Dentists and health trust barely speak’

MARK NICHOLLS The relationship between health chiefs and dentists in Norfolk has reached an all-time low following the introduction of a new dental contract last year.


The relationship between health chiefs and dentists in Norfolk has reached an all-time low following the introduction of a new dental contract last year.

And unless it improves, more dentists will leave the NHS to go private, according to Nick Stolls, secretary of the county's local dental committee.

Yesterday he told the county council's health overview and scrutiny committee that dialogue between dentists and Norfolk Primary Care Trust (PCT) had virtually broken down in recent months.

He said there were problems with payments to dentists, that the amount the PCT received from the government was insufficient, dental out of hours services were poor and there was a growing waiting list for orthodontics.

Mr Stolls added: “The only contact we have had with the PCT is two letters, both of which we found aggressive and very unhelpful.

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“If dentists are pushed only a little bit harder, morale is so poor that more are going to go private.”

Dentists also had concerns over whether there would be sufficient funding from 2009 , after cash for dental services was no longer “ring-fenced.”

Mr Stolls told the watchdog committee that the PCT had made changes to its dentistry management team and a rapport was again starting to develop but added:“We still have grave concerns about the future of dentistry.”

The PCT was also accused of not using money for NHS dentistry that was released after some dentists went private.

PCT finance director David Stonehouse told the meeting that under the funding arrangements, the PCT - which is £49m in debt - had been left £2.5-£3m short and because of its financial position was unable to make the funds up from elsewhere.

He said:“The PCT has had to take some difficult decisions and we have had a year-end overspend on the dental budget of £800,000. It is not true that we have underspent to pay off our deficit.”

He accepted that the financial position had left some north Norfolk patients at risk of not being able to get dental treatment and moves were in place to invest in dental services in that area.

Mr Stonehouse said there had been scope to improve the dialogue with dentists and that a review of dental out of hours services was being planned.

Former dentist Tony Darwood, the chairman of the PCT's public and patient involvement forum, said: “The new contract is a bad deal for patients, a bad deal for dentists and a bad deal for the PCT.”

Committee member Derek Baxter said: “The PCT must note that this committee is gravely concerned with the situation as it stands and it must establish a rapport with dental practitioners in the county.”

The committee asked the PCT to report back in six months on progress made.

t Dentist Barrie Lawrence, who has just retired after almost 40 years in the profession, believes there have been significant changes in dentistry in that time.

Dr Lawrence bought a practice in Norwich in the early 1970s and later opened a second practice in Aylsham.

Now recently retired at the age of 62, he plans to spend more time travelling and working with Aylsham Community Church, where he worships with his wife Wendy.

He said: “I think a lot has changed in dentistry.

“There is more demand for dentistry, people's expectations have risen - they do not just want their teeth ripped out now when it hurts. People are now more genned up on what they can have done.

“In recent years we have seen a big increase in private dentistry, where people are prepared to pay for their treatment, though it is a problem that sometimes people cannot get an NHS dentist in some areas.”

He said that in the current climate, there was a degree of insecurity among dentists.

Dr Lawrence said: “People do not know what is going to happen. I do not think the future is very clear. There are a lot of decisions that have to be made over the next two to three years and while it is not all bad, there are some serious anomalies.”

He said the payment system within the new contract created a potential disincentive to do “extensive or sophisticated treatment” and dentists could be reluctant to take on patients needing complex treatments.

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