Michael Watson on new contracts and London buses

New contracts are like London buses – you wait ages then three come along together. The 1990 contract was for many years the ‘new contract’. Then came another ‘new contract’ in 2006. Now it appears there are two other ‘new contracts’ in preparation. Apart from the pilot contracts arising out of the Steele Report, the General Dental Practice Committee (GDPC) has been sucked into
discussion on the ‘new contract’ proposals of Dr Mike Warburton.

In his blog, BDA chief executive Peter Ward writes that his teams have been ‘working frenetically’ to make sure members’ interests are protected. But what are these proposals? And why do BDA members need to be protected from them? And why are they a closely guarded secret?

Dr Warburton was brought in to head up a ‘dental access team’ to improve access to NHS dentistry. His remit appears to have been changed to rewriting the 2006 contract, with the help of the DoH’s commercial division. His team is working with the BDA, amongst others, to refine a ‘new contract template’. Although his work is mainly about procuring new services, his team is producing a contract management handbook to help PCTs better manage their existing contracts.

There is a distinct possibility that these Warburton proposals  will go through and that the Steele pilots will be abandoned in the aftermath of the expected Conservative victory in next year’s election. The new contracts, to be awarded for new NHS services this autumn, could be considered as sufficient piloting and then be rolled out across all practices. Everyone expects negotiations or consultations to be confidential, but the GDPC is playing with fire by not telling the profession what the issues are.

Meanwhile, NHS access figures, up to the end of June this year, brought some joy to the government. Just under half a million fewer patients were seen in the two years preceding that month compared with the figures for March 2006; this is down from 1.2 million in June last year. By the end of the year they should be back to the pre-contract figures; not exactly progress. There had also been a 1.4% increase in UDAs commissioned in the last quarter. Yes they have been commissioned but only in practices that are not yet up and working. This also takes no account of the massive under-delivery of UDAs, which stood at 7% of commissioned activity last year.

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