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Contract war gathers pace
6th Dec 2005
A delegation of 70 dentists from the federation of London Local Dental Committees met with a dozen MPs last week to express concerns about the new arrangements for NHS dentistry, due to start in April 2006. Chris Audrey, head of primary care policy at the Department of Health (DoH), replied on behalf of the Government, revealing that in London there are no significant problems with access, and he strongly hinted that noise (for example, queues, tabloid headlines, backbencher questions) was a key motivating factor in getting action from the DoH. To the disbelief of dentists, he said that PCT allocations are not capped, and will in future contain an element of growth. Dentists who have been negotiating with PCTs did not believe this was the case. When asked what dentists should do if they managed to achieve their Units of Dental Activity (labelled the new treadmill) targets after nine of 12 months, Chris Audrey said, ‘renegotiate your contract with the PCT’. Dentists laughed at this, to the shock of MPs, replying that they had no confidence or reason to believe the PCT would have neither the funding nor the inclination to grow their contract. There was a total disagreement on whether the new contract is based on PDS pilots. Dentists said it is untested and unproven and Chris Audrey disagreed. He was asked if he knew of PCTs taking money away from dentists and being reallocated to other projects. London dentists have experienced this, and they gave examples. The issue of London weighting was raised by DPA and GDC man Amolak Singh. Chris Audrey said there is already a London weighting being factored in automatically by local Primary Care Trusts. The federation listed a number of concerns, which the DoH countered. The concerns included: 1. The new regulations will reduce the number of dentists working in the NHS, therefore making access to NHS dentistry harder, not easier 2. The proposals imply that dentists will be expected to treat more patients, with better quality, for the same money 3. Dentists are small businessmen and are expected to fund new practice, which can cost £40,000, and comply with increasing legislation, all for no extra funding or recognition 4. No London-weighting 5. PCTs have massive deficits and they do not understand dentistry. There is no confidence they will get sufficient funding to maintain current levels of NHS care 6. Why are patient charges increasing, but yet dentists’ incomes are to be capped for three years? 7. Root canal therapy gets the same funding as an extraction. Root canal work can take up to four hours per tooth, whereas an extraction can take four minutes. This will encourage the very opposite to a preventive approach, removing natural teeth, prejudicing long-term oral health. 8. And much more. The federation, which represents 1,600 dentists in the London area, contacted local MP John McDonnell, member for Hayes & Harlington, and requested an audience with MPs. Under the title, ‘The 2006 dental contract will cause more toothache’, the special meeting was held in the grand committee room in the House of Commons, preceded by a document, which bullet- pointed concerns. This was sent to the minister for health responsible for dentistry – Rosie Winterton. The special meeting was dogged with misfortune. This was because the Health Bill, the same piece of legislation they were complaining about so vociferously, was going through a second reading. All MPs sympathetic to the plight of dentists were debating the Bill. The meeting allowed dentists to let off some steam about the proposed new arrangements. It served to highlight dentists’ total lack of trust in the government’s willingness and ability to guide and direct PCTs with the funds they are given.
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