Last week, I attended the Westminster Health Forum seminar, in what has now become an annual event to discuss what is happening in dentistry, on commissioning, access and ‘towards the new dental contract’. I am really still none the wiser. John Milne, chair of the GDPC said he was 'positive about the direction of travel', but that there was 'still a lot we don't know'. If he doesn’t know, what hope do the rest of us have?
We have known since the beginning that the new contract would be based on registration and capitation. But what does that mean in terms of fees and, more important, patients charges? One contributor, a health economist, who I understand is involved in the process, seemed totally unaware that some patients pay about two thirds of the cost of their treatment.
Will patients be prepared to a charge to register with their dentist, which they don’t have to pay to register with their doctor? Are they prepared to pay a charge for prevention? For an appointment when, in their eyes ‘nothing is done’? This is being piloted in the second wave through interim care payments and it will be interesting to see if there is consumer resistance.
The CDO also told us that it remain a commissioned service rather than a market open to ‘any qualified provider’. Additionally, the man from the Office of Fair Trading told the symposium that they would be pressing for fixed-term contracts. In this he was strongly opposed by the BDA’s Martin Fallowfield, who pointed to the major capital investment that dentists personally make in their practices.
A distinct possibility remains that, when the new contracts come in – perhaps in under two years – dentists and corporates will have to bid for their contracts – and that these will only be for five or seven years. Competitive tendering will apply to all, and guess who will win the lion’s share.
Yes, our old friends the corporates and probably some new corporates you have never heard of, because they are not in dentistry at present. Your choice could well be work for a corporate or move into the private sector. Would Dr Milne be quite 'positive’ about that direction of travel?
It could well be a stimulus for the private market in dentistry, offering more personal care for patients with a dentist they trust. But shouldn’t the BDA be forewarning its members of this possibility, so that they can be forearmed?