As the NHS pilots new dental contracts, issues in NHS dental care could result in the resurgence of dental payment plans. Henry Clover discusses the future of dental and the challenges that lie ahead
It's fair to say that the Department of Health (DoH) has seen some real economic turmoil in the past ten years.
In fact, the deficit between the amount of spending and the amount of income has been increasing at an alarming rate since 2001.
The coalition government has now created plans to cut this deficit over the next few years, with resources set to rise by 1.3% by 2015.
This, however, is overshadowed by the fact that overall capital growth is set to decline by 17% in order to reduce the level of borrowing (see Figure 1).
The DoH is by far the largest sector for government spending, with an overall budget of about £114.4bn.
Dentistry only represents 3% of this budget, so with capital growth on the decrease, it's easy to understand why access to NHS dental care remains an issue for many people.
Dental is, however, increasing in popularity as an employee benefit for exactly this reason and can be far more then a bridging product for private medical insurance (PMI).
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When looking at the growth of primary dental care over the past decade, it is clear that private dentistry is growing faster as a sector than that of NHS care.
In fact, about 20% of dental patients are choosing to pay for their dentistry privately or through a benefit scheme (see Figure 2).
Interestingly, from that 20%, a third of all dental income in the UK is generated, indicating that private dentistry is becoming more popular and profitable than NHS care.
This may be partly due to the controversial NHS contract changes in 2006, which resulted in many NHS practices converting to private. NHS access figures only recently recovered to 2006 levels.
More recently, pilots for a new NHS dental contract began and about 70 practices are taking part in testing different models of capitation - a set amount per patient enrolled.
This is something that payment plan providers have been using for many years.
The difference being that the new NHS pilots are testing models of capitation based on factors such as age, sex, and areas of deprivation, rather than a community-rated system.
These pilots are set to run for a year, after which there will be a public consultation in July 2012 - resulting in contracts potentially being introduced in April 2014.
But the underlying problem with any NHS contract is that it is not possible to please all interested parties.
