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Wales contract update
30th Mar 2006
Dentistry magazine highlights the contract controversy in Wales. The NHS regulations governing the Welsh dentistry profession have been approved minus a major change it had once been intended to incorporate. Welsh health minister, Brian Gibbons had been forced by the National Assembly’s health committee before Christmas, to concede a change to the new contract – which is almost identical to the English document. Opposition parties on the Labour-run Assembly had forced through a change allowing NHS dentists to give priority of admission to their lists to young people. But when the final contract was presented to a plenary session for debate, Dr Gibbons reversed his earlier agreement. He argued no change to draft regulations was needed. He said the intended effect of the change ‘is already covered in the regulations’. Dr Gibbons, a GP said: ‘It will be for the local health board to consider, when negotiating a contract with a contractor, whether needs in a particular area are such that a contract should specify that services will only be provided to a particular category of persons. He added: ‘LHBs will wish to consider the provision of dental service to vulnerable groups, including children, and this will be covered in guidance.’ Despite this, Jenny Randerson, Liberal Democrat health spokesman, tried to force through an amendment obliging LHBs to improve preventive care for children. She failed when insufficient Plaid Cymru and Conservatives turned up to vote – it is understood they realised success was unlikely as one Tory AM was on paternity leave. Mrs Randerson said afterwards: ‘In areas such as Pembrokeshire, where only 15% of people are registered with an NHS dentist, it is necessary to take emergency measures. The minister is content to leave the issue to LHBs, but some boards, such as Powys, cover vast areas where conditions will vary considerably.’ Mrs Randerson also failed in to increase the contract’s emphasis on preventative care. The minister replied: ‘prevention should be absolutely intrinsic, not only to discrete episodes of dental care, but to all stages.’ Afterwards, Stuart Geddes, BDA Wales director, said he was still concerned that there was no specific UDA, ‘that there is no reward for preventative care’. Facing opposition gibes about when Tony Blair’s 1999 pledge of dental services for all would be achieved – and whether it applied to devolved Wales – Dr Gibbons replied that no one knew what proportion wanted NHS dental services. He suggested it varied between 75 and 90%. The minister added: ‘We have changed the contractual arrangement, and we are putting in the necessary investment in training, and that will, hopefully, put us in a position whereby the people who want NHS dental treatment should be able to get it.’ The Assembly press office denied that the minister’s comments during the debate amounted to a death sentence on PDS schemes. From April, dentists on PDS pilots can opt for a GDS contract or for a permanent PDS agreement, revised to reflect commitment during the test period. In general, new permanent GDS contracts will be for mandatory services, and new PDS contracts for specialist services such as orthodontics.
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