Letter: Competition in dental care

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Sir: Your leading article (7 May) on the British Dental Association's response to the Bloomfield Report on dental remuneration seriously misrepresents our proposals. Governments have continued to raise NHS dental charges over the years, the most recent rise to 80 per cent being last month. Where was the protest from the Independent then? This erosion of funding has gone so far that the state's contribution to adult treatment is about pounds 10 per patient per year - not enough to pay for an average filling. We believe that the time has come to face reality and target this meagre amount where it will do most good.

Your statement that 'consumers are virtually powerless to control prices in health markets' is at variance with the reality of economics and dental practice. A dentist who raises fees by a greater amount than the market will tolerate will lose patents in the same way as you would lose readers if you raised your price to pounds 5 per copy. Even now, patients make choices between, say, a crown or a filling.

Under our proposals the free examination will be restored, which means that two patients in five who now pay will pay nothing at all. Two-thirds of all patients will have free treatment or pay less than they are paying at present. Some will pay more, but a 'proper market' will develop, despite your misgivings.

What could be more 'proper' than genuine competition between more than 18,000 practitioners, where patients are free to choose their dentist, and can accept or reject treatment? Your comparisons with existing private charges and the US are misleading - the former because the market is currently small and the latter because of the intervention of third-party funding.

The screening examination lies at the heart of any preventive programme. Not only are dental caries and periodontal disease diagnosed and monitored, but life-threatening conditions such as oral cancer are detected. The patient who attends regularly and follows advice on diet and oral hygiene measures will have a positive financial reward in the form of lower charges. Dentists will have an incentive to offer a quality service. We believe that our proposals will be good for patients, as well as dentists.

Yours faithfully,



General Dental Services Committee

British Dental Association

London, W1