More for less

Barely was the electronic ink dry on last week’s blog, asking why we were waiting for the consultation document on contract reform, than the Department of Health (DH) published four papers introducing an ‘engagement exercise’ on ‘the way forward’.

Now I am not conceited enough to think that the blog jolted the DH into action, but it comes just under a week before the LDC Conference.

It will no doubt fuel discussion amongst the delegates.

One section in particular may catch their eye.

It is in the first paper and gives the elements of NHS dentistry that are not expected to change.

Expenditure on NHS dentistry is not expected to alter and the scope of NHS care is expected to remain unchanged.

At the same time the Government is committed to reforming the current dental contract ‘in order to further increase access’ and improve oral health, particularly of children.

More people seen and improved oral health.

Looks at first glance like the same money to see more patients and deliver better oral health for them.

Put bluntly more work for the same funding.

However the department might well point out that, in the second paper, mention is made of the difficulty of moving patients away ‘from the very established idea of the “six month check-up"’.

Put simply they expect dentists to see more patients but see them less frequently.

In that way the circle may be squared.

There is another aspect, highlighted by a report from the National Audit Office last year. It noted that ‘the current government, like the one before it, sees contracting out as a way to reform public services and improve value for money’.

This process, often called outsourcing, means delivering better and more services at reduced costs.

In NHS dentistry it means that corporates are in a much better position to deliver ‘more for less’ than the traditional one or two dentist practice.

The ones who will pay the price will be, as always, the associates, who will be expected to do more work for less money.

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