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GDP airs contract concerns
6th Dec 2005
GDP Anthony Lipschitz tells Penny Palmer what he really thinks of the new contract and how it will affect the profession. Anthony Lipschitz, runs a thriving dental practice in Dunstable. He has patients that are both private and NHS, but when it comes to signing the impending contract in April, he is still undecided. Speaking exclusively to Dentistry magazine, he explained why; ‘We are a typical middle England practice with 10,000 patients. Less than 10% are on income support but we still don’t know if we are going to sign the contract yet.’ So far, said Anthony, the practice has stuck with the NHS, but the Government is making it increasingly difficult. The practice employs four dentists – three of them work mainly with NHS patients – and they try to take on new patients whenever they can. ‘We are the type of practice that really should be in the NHS but the Government is proposing marriage to us in the hope that we do not accept. In my opinion it looks like an act of political vandalism,’ stressed Anthony. He added that dentists still don’t know what the Government is proposing, but is perplexed why they are still left in the cold. ‘How can they change the whole NHS without consulting us? There has been no consensus amongst dentists – they want practices like me out because it’s cheaper for them.’ Anthony said that he agreed that dentistry should be changed, but instead of chasing items per service, dentists will now be chasing UDAs and there are many questions that need answering. For example, here are just a few that need clarification; • What happens if dentists don’t achieve the right amount of UDAs? • What happens if there are shortfalls in patient payments? • Who are our patients? • What are our targets? • Who owns our patient lists? • Who is going to fund the hardware/software costs? Banding levels On the subject of consultation fees, Anthony replied that there should be more banding levels. ‘There should be a lower band because if you are a regular patient you pay more – it’s all so ambiguous and there are no definite answers.’ Computer issues are another concern. ‘We have to put in new software and hardware because of the new contract and this will cost £15,000; plus there will be more administration, but will we have the infrastructure to do this and will it be ready in time?’ Anthony feels that ‘essentially the Government doesn’t want us anymore’, and even if it did, it has spoken to the wrong people. ‘The Government doesn’t speak to middle England dentists and has not listened to our concerns. If it had funded certain things in item services dentists would have come back,’ said Anthony, adding that the government had reached a compromise with doctors, so why not dentists? With child-only lists, Anthony is honest, saying; ‘Personally I don’t think dentists should have these lists, because what happens when the children reach 18? Many fair-minded dentists would probably agree with this.’ Supervised neglect On thoughts of the impact of the new contract, Anthony said: ‘It will encourage a form of supervised neglect. It seems that the Government is clearly only interested in access, and not quality of service.’ This, continued Anthony, explains the publicity given to dentists who are recruited from overseas, as well as the disregard to middle England patients who would like to see the dentist (with whom they formed a personal relationship over many years) on the NHS. ‘I’d like to think it will be a success, I really would,’ added Anthony ‘and I’m not hoping it will fail but the omens are not good.’ But he said that it’s down to the voters now. ‘They will have to decide whether having third world teeth is a problem or not; people who can afford it will have good teeth, and those that can’t won’t.’ Anthony also said that all the proposals ‘must have cost a fortune’, and the money allocated to the contract could have gone directly into dentistry. On whether he will stay or quit the NHS he said: ‘I would like to stick with the NHS for as long as I can, but if it becomes so restrictive and ambiguous I don’t see how I can. I will do everything in my power to take the contract but it all depends on what they offer us.’ When asked whether he thought his NHS patients would change to private, Anthony replied: ‘A fair proportion would stay with us but fundamentally the NHS should be there. However, if the Government doesn’t want us we will be forced out.’ He concluded: ‘We all agree that the NHS needs changing, but there has to be a consensus. Most dentists in the NHS are middle England practices and want to continue to be in it – I just wish the government would listen to us so we could come up with something viable.’
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