The British Dental Association proposed scrapping the ceiling of 80 per cent, up to a maximum of pounds 250, on non-exempt patients' contributions to the cost of treatment. In evidence to the Government's review of the system for paying dentists, the association argued that, for most treatments, fees should be set by dentists according to what patients were willing to pay. Inspections, for which there has been a charge of between pounds 3 and pounds 11 for the past three years, would become free again. A free core service would also cover X-rays and emergency treatment. The current exemption for pregnant women would disappear.
The submission from the association, whose 18,500 members represent the vast majority of dentists, follows publication of a government-commissioned report in January by Sir Kenneth Bloomfield, former head of the Civil Service in Northern Ireland. He set out a range of options for modernising the current, complex system. They included a purchaser-provider split, along the lines of the NHS hospital sector.
The association rejects the idea of an internal market on the grounds that it would bring too much expensive bureaucratic upheaval.
The review was established after the Government was forced to withdraw a proposed cut in the fees paid to dentists following strong opposition from the profession. The BDA says that its scheme would 'avoid a repetition of the current dispute by allowing Government expenditure to be better targeted and more stable'.
David Blunkett, Labour's health spokesman, welcomed the call for the re-introduction of free examinations. But he feared that restricting a free treatment service to the poor alone always ends up as a poor service.
He added: 'Under such proposals, many inner-city dentists would go out of business or move to more prosperous areas, leaving whole tracts of the country to a makeshift, stop-gap salaried dental service.'
John Hunt, chief executive of the BDA, said the proposals had been made 'somewhat reluctantly', as the profession remained committed to a comprehensive NHS service.
He accepted that some patients would have to pay more than pounds 250 per course of treatment under the BDA plan, and that dentists could charge whatever the market would bear. 'Only about two-thirds of children, and around 58 per cent of adults, go to a dentist regularly.
'To improve on those figure requires investment of more resources, which the Government appears unwilling to provide,' he said. 'In those circumstances, someone has to suggest where priorities should be set.'
The Department of Health is expected to announce its response to the review by the end of this month.
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