Dentists 'turning away poor children'

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Political Correspondent

An urgent review of the way dentists are paid for treating children was called for by Labour yesterday in the light of figures showing wide variations in the numbers registering under the National Health Service.

Tessa Jowell, a Labour health spokeswoman, said the Government's capitation scheme for paying dentists had created a service favouring children from more affluent areas and turning away those in most need of treatment.

Figures she has obtained show Lambeth, Southwark and Lewisham, all in south London, with the lowest proportion of under-18s registered with an NHS dentist - 42 per 100. The area was followed by Wolverhampton, West Midlands (44), Greater London (48), Sunderland (51) and Liverpool (54).

Dorset had the highest number, 71 per 100, followed by West Sussex (70), Hertfordshire (68) and Avon (67).

Ms Jowell said that the areas where fewer children were receiving NHS treatment corresponded with those where tooth decay was highest. In a letter to Stephen Dorrell, Secretary of State for Health, she blamed the changes in the funding of NHS dental work introduced in 1990.

Under the capitation system, dentists receive fixed payments for treating patients, giving a financial incentive to dentists to take on children with better teeth and turn away those in more in need of help.

Ms Jowell, who checked her conclusions with an academic dentist and a health authority chief dental officer, said many dentists found the rate of remuneration so uneconomic that children were turned away from practices if their initial examinations indicated they needed extensive treatment.

"The present system of paying dentists ... discriminates against poorer children who have higher levels of tooth decay due to a poorer diet," she said.