented treatment rather than prevention, she said.
Dr Sanderson, who has two practices in Sheffield, one entirely NHS and one mixed, told the committee that the unit of dental activity (UDA) was 'a crazy unit' unsuited to measuring what dentists were doing. The target driven nature of the new contract, which was imposed on the profession in April 2006, was driving dentists away from the NHS, she added. One of the dentists in her own practice was taking early retirement, at the age of 55, because she 'could not take any more' and would be a great loss to the NHS, said Dr Sanderson. The BDA believes 1,000 dentists have been lost to the NHS since April 2006.
Overall access to NHS dental services had dropped by about 250,000 since 2006, she told the committee.
In written evidence to the committee the BDA said PCTs' varying expertise in commissioning services had led to 'a new postcode lottery of NHS dental provision.'
It called on the government to allocate full dental budgets to PCTs so that they would no longer be reliant on income from patient charges.
In 2005/06 patient charge revenue was £159 million (26 per cent) lower than anticipated by the Department of Health, so PCTs were 'forced to cover this deficit by commissioning less dentistry and implementing inflexible targets for dentists,' said the BDA.
Asked by health select committee chair, Kevin Barron (Labour, Rother Valley) what dentistry would look like in 10 years time, Dr Sanderson said: 'I do fear for the diversity of care.'
Iain Hathorn, chair of the British Orthodontic Society, said there were six year waiting times for orthodontic treatment in parts of the country.
Commenting on the effects of the dental reforms on manufacturers, David Smith, vice-president of the Dental Laboratories Association, told the committee that complex dentures and bridge work had virtually disappeared while there had been a massive increase in demand for one-tooth partial dentures. 'We hardly made them at all before. But now we are making them in vast numbers,' he said.