A shake-up of NHS dental services starts on April 1. The Government's chief dental officer, Dr Barry Cockcroft, told Health Reporter Emma Brady about the new system...
Dr Barry Cockcroft was a practising dentist in Warwickshire when he took part in a pilot scheme to test new ways of working.
Now, he is responsible for a radical shake-up of the profession when new dentists' contracts come into affect next month.
Dr Cockcroft, who ran a practice in Rugby for 28 years until he was appointed England's chief dental officer in October 2002, yesterday tried to temper the public's confusion over the impending shake-up.
Fears of an exodus of dentists across the region, drastically reducing NHS dental care, and confusion over what patients pay for which treatment have been highlighted by local dental committees, including Birmingham.
But Dr Cockcroft said the new system would be based largely on clinical need rather than routine appointments, so those with good oral health will not need to be seen so regularly, while those at high risk of dental problems will been seen more often.
He said: "In terms of public concern that access to NHS service could be difficult, we are confident that should not be an issue, especially as we have lots of dentists in Birmingham that want to grow that side of their practices.
"Early indications are that the vast majority of dentists will still provide NHS services, but there are now virtually no practices which are 100 per cent NHS any more.
"I think that NHS and private services complement each other well. For example if a patient only needs one thing done, such as a filling, it may actually be cheaper for the dentist to charge a private fee for that instead of what they would pay under the new system."
Dr Cockcroft said payment would relate to a "course" of treatment and patients returning within two or three months needing more treatment would not be required to pay extra.
"At present less well off families are currently exempt from paying for NHS treatment and that will continue under the new pricing scheme," he said.
"In rural parts of the Midlands I know primary care trusts (PCTs) are strategically planning services to meet the needs of patients in these areas, such as Shropshire where new practices have been opened in Shrewsbury, Oswestry and Telford to achieve this.
"There have been some difficulties in Worcester with dentists saying publicly they're going to leave the NHS but we won't know that for sure until we receive their contracts back, so there is some uncertainty as to what may happen there."
In 1998 his surgery was one of 15 in a pilot scheme which would become the blueprint for the new contract and pricing system.
The National Audit Office carried out a comparison study between the pilots and other surgeries in the same areas, and it could not find any deterioration in patients who had been seen less often.
However Birmingham's Local Dental Committee and patient groups fear people may opt to stack up dental problems in order to get "value for money" by paying for just one appointment.
Dr Cockcroft added: "Some dentists are saying this will happen, not the patients, and it is a type of behaviour we've never seen.
"Patients will be charged for a course of treatment and that will include everything involved. So if a patient then needs more treatment, that will be included in the cost for their first treatment."