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Dentists will be required to refund £120 million to the health service because they failed to treat enough NHS patients last year, The Times has learnt.
About half of dental practices have fallen short of targets for NHS treatment agreed with local health authorities, meaning dentists will have to pay back tens of thousands of pounds each.
In the latest repercussion of the troubled dental contract, clawbacks are threatening to put some practices out of business and may persuade many more dentists to leave the NHS, the British Dental Association (BDA) says.
Thousands of patients across England are still said to be struggling to find NHS treatment, and yet about five million fewer treatments were carried out in 2007-08 than were budgeted for by the health service, figures show. This represents a 5 per cent rise in the amount that dentists will be expected to pay back, in the second year of a new pay contract that has been heavily criticised for creating a “drill and fill” culture and failing to improve access to NHS treatment.
In the past dentists were paid a fee for each treatment they provided but, under the dental contract introduced in 2006, they receive an annual income for carrying out an agreed amount of NHS work, measured in “units of dental activity” (UDAs).
Dentists, however, say that the only way to reach targets is to take on quick jobs, such as extracting a tooth rather than carrying out root canal surgery to save it, because both treatments have the same UDA value.
About 1,000 dentists opted out of providing NHS services when the new contract came into force, meaning that 900,000 fewer patients were seen in 2006-07 than under the old system, a report by MPs found this year.
The Health Select Committee suggested that dentists were being set unrealistic targets for NHS work and that a failure to meet targets in the first year of the contract meant a loss of revenue for the second.
The latest figures, obtained under the Freedom of Information Act by DPAS, a company that provides private dental plans, suggest that some regions have experienced particular problems.
In Leicester, for example, more than 50 per cent of UDAs have not been delivered and 21 dental practices face repayments of £50,000 or more.
Across the country, 89 per cent of primary care trusts responded to a survey that found a total of 411 contracts where targets were missed by £50,000 or more.
Peter Ward, the chief executive of the BDA, said that dentists who failed to meet their targets in the first year were likely to have failed to do so again last year, creating a “roll-over effect”.
He said: “Once again this highlights problems with a target-driven contract that contains one crude measure of performance, which has long been criticised by the profession and patient representative groups.”
Quentin Skinner, the chairman of DPAS, said: “For those dentists who fell rather short of the mark, the future for them in the NHS certainly looks bleak.”
Barry Cockcroft, the Chief Dental Officer for England, said: “The Government is committed to growing NHS dental access year on year. This is why increasing the number of patients seen has been made a national priority for the NHS – and backed up by an uplift in funding of 11 per cent (£209 million) this year.”
“The increased focus and funding is already starting to show results, with 655 more dentists working in the NHS in 2007-08 than the previous year and 36 million courses of treatment delivered compared with 35.1 million in 2006-07,” he added.
Mike Penning, a Conservative health spokesman, said: “It is extraordinary that [these clawbacks are] happening at a time when over one million people have lost access to their NHS dentist in the last two years. These figures show, yet again, why we need to rip up Labour’s botched contract and move towards a registration system based on clinical need, one that is targeted at preventing dental ill health rather than reacting to it.”
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The NHS dentists are overpaid and then they walk out ?
Try some logic, people!
If dentists who used to work for the NHS have left a safe job with an index linked pension there must be something very wrong with the system-try costs per dentist of £110K pa not paid for by the NHS.
tim moody, taunton, somerset
Most government officials and the public take for granted the dentist. The dentist went to school extra, studied extra deals with all types of patients all of whom have different health and bacterial load status. the public believes that they are making too much. How come only 3% can retire?
brian, downers grove, usa
Consider this, NHS dentists will see around 60 individuals a day; consider the time available for each person and now consider the quality of work that the dentist is able to achieve while working under that kind of pressure! They're paid for a WHOLE course of treatment so not even an hourly rate!
Rachel, Yeovil, Somerset
The NHS fee payable to a dentist for a clinical exam and report is about £8.Say about 5 an hour? Try covering the costs of running a small business (nurse, reception, loans, insurance etc) on that hourly rate and you can see why the only option is to take on private work.
Mathew, Lisburn, UK
Another brilliant Labour innovation.
Justin, Hong Kong,
I thought dentists made their exodus in 2004. I was forced into private care and my dentist had the temerity to write me last year to say that if I did not show in the next 6 weeks for another private exam', she'd remove my name from her records. Perhaps all the 1000 opt-outs are in Cambridgeshire!
Annie, Cambridge , UK
Kim,
Are you suggesting that everyone that has been put through university at the tax payers expense be signed into the civil service?
My bank manager went to university paid for by the tax payer. How do you propose you limit his working to serve the public?
Neil Harris, Gloucestershire,
Aren't dentists, like doctors, trained via the taxpayer? If so, then why are we paying to train a profession that will not treat us unless we pay them privately?
Maybe the government should stop paying to train them unless sign a caveat saying they will treat us on the NHS!
kim, london,
They should be the same as everyone else. If they are over paid then they should pay it back. Prosecute those who dont for fraud or deception.
andy, london,
If the NHS applied the same rules to doctors, your local GP would be allowed to saw your foot off, but not to treat your diabetes.
Frank Upton, Solihull,
Why moan at dentists earning a fair wage.They are professionals, who are the among the brightest and hard working people in the country.I bet the majority of people spend more on their hair cuts than they do looking after their teeth.You want the best dental care, then you pay for it.
alistair, Birmingham, UK
655 more dentists? More and more are working part time. A three surgery practice may be staffed by 6 dentists throughout the week. These are all counted using Barry's stats. Dont be fooled.
Paul, Wirral,
Returning after 20 years to the UK for a visit I was shocked at non-NHS availability of treatment (yes have paid contributions) and at the huge cost of private. Dentists seem to have become gold diggers not gold (or amalgam) fillers.
Phil, Hong kong,
The problem is that dentists are pure greed. Long gone are the caring health professionals in dentistry who prioritise patient care - it's time the DoH redesigned dentistry and cease contact with private practitioners completely. More pure NHS practices on the high street are needed.
Nick, Derby,
it not jsut about quantity of practices it is also about quality - and the targets should be based on quality of treatment not on quantity - to rush a filling means that filling needs to be replaced quicker...contracts all wrong someone needs to admit it.
Amit Hindocha, birmingham, uk
So we can expect our Dentists to propose unnecessary filings and extractions of healthy teeth in order that they can meet their NHS targets? Not the sort of incentive the country needs to encourage more trips to the dental surgery.
Bob, Reading,
The bell tolls for the NHS.....RIP.
Raj, Nairobi, Kenya
Tell us what the average dentist earned after the payback?
campbell, Southampton,
What the CDO fails to point out is that nearly all the new dentists are recently qualified foreign dentists who end up staying for a couple of years. These are the 'extra' dentists - whereas UK trained and qualified dentists are enthusiastically looking for work in the private sector.
Merseymike, Liverpool,
Allowing the NHS Dentist and hospital Consultants to straddle both NHS and private work simultaneously enables them to have a cake and eat it. Let them choose only one, then there will be true competition. The fee and availability of both NHS and Private service will improve
raj, harrow, uk
So this explains why suddenly my local dentist opened his patient list to new NHS patients I think.
From services provided so far, I am certain I will NOT be getting the full treatment I desperately need (instead of pain management) and deserve for having paid into the system.
It's a disgrace
Somė, Manchester, UK