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My Lords, patients will benefit from a more preventive approach to primary care dentistry. Dentists will no longer be paid for each item of treatment. This should clearly free up capacity for dentists to spend more time with each patient, including more time for preventive care. The new system of patient charges will replace more than 400 separate charges with a system of three bands, making the cost of NHS dental treatment easier for patients to understand.
My Lords, I thank the Minister for that reply, but is there not a problem with this new three-band system, which I am told will be based on units of dental activity? It has not been trialled in any way. There have been extensive pilots of the new ways of issuing dental treatment but the charging system has not been piloted at all. Will it be made clear to patients exactly where they stand on this matter? I am sure that if the Government do not do so, programmes such as "Money Box" or the financial papers will make it very clear to patients that, if they wait longer and let more holes build up, they will get better value for money from their dentist. Can the Minister tell me exactly what the Government intend to do in respect of informing patients?
My Lords, the Government will ensure that in each dental surgery information is made available to patients explaining the three charging bands. It is important to emphasise that overall we will be collecting the same proportion of income from charges. The system should therefore be cost-neutral to patients over time.
My Lords, I cannot confirm or deny the figure of 48 per cent, but I can affirm that this is not the privatisation of the dental service. We provide a high standard of care for people under the NHS.
Yes, my Lords, it is hoped that more dentists will be encouraged to work within the NHS because we believe that that is a way of providing a better service to more patients.
My Lords, one of the aims of the 2002 Options for Change report was to provide incentives for promoting prevention and oral health advice and the Minister has said that that is important. Why, therefore, do the new contractual arrangements do nothing to encourage preventive care and do not specifically attract any of these units of dental activity? Furthermore, when will she appoint a new chief dental officer, because it is important to have someone in place at such a difficult time?
My Lords, I cannot confirm when a new chief dental officer will be appointed, but I am sure that the noble Lord will be informed at the earliest opportunity. I well understand the importance of such an appointment.
On preventive care, because dentists will be providing units of treatment to patients rather than drilling and filling, as in the past, we believe that they will have much more time to spend with patients and encourage them in preventive care.
My Lords, I understand that the draft contract will require contractors to provide care and treatment to any patient. Does the Minister agree that, perversely, that might mean that NHS dentists will be unable to prioritise care to those who need it most, such as children, without risking a challenge of discrimination?
My Lords, dentists will be encouraged to work with their current lists, but the noble Baroness is correct in saying that they will also be encouraged to work with whoever needs dental care. We do not believe that that will endanger any sector of the population.
My Lords, I was encouraged by the Minister's belief that the new NHS contracts will increase the number of NHS dentists available to the public. My experience is that it has worked to the contrary. Will the Government monitor that situation? Do they have any targets and, if not, why not?
My Lords, the Government will be monitoring that situation most carefully. However, the point about the new contract system is that it is a devolved one. Therefore, there will be no central targets but each PCT will be encouraged to ensure that it is providing a high level of NHS dentistry within its area.
My Lords, given that the terms of the contract mean that more people will have to pay a higher price for basic dental treatment, how does that square with the Government's drive to iron out health inequalities? Will it not accentuate those inequalities?
My Lords, the noble Earl is correct; the first call at a dentist for an inspection will be more expensive, but the overall cost to patients for treatment will be lower. It must be remembered that those people who are presently excluded from costs will continue to be so. We believe that those people are most in need of such assistance and therefore the system will not be exclusive.
My Lords, the noble Baroness is correct that there has been no piloting of the bandings, but a lot of research has been undertaken into what their effect will be. The Government are confident that banding will not have a negative effect.