Government Responds to Health Select Committee
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- Published: Friday, 15 December 2023 10:03
- Written by Peter Ingle
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The Government has now responded to the House of Commons Health and Social Care Committee inquiry into NHS dentistry, held in the summer. According to the UK Parliament website the Government has accepted the “majority of MP’s recommendations on NHS dentistry”.
In the Committee’s report, published in July, Ministers were called on to end a ‘crisis of access’ that had led to unacceptable levels of pain and distress.
The report made a number of recommendations, and Victoria Atkins, Minister of State for Health and Social Care dealt with each in turn in her response. NHS Dentistry: Government Response to the Committee’s Ninth Report of Session 2022–23 - Health and Social Care Committee (parliament.uk)
The first recommendation was that the Government set out how it would achieve its stated ambition for NHS dentistry, to be available to everyone who needed it, and give a timeline for its delivery. This was accepted with the Minister setting out how the 2022 reforms would help, but also conceding: “But we know we need to do more to ensure that everyone who needs access to an NHS dentist can do so.” The Minister also mentioned the role of ICB’s in dealing with specific local needs, the “forthcoming recovery plan,” and that, “some of the population will prefer to access private dentistry.”
The second recommendation was about improving public understanding of how NHS dentistry is delivered, and to clarify misconceptions including those about registration and recall intervals. The Minister accepted this and mentioned the contractual requirement for practices to update their NHS website information every quarter. The Minister added that compliance with this, “should be higher.” NHS England would be monitoring this and feeding the results to ICB’s who, “have the contractual powers to ensure adherence to these requirements.”
Recommendation three was that practices should abide by NICE recall guidance of up to two years for “most adult patients,” but that, “people should not be automatically removed from a dentists register without good reason.” They wanted this to be monitored by NHS England. The Minister accepted this and revealed that FP17 data on recall intervals was now being shared with ICB’s.
Next, the Committee recommended that the ringfence for any dental underspend, announced for 2023/24, be made permanent. Revealing a possible lack of confidence in this being enforced, they also asked for NHS England to “put in place transparent scrutiny to ensure compliance.” This was accepted by the Minister.
The following recommendation asked for a “fundamentally reformed” contract with a move away from the UDA system with a weighted capitation element, and in “full consultation with the dental profession.” This was only partially accepted, with reference to the pilots, saying they would not have maintained access if rolled out, and that they provided no evidence of capitation improving care. The Minister spelled out the intention to instead pursue further reforms to the 2006 UDA based contract.
A recommendation that patient registration be reinstated, repeated one made by the 2008 Select Committee report on dentistry. The Minister rejected it, making the startling assertion that the current system provided superior choice and flexibility.
Lastly the committee recommended that a dental workforce survey was commissioned to improve understanding of the hours and private / NHS mix being provided. This was accepted.
In response the Chair of the Health and Social Care Committee Steve Brine MP said:
“We welcome the Government’s admission that it needs to do more to make sure that everyone can access an NHS dentist and we’re pleased to see the new Secretary of State’s commitment to ‘make real improvements.’ Ending the pain and distress people suffer because they’re denied access to a dentist must be a top priority.
“However, we called for fundamental reform to the contract that pays dentists for NHS work so it’s disappointing that the Government hasn’t fully accepted this recommendation and we’re concerned steps taken will still not go far enough.
“The Secretary of State says the Government has ‘begun laying the foundations of change’. Yet there is still no date for the publication of the dental recovery plan to this committee’s continued frustration. We’ll be pressing her on this point when she appears before us this afternoon.”
When it was published on July 14th the Committee report had stated: “The Government has two months to respond.” That it has taken more than twice as long to provide a guarded response may tell both Steve Brine and contractors, all they need to know about the Governments interest in NHS dentistry.
The Govt response to @CommonsHealth’s inquiry offers big ambitions but no action.
— BDA (@TheBDA) December 13, 2023
Ministers claim to want access for all.
But offer no commitments that could achieve that.
If they won’t fix a failed contract NHS dentistry will remain built on sand, & risks being swept away. pic.twitter.com/xzXOiZXvF2
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