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Your contract needs you: Lord Howe

Michael Watson reports on the health minister's speech about the new dentistry contract.

Key points

  1. Prototype contracts will start in 2015
  2. Change will be evolutionary not revolutionary
  3. Online consultation documents out in a few weeks
  4. Capitation will be central to remuneration
  5. 'Don’t mistake my caution for hesitancy' said Earl Howe.


Echoing the famous first world war saying, health minister, Earl Howe, urged all dentists to become involved with discussions over the next six months.

Speaking at the British Dental Association’s (BDA) conference in Manchester the minister set out a timetable for the implementation of the promised new contract.

But the profession must wait before it is finalised.

'The one thing I have consistently felt about the new contract is that we need to get it right' he said.

'Change will be evolutionary not revolutionary', the minister insisted.

The intention is in 2015-16 to move from pilots to prototype contracts.

These will test not just elements of the system but whole versions of a new contract.

At first these will be adopted by a select number of practices, with a view to rolling them out later on.

Lord Howe said he did not wish dentists to mistake his ‘caution for hesitancy’.

He remained totally committed to contract reform and as keen as ever to move forward.

'However,' he said, 'this is too important a mission to allow me to brush aside all the uncertainties.'

The clinical pathway will remain central to any new system.

But the Government also remains committed to improving access and quality.

So any new remuneration system must take all these factors into account.

Capitation will be a central part of remuneration, together with some payment for quality.

But the minister said that 'some elements of payment related to activity, may be needed to deliver a balanced system.'

The minister said that any new system must command ‘confidence amongst the profession’.

He was therefore announcing an ‘engagement exercise’.

This will focus on broad themes around clinical care, measuring and monitoring outcomes and performance, business issues and remuneration models.  

Lord Howe wants as many dentists as possible to participate in this exercise.

As he said, borrowing a phrase from 100 years ago: 'Your contract needs you!'

Consultation documents will be prepared over the next few weeks to inform those participating.

Decisions will be made in the early autumn about how the prototype contracts will look in 2015/16.

The minister summed up his messages by saying that the Government continued to be committed to reform.

The change that will bring about reform of the dental contract will be evolutionary and not revolutionary.

There will be no big bang.

‘That is an assurance which I hope will relieve rather than disappoint’, he said.

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The whole pilot scheme is a mess and there are so many problems with it, from long waiting lists, to, loss of income for type 2 and type 3 pilot practices, plus a significant fall in patient charges. It can not be done, the way Jimmy Steel and the DOH were marketing it when they stated it as any "wet handed" dentist who has not spent his whole working life in an academic environment, treating 3-4 patients / day could have told them from the very beginning.
What patent pap the Lord Howe spouts! I am extremely pleased to have 'jumped ship' from the NHS when the last ill-thought out dogs breakfast of a contract was imposed from on high in 2006. Best of luck with the latest nonsense, those foolish enough to continue to suckle at the NHS teat........
It would have been a better article IF it had reported on the Questions put to the Minister at this session. The first question was about the terrible price our Profession is paying for the Stress and Bureaucracy by NHS managers who are unaccountable to anyone it seems, for increasing pressures and acting aggressively, often the last straw in dental Suicides and stress-related illnesses :( My Question was asking the Minister to admit that the current NHS dental system in England cannot meet all the Nation's clinical needs and thus is limited to start with - we must not replace the current Big Lie with an even BIGGER LIE after the general election next year! He had seen the letter in the Telegraph and noted I was unimpressed with DH responses which were stuck in denial etc. To Lord Howe's great credit, he admitted publicly the NHS Dental system in England is limited !!! That is a first and worthy of reporting too, surely? Yours proportionately, Tony.