Anger over cut to fees multiplier
The industry has warned Scottish ministers that proposed cuts to fees multiplier will undermine sustainablity for the future
Scottish ministers have been warned that scaling down financial support for NHS dentistry will risk undermining its future sustainability. The British Dental Association Scotland says that cutting the multiplier to the fees paid to provide NHS care could cause profound problems for the profession.
For the past few months, dental practices north of the border have received a multiplier of 1.7 to reflect the unprecedented backlog they have faced as they try to live with Covid.
Ministers have now moved to pare this back to 1.3 for the immediate future. There will be a further review of the fee structure in October this year.
The BDA says there has been no dialogue with the Scottish Government over the change and the discredited low margin/high volume model dentists in Scotland work to leads to the fact that treatment can often be delivered at a loss. It goes on to warn that there is a growing problem given the rising levels of unmet need, particularly among those from more deprived communities.
Official data suggests the total number of high street NHS dentists in Scotland has fallen by more than 5 per cent since the onset of the Covid pandemic.
The BDA says that heavy-handed policies will push Scottish dentists down the road found in England, where thousands of dentists have left the NHS since lockdown amid warnings from MPs south of the border that NHS dentistry now faces a slow death.
David McColl, chair of the BDA’s Scottish Dental Practice Committee, accused ministers of “playing with fire” and “pulling away the life support from a service millions depend on”. He added: “This multiplier helped ensure NHS dentists received fees for care that actually covered their costs.
“Slashing them will leave colleagues churning out dentures at a loss while thinking twice about their future.”
The BDA is urging the Scottish Government to develop a suitable interim funding package to support dentists as they work through the backlog. It also wants work to begin on a new and sustainable long-term model for NHS dentistry.
There are concerns that even though it says it will not return to pre-pandemic financial arrangements, the multiplier might be removed altogether by the government at the first opportunity. The association has repeatedly voiced its strong opposition to a return to what it describes as the pre-Covid “treadmill”.
A Scottish Government spokesperson responded by saying: “We are continuing to provide NHS dental services with an unprecedented level of financial support to incentivise dentists to see and register new patients. At present dentists receive an additional 30 per cent payment on each treatment they provide. This additional funding combined with the recent relaxation of the infection prevention controls means that NHS dental practices should be able to deliver normal levels of activity.”
The spokesperson added: “We have also provided dentists with an additional £20 million of increased fees to see more patients with a particular focus on children and tackling oral health inequalities. This includes extending our flagship preventive care programme Childsmile in high street practices to children up to 17 years of age. Scotland has 54 dentists per 100,000 of the population providing NHS dental services, compared with 42 per 100,000 in England.
“We have over 28 per cent more dentists per head of population than is the case in England. Under this government there has been a 32 per cent increase in dentists providing NHS dental services in Scotland.”