Patients and Dental Laboratories Suffer Under NHS Contract

NOTTINGHAM, England, March 30/PRNewswire/ -- The new NHS Dental Contract has been slammed by Richard Daniels, Chief Executive of the Dental Laboratories Association, for delivering bad service to patients and forcing many dental laboratories out of business.

The Dental Contract altered the way that dentists are paid for the NHS work they carry out for patients. Instead of being paid per item of work, dentists now receive regular lump sums which they must then spend on NHS patient treatments, salaries and running costs.

Speaking to Today, the BBC's flagship current affairs radio programme, Mr Daniels said, "Since April 2006, when the new contract came into effect, complex treatments were effectively removed from the NHS. Dentists have been put in a perverse position where the more they prescribe, the less they will earn."

Skilled technicians at Britain's dental laboratories create crowns and dentures for patients, which are then fitted by the dentist. But the funding that the Contract allocates to dentists to carry out certain procedures often does not meet the real cost of the treatment. As a result, some dentists are prescribing less expensive and less suitable treatments.

"If you look at a patient who needed a tooth replacing on the old 'fee per item' system, they would normally have been given a crown. Under the new system they're being given a one-tooth denture, because there is a much greater cost incentive to do that, in terms of time and materials," Mr Daniels explained. Similarly, where a patient might once have been prescribed a chrome denture with greater strength and comfort, they may be given a cheaper acrylic alternative instead. The Daily Mail reported that "in the year since the start of the new contract, dental laboratories have seen a 90
per cent fall in the number of chrome dentures the NHS is ordering."

Patients are losing out because they may receive a less satisfactory treatment, and laboratories face lower workloads which are starting to mean that their business is no longer viable. When they close, the dental technology industry will permanently lose a highly skilled workforce, limiting the availability of new dental techniques for patients in the
future.

Mr Daniels warned, "The dental laboratories are just like coalmines. Once they close, they'll never re-open. We're losing an awful lot of skills at the moment and to compound that problem, dentists trying to cut costs are now
looking to go overseas for their laboratory work. So some NHS patients may end up with work made by companies outside the EU like China, India and Africa, which unfortunately are not governed by the same regulatory responsibilities as UK laboratories." These regulations protect patient safety by ensuring that only non-toxic and non-irritating materials are used in appliances made by British dental laboratories. Without those safeguards, dentists ordering work from unregulated countries may inadvertently be putting their patients at risk.

"Yesterday I was having a conversation with a group of dentists at the British Dental Association - and they told me that prescribing has been set back by 20 years as a direct result of the contract," Mr Daniels said. "Patients are not receiving the same complex treatments that they were on the previous system. The whole system is geared towards the dentist being put under extreme financial pressure so that they can't make the appropriate treatment, and decisions on treatment are being made based on finances rather than clinical need."



Visit: www.dla.org.uk



Note 

The Dental Laboratories Association is the UK trade association for dental laboratory owners and has been established for over 45 years. It has around 1000 member organisations employing approximately 75% of the UK's dental technicians.

Dental Technicians work to the prescription of a dentist in order to design and construct dental appliances, which are supplied to dentists across both the NHS and private markets. Dental appliances comprise: Crowns, Bridges, Implants, Inlays, Veneers, Dentures, Orthodontic appliances, Mouthguards, Anti-snoring devices

(2/4/07)