§ The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)My right honourable friend the Secretary of State for Health (Dr John Reid) has made the following Written Ministerial Statement.
In my Statement on 16 July at cols. 89WS to 91WS I set out our plans for rebuilding National Health Service dentistry to ensure better access to NHS dental care and to improve oral health in England. There have been major developments since then and we have been taking stock of the timetable for further stages of the changes.
In the past six months there have been significant developments on a number of fronts,
In my earlier Statement I reported that there were already 1,500 dentists in more than 750 practices working under personal dental services (PDS) pilots. The interest among dentists in moving to these new ways of working has been very considerable. I am now able to report that we have some 3,500 dentists in 1,300 dental practices working under PDS arrangements. Furthermore there are some 500 practices with applications in the pipeline. When those applications have been approved there will be some 20 per cent of practices in PDS and the numbers of dentists seeking to move to the new arrangements is growing daily.
In November we received a report from the National Audit Office in which it acknowledged that "there is a strong rationale for reforming NHS dentistry". However, it also identified risks to the successful implementation of our reforms. The NAO was particularly concerned that primary care trusts should have time to acquire the necessary skills and resources before the full commissioning of NHS dentistry was delegated to them. We are preparing guidance and additional support for PCTs. Nevertheless we recognise that this is a major new responsibility and PCTs need to be well prepared for it.
We have made very good progress towards recruiting 1,000 whole time equivalent dentists to address access issues. The first batch of dentists from Poland has arrived in England and, following induction, will be starting work during January in the south-west, Cumbria and West Midlands. Further tranches of Polish dentists will be starting at regular intervals between now and October. We have also begun recruitment activity in other European countries, including Spain and Germany. On the domestic front the NHS locally has been recruiting dentists and the keeping in touch scheme has supported dentists back to practice after a career break.
3WSWe have addressed the backlog of people waiting to take the international qualifying exam which enables dentists from non-EU countries to practice in England. The numbers of candidates passing this exam in 2004 was 199 compared with 81 in 2003. The Department of Health in conjunction with the General Dental Council and the Royal College of Surgeons (Edinburgh) has arranged a sitting of IQE Part A in India at the end of February for dentists who wish to work in England.
The National Institute for Clinical Excellence issued guidance in October 2004 on recall intervals. It recommended that patients should be recalled on the basis of clinical need with intervals varying from three to 18 months. These intervals will move away from the current practice of many dentists who recall patients every six months.
The system reform which we will be undertaking is a complex one where we have to ensure that the component parts interconnect effectively. As the NAO report indicated we have to manage the risks associated with these changes and ensure that their implementation is fully effective. We have been making rapid progress and considering when would be the optimum time to make further changes. We have decided to continue implementing some of the changes currently under-way. It is important that dentists who want to move to PDS status should be able to do so as quickly as possible. Dentists also need to be able to take account of the NICE guidance in their day-to-day practice. The Dental Practice Board and dental software suppliers also need time to make the necessary changes to information technology systems. Major changes, such as that to patient charges, need to go out for public consultation and be subject to debate in Parliament. In that context, we are considering the recommendations of the NHS dentistry patient charges working group. We also need to take account of the NAO's constructive recommendations about managing risk. For example, strategic health authorities are performance managing primary care trusts in terms of our key objectives: buying-back additional NHS capacity from existing dentists, encouraging further transfers to PDS and matching new recruits (including international ones) to vacancies in the hardest-pressed areas. Through this process we can ensure that the changes which are introduced are in the best interests of patients, dentists and the NHS.
For all these reasons, we believe more time is needed to ensure complete system reform and have therefore decided that full implementation will now take place by April 2006. A longer lead-in time will allow many more dentists to move to new ways of working in the mean time, will enable public consultation on key aspects and the parliamentary process to be fully observed and will allow primary care trusts to prepare their new roles.
I can also confirm intention to publish for consultation the new regulations for local commissioning of primary dental services and dental charging in the summer of 2005.
4WSThe changes which we have been making to NHS dentistry are proving to be very successful as evidenced by the high level of interest among dentists in moving to new ways of working.