DENTISTS

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Becky Smith called an emergency number at 3am in agony on Sunday morning but she was told to travel to Catterick Garrison, 50 miles from her home town of York. Miss Smith was driven by her mother to and from the garrison, where the dentist gave her antibiotics to relieve her pain. A North Yorkshire and York Primary Care Trust (PCT) spokesman said, "The PCT makes every effort to provide access to urgent out of hours dental services throughout the week, including weekends. If anyone requires an emergency appointment they can call NHS Direct where they will either receive assistance over the phone or, depending on their individual circumstances, may be sorted and then directed to an emergency treatment centre where an emergency appointment will be made."

He added, "Due to the nature of urgent appointments they and allocated on a first-come, first served basis. Demand for weekend urgent appointments is significantly lower and so to meet current demand the PCT provides access to weekend emergency treatment centres in Scarborough and York on a Saturday and Ripon and Catterick Garrison on a Sunday. If symptoms exceed those which soley relate to tooth pain and thus constitute an emergency situation, for example extreme trauma, they should refer themselves to their local hospital's A&E department." (Source: Daily Mail, Oct/07)

Dentists are being forced to take holidays to avoid treating patients because the NHS has run out of money in some areas. The scandal reveals how the Government's reform of NHS dentistry has failed patients and dentists just a year after the controversial shake-up. Nine out of 10 dentists claim the new system, which has gone £120 million over budget, is on the point of collapse. A survey by the British Dental Association (BDA) to mark the first anniversary of a controversial contract for dentists found it failed to achieve any of the Government's stated aims.

Around 85% of dentists believe it has not improved access to NHS treatment for patients, backed up by the Government's own figures, and 93% of dentists say the system does not encourage a more preventive approach to care. In the first six months of the contract calls about dental problems to the 24-hour helpline NHS Direct shot up 43%. Some parts of the country are "dentistry deserts" of access to NHS care, according to a Citizens Advice survey.

The research comes after official figures showing the number of adults seen by an NHS dentist has dropped by 69,000 in the last year, with 11,000 fewer children now getting NHS care. Around 5,000 NHS practices, one in four, are treating too many patients too quickly and being told by primary care trusts (PCTs) to delay treatments to save money. At NHS Dentist, a practice in west London that treats only NHS patients, seven out of eight dentists have been sent on holiday because local health chiefs can't afford to meet the costs of treating more patients.

Health minister Rosie Winterton defended the system, saying, "If some dentists get through their contracts more quickly, even though it is based on what they had done the year before, it really isn't fair on the thousands of other dentists who have planned their work properly so that they can carry out their work throughout the year. It is not fair on the thousands of other dentists who are planning their work properly to be able to say 'if we get through all our work early, you will have to give us more money.'" (Source: Mail on Sunday, Mar/07)

Dentists will be required to refund £120 million to the health service because they failed to treat enough NHS patients last year. About half of dental practices have fallen short of targets for NHS treatment agreed with local health authorities, meaning dentists will have to pay back tens of thousands of pounds each. In the latest repercussion of the troubled dental contract, clawbacks are threatening to put some practices out of business and may persuade many more dentists to leave the NHS.

Thousands of patients across England are still said to be struggling to find NHS treatment, and yet about five million fewer treatments were carried out in 2007-08 than were budgeted for by the health service, figures show. This represents a 5% rise in the amount that dentists will be expected to pay back, in the second year of a new pay contract that has been heavily criticised for creating a “drill and fill” culture and failing to improve access to NHS treatment.

In the past dentists were paid a fee for each treatment they provided but, under the dental contract introduced in 2006, they receive an annual income for carrying out an agreed amount of NHS work, measured in “units of dental activity” (UDAs). Dentists, however, say that the only way to reach targets is to take on quick jobs, such as extracting a tooth rather than carrying out root canal surgery to save it, because both treatments have the same UDA value.

About 1,000 dentists opted out of providing NHS services when the new contract came into force, meaning that 900,000 fewer patients were seen in 2006-07 than under the old system, a report by MPs found this year. The Health Select Committee suggested that dentists were being set unrealistic targets for NHS work and that a failure to meet targets in the first year of the contract meant a loss of revenue for the second. (Source:Times Online, Nov/08)

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