Tories ponder hygienist options

The Conservative Party is investigating proposals to ‘free up’ dental hygienists to allow them to practise in the high street without the need for referrals.

Mike Penning MP, who was recently appointed the party’s spokesman for dentistry, said he hoped to launch his party’s response to the government’s ‘fatally flawed’ contract later this year.

But he revealed to Dentistry that he wanted to ‘look into freeing up dental hygiene’ as part of a drive to increase access to health services. Mr Penning said dental hygiene work ‘tends to be done inside a dentist’s surgery’.

Changes to the law in July 2006 enabled hygienists to set up stand-alone high street practices – but patients are still required to obtain a referral from a dental surgery before they can be assessed or receive treatment.

Since the reforms, just a handful of dedicated dental hygiene practices have opened across the country, including two in the north east, one in Brighton, East Sussex, and one in Somerset.

It is understood the Tories will investigate the possibility of further relaxing the rules. One option would be to let oral hygienists operate in a similar way to physiotherapists, who refer their patients up to a GP if required, rather than forcing them to seek permission from above to carry out a basic assessment, as is the case with dental hygiene.

Mr Penning said most oral hygiene treatment currently had to be done within dental surgeries, adding: ‘I don’t think that’s right in the 21st century’. Any reform would seek to support ‘qualified people’ and not ‘cowboys’, he stressed.

The Department of Health, asked to respond to the Tories’ idea, said it was ‘focusing on bedding in the new dental contracts and making sure we get that right’. A spokesman added: ‘It is more the responsibility of local primary care trusts to make sure they are delivering services to meet the needs of local patients.’

Mr Penning, who replaced Andrew Murrison as the shadow spokesman for dentistry in July, confirmed the Conservative Party remained dissatisfied with the dental contract, introduced in March 2006.

While GP contracts ‘seem very good for GPs but not brilliant for patients’, he did not think the dentists’ contracts ‘are very good for anybody’. He said: ‘I am definitely looking again at the dentistry contract. Everybody knows it is fundamentally flawed, and doesn’t give value for money for taxpayers.

‘It doesn’t provide advanced treatment and it doesn’t give incentives for dentists to do intervention work, getting in there for oral hygiene early on rather than emergency work later.’ In this way, he said, the contract was ‘perverse’.

Mr Penning, who represents the Hertfordshire seat of Hemel Hempstead, added: ‘We would really like to see encouragement through the contract for preventative work. There would be huge savings because there won’t be so many extractions going through the system.’

The Conservative Party’s health team, led by Mr Penning’s boss, shadow health secretary Andrew Lansley, have yet to respond to the party’s public services policy review, published in September.

The review, led by former health secretary Stephen Dorrell, set out a series of recommendations to help the party leadership formulate its manifesto for government. They included a proposal to locate dentists‚ surgeries in ‘health villages’, along with a range of other health services to make delivery more efficient and to ‘relieve pressure on resources’.

The review, which is not binding on the party leadership, also featured a call to create ‘an intelligent and value-for-money system that moves back to individual patients registering with a dental practice’ and delivered oral health, education and health promotion programmes.

The group said the result of the new contract had been to ‘undermine commitment to the NHS within the dental profession as well as undermining the ability of patients to secure access to an NHS dentist’.

Its report, Restoring Pride in Our Public Services, said: ‘We propose the next Conservative Government should work with professional and patient groups to develop a new primary dental service contract that ensures equitable access to dental services.’

By Andy Tate, parliamentary correspondent

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