Introduce a fee-per-item system, dentist tells next government

Introduce a fee-per-item system, dentist tells next government

With less than two weeks to go until the 2024 general election, Nilesh Parmar offers his views on what the government needs to do when it comes to UK dentistry.

If you go back to a time when the actual dental health of the country was good, it was when dentists had no quotas and operated on a fee-per-item service. This meant that they were rewarded for actually doing dentistry.

Currently, we have a system that only rewards dentists for doing the bare minimum. You are not encouraged to handle more complicated cases or cases of higher need because of the quota-based system, and these never work well in healthcare. A fee-per-item system with no quotas encourages dentists to do more work and be paid a fair amount based on the actual clinical work they carry out.

It’s ridiculous to think that the government believes dentistry is a fixed cost. A patient who needs one filling versus a patient who needs ten fillings represents a different cost to the dentist, and that cost needs to be covered by either the government or the patient.

More investment

When it comes to dental nurse retention, we should be making it a career. Give them access to NHS pensions and crown indemnity. Why do we have GDC nurse registration when nurses or dentists have to pay for it themselves?

They’ve been given more responsibilities and costs, which many do not want and their salary does not reflect the additional responsibility.

When it comes to the future of the health service, I don’t think it’s looking good for dentistry. The current government fails to understand what is needed and they do not have appear to have the mental capacity to understand what is needed in NHS dentistry. This is despite people like me and the British Dental Association (BDA) telling them what needs to happen. They seem incapable of listening or too lethargic, or think it’s not in their benefit.

What they need to do is simple: they need to introduce a new contract where dentists are paid for the work they do. For example, one filling is £50, and two fillings is £100.

It will require more investment. I don’t see why increasing the investment amount is an issue when we can send billions in foreign aid, but we can’t even improve the oral health of our own citizens.

We need to improve the oral health of the population. To fund this, they might consider an additional tax, such as on sugary foods or smoking. The oral health of the nation has declined and this is due to the NHS contract, which, as we’ve been saying for a long time, isn’t fit for purpose.

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