§ Mr. FormanTo ask the Secretary of State for Health when she intends to announce the Government's plans for the future of the general dental service following the consultation of the Green Paper "Improving NHS Dentistry." [19125]
§ Mr. MaloneI am today writing to all dentists in England setting out the Government's proposals for the future of national health service dentistry. Ministers in the Scottish, Welsh and Northern Ireland Offices are writing in similar terms to the dentists in their countries.
I am outlining a package of reform that will ensure access to high quality oral health care for the patient, stability for the dental profession and value for money for the taxpayer. These reforms will ensure that the oral health of the nation's children continues to improve. All treatment which is clinically essential will continue to be available in the national health service, as it is now.
As set out in "Improving NHS Dentistry", all present exemptions and remissions from patient dental charges are to remain unchanged. This announcement does not include any changes to the structure or level of dental charges.
1212W"Improving NHS Dentistry" drew on Sir Kenneth Bloomfield's review of dental remuneration and the Health Select Committee's report on dental services. It set out two options for short-term reform of the current system of paying dentists. The first was a system of sessional fees which would reward dentists for the time spent treating NHS patients. This system will not be pursued as a short-term option.
The other option was to reform the current fee-based system of paying dentists and I am today announcing a package of reforms which will achieve this. The package has five components:
- (1) The Government's highest priority is to sustain and develop the improvements in child oral health. We therefore intend to improve the capitation system currently in place for the care of children by relating payments to dentists to disease levels in children most in need. Details will be discussed with the profession.
- (2) In adult care, we will introduce more rigorous prior approval procedures for monitoring treatment to ensure that the general dental service provides only those treatments which are clinically essential and for which there is no clinically acceptable, less costly, alternative.
- (3) We also wish to reform the system of continuing care payments which dentists receive for adults on their lists to ensure better value for taxpayers' money. The continuing care relationship between dentists and patients will remain. We will discuss changes with the profession. If reform proves not to be possible, the Government will reconsider the future of these payments.
- (4) We intend to develop the role of the community dental service to meet the needs of patients in areas of the country where there is difficulty obtaining NHS treatment under the general dental service. This will include, subject to Parliamentary approval and the passage in due course of any necessary legislation, allowing the community dental service to levy charges. All charge exemption and remission arrangements that apply in the general dental service will apply equally in the community dental service.
- (5) The Government also intend to discuss with the profession the issue of past overpayments under the previous remuneration system and how we can together ensure financial stability in the general dental service. Providing satisfactory progress is made in the fundamental review of dental remuneration, the Government will not rule out waivers of past overpayments.
I reaffirm the Government's aim of introducing a system of local contracts between health authorities and dental practices similar to that which operates elsewhere in the health service. "Improving NHS Dentistry", our Green Paper published last year, noted that such a system would need careful piloting and evaluation before any decision were taken on nationwide introduction. Primary legislation is required to set up pilots. Over one third of local dental committees said that they were prepared to take part in pilot schemes. The Government therefore intend to seek an appropriate opportunity, in due course, for the necessary legislation. Meanwhile, we are keen to work with the profession and other interested groups to develop the proposals further. The system of paying dentists through sessional payments, set out as an option in the Green Paper, can be tested as a part of this pilot scheme.
The Government remain committed to an accessible, high quality NHS dental service and believe that the measures now proposed will provide stability and security for NHS dentistry. They will ensure the correct balance between the prevention and treatment of disease, deliver increased quality of care for patients and promote better use of resources by targeting areas of greatest need.
1213W
§ Mrs. BeckettTo ask the Secretary of State for Health how many patients were deregistered by family health services authority area for the periods (i) 2 July 1992 to 31 March 1993, (ii) 1 April 1993 to 31 March 1994 and (iii) since 1 April 1994. [18575]
§ Mr. MaloneThis information will he placed in the Library.
§ Mrs. BeckettTo ask the Secretary of State for Health how many patients in each family health service authority area, and in total, requested help in finding a dentist (i) between 2 July 1992 and 31 March 1993, (ii) between 1 April 1993 and 31 March 1994 and (iii) since 1 April 1994. [18576]
§ Mr. MaloneThis information will be placed in the Library. Family health services authorities consistently report that they can help patients to find national health service dentists.