NHS Dentistry

My honourable friend the Minister of State (Rosie Winterton) has made the following Written Ministerial Statement. Last year Harry Cayton, the national director for patients and the public, led a working group that reviewed charges for National Health Service dental treatment. Representatives of patients and consumers and dentists were among those who made a substantial contribution to the work of the group. We have been considering the group's report against the background of the changing patterns of treatment in personal dental services (PDS) contracts that are being piloted in parts of the country. I have accepted the working group's recommendation for a new system of patient charges based on three bands, related to the complexity of the treatment provided. The new system will be fairer, reducing the maximum cost of NHS dental treatment by more than half and maintaining the existing exemptions for children under 18, new mothers and those on income-related benefits. These exemptions cover 25 per cent of all adult treatments provided by the NHS. It will be simpler for both patients and dentists, moving from 400 individual charges to three price bands, and it will be clearer, so that patients know how much they are being charged and what treatment they will receive for their money on the NHS. The new system will also provide good oral health for patients and reduce the burdens of administering the dental charge system for dentists. It will not increase the proportion of revenue raised from patients' charges. Today I am launching a three-month public consultation process on the draft regulations for the new patient charges system. The new arrangements will apply throughout England. I am placing copies of the consultation document in the Library. During October, we will analyse the responses to this consultation. Before the Christmas recess, draft regulations will be presented to both Houses for affirmative resolution. The new system will come into effect in April 2006. Alongside the proposed changes to NHS charges, I will be publishing an outline of a new contract for NHS dentists. This will encourage the promotion of good oral health and pay dentists for the overall service they provide to patients, rather than on a ““fee for service”” basis. I will shortly be making available the draft regulations on these new contractual arrangements. Before laying the regulations before Parliament, we will be discussing their content with the profession, NHS management and other key stakeholders—so that effective, workable local contracts can be agreed in order to deliver our commitment to modernise the general dental services (GDS) contract by April 2006. The regulations will include important changes to the current terms of service including compliance with recent guidelines from the National Institute for Clinical Excellence on recall intervals for patients. Both the new system of patient charges and the new contract for dentists build on the steps we have already taken to improve dental care for NHS patients, including investing £368 million in dental services in England. In the past six months we have recruited the equivalent of 849 dentists towards our target of recruiting the equivalent of 1,000 by October 2005. This has been achieved through domestic and international recruitment and making available additional capacity from existing dentists to NHS patients. Alongside this, we are funding 170 extra training places for dentists in England—a 25 per cent increase compared with 2004–05, supported by capital investment of £80 million over four years to improve facilities in dental schools. The NHS locally has been working hard to recruit dentists and the Keeping in Touch scheme is supporting dentists back to practise after a career break. We have also speeded up the process for people waiting to take the international qualifying exam (IQE), which enables dentists from non-EU countries to practise in England. One hundred and ninety-nine candidates passed the IQE in 2004 compared with 81 in 2003. PDS pilots have expanded from 3,500 dentists in 1,300 dental practices to over 6,000 dentists in 2,200 practices. The proportion of dentists now in PDS is 30 per cent. These dentists are enjoying new ways of working that are also proving popular with patients. Taken together, these actions will improve both the short and longer-term supply of dentists for the NHS. Against the background of these developments, we have been reviewing the position of PDS contracts. The new ways of working in PDS have benefited patients and dentists alike and from next April will be available to all dentists under the new GDS contract. I have therefore decided that it is best for most of those dentists, who have not already moved across to a new contract, to do so next April through the new GDS, rather than in piecemeal fashion between now and then. In this way, we can ensure that the lessons of best practice in PDS have been fully learnt and that we obtain value for money for the taxpayer under the new GDS contract. We will be talking to key stakeholders about these developments. The Department of Health will process applications which it has already received and a number of other exceptional applications between now and next April. Significant numbers of dentists will have moved across to PDS before April 2006. However, the majority will still need to transfer to new contractual arrangements at that point. We are looking to primary care trusts to engage with those dentists in the coming months and secure their commitment to NHS dentistry under the reformed system. I can now confirm that the date for full implementation of these dental reforms will be 1 April 2006.