NHS accused of wasting money
If Professor Tim Briggs took a closer look at NHS dentistry what would he find, Michael Watson questions.
A report in The Times last week caught my eye.
It said that Health Secretary, Jeremy Hunt, had endorsed a report that concluded the NHS is wasting money on poor care.
The author, Professor Tim Briggs, an orthopaedic surgeon, said hospitals do not ‘deserve more money until we put our house in order’.
The Health Secretary said the NHS could ‘improve care and eliminate waste at the same time’ by reducing the variation in treatment between hospitals.
The report focused on general surgery, but it is part of a huge project considering 34 specialisms covering 90% of activity in hospitals.
So, the report is about surgery and hospitals, not primary care in dentists’ practices.
So, we needn’t worry – or should we?
Now, before you put pen to paper or finger to keypad, I recognise that for dentists it is an article of faith that NHS dentistry is very cost efficient and represents good value for money for the taxpayer or charge payer.
And for most of the first 60 years of the NHS this was true.
Dentists worked extremely hard for derisory fees, providing a great deal of treatment to whomever wanted it, but were rewarded with a cut in fees if they did more than the Government said it could afford.
But where might Professor Briggs turn his eagle eye in NHS dentistry today, and who knows he might, what would he find?
He might wish to know why two practices in the same area, perhaps the same street, are paid wildly different UDA values.
He could well query why the NHS pays the same for a course of treatment consisting of an exam and a single filling, as one containing multiple fillings and perhaps endodontics.
He might question why a simple course of treatment of an examination and bonded crown in Scotland costs the NHS about £150, but in England costs maybe double that.
One of the examples he quoted in his report was that £23 million a year was wasted by some hospitals keeping patients in bed for 10 days when at the best ones they are discharged after five.
If he looked at dentistry he might ask why, 40 years after the late Professor Aubrey Sheiham asked whether the traditional six-month check-up was necessary, this recall interval is still the norm in many practices.
How much money could be saved by only allowing a yearly examination for adults?
And would that money not be better spent on providing children with a dental check by the age of one?