Dentists to get salaries to cap unnecessary work

Dentists could be paid NHS salaries instead of fees for each treatment under reforms that would remove the "perverse incentive" for them to do unnecessary work.

At present, dentists are paid individually for every filling, crown or procedure on NHS patients, under a "fee per item" system relatively unchanged for half a century. But proposals by the Department of Health yesterday could mean dentists are paid fixed salaries or contracted to provide a specific level of service for a given number of patients every year.

Other options for reform, to be piloted over two years, include a simpler fee scale. The present NHS fees guide includes prices for nearly 100 procedures. Despite difficulties finding an NHS dentist in some areas, most of Britain's 18,000 practitioners derive the majority of their income from health service work and only about 1,000 treat solely private patients.

The British Dental Association says the average salary for NHS dentists is £49,000. But there has been criticism that some unscrupulous practitioners maximise their income by giving patients unnecessary fillings.

A report by the Commons Health Select Committee last year also highlighted problems accessing NHS dental services and said the payment system was driving dentists into private work. The BDA says only 39 per cent of practices are taking on new health service patients.