Tuesday, April 07, 2009

Number of NHS tooth extractions soars by 30% in four years

Very primitive

Thousands of Britons are having teeth needlessly pulled out, it was claimed yesterday. The number of extractions has soared by 30 per cent in four years, according to figures obtained by the Liberal Democrats. The party claims this demonstrates how much dental care has deteriorated under Labour, leaving thousands missing out on treatment that could save their teeth. More than 175,000 Britons had their teeth extracted under general anaesthetic in 2007/08, up 40,000 on the 2003/04 figure, a parliamentary answer revealed.

Of these, 44,300 were aged between six and 18 and 14,200 were under five years old. LibDem health spokesman Norman Lamb said: 'The extraordinary number of people needing their teeth extracted under general anaesthetic could well be the result of the appalling access to NHS dentistry.' He pointed the finger at the general difficulty in finding a Health Service dentist since the Government introduced a 'botched' contract in April 2006.

Designed to increase access to NHS dentistry, the deal actually saw hundreds of dentists leave the NHS. The number of patients seeing a dentist fell by 1.2million, leaving thousands without the treatment that could have stopped their teeth getting so bad that they had to be pulled out. But dentists' salaries have soared by 11 per cent since the change – to an average of more than £96,000.

Mr Lamb added: 'The dental contract was supposedly designed to improve the situation, but the staggering rise in tooth extractions proves the massive failures of thisbotched initiative. The crisis in NHS dentistry is one of this Government's most shameful legacies.'

Although the rate of extractions increased throughout the four-year period following April 2003, it gathered pace after the new contract for NHS dentists was introduced. In 2005/06, the year before the new contract, the number of extractions stood at a little more than 149,100. Two years later it had risen to just over 175,400 – an increase of 18 per cent.

The contract also changed how dentists were paid. Experts have warned that the incentives it offers make it more profitable for dentists to take a tooth out than to try to save it with complex treatments such as crowns or bridges. A patient has to pay £45.60 for a tooth to be taken out, and £198 for crowns, bridges or dentures. Before the contract dentists were paid per procedure, but after it came in they were paid to provide a specific rate of procedures in the coming year. With the money already in the bank, the fear is that some dentists may feel less inclined to carry out complex and expensive procedures and instead choose the cheaper option of taking the tooth out.

Last year MPs concluded that patients were having teeth pulled out unnecessarily as a result of the dental contract. The Commons health select committee found that the number of complex treatments such as crowns, bridges and dentures had plummeted by 57 per cent since 2006, at the same time as the number of extractions were rising. It said this happened because dentists had no financial incentive to give appropriate treatment. In Scotland, which did not bring in the new contract, the number of complex operations has gone up.

The British Endodontic Society said the contract provides dentists with a 'financial incentive to persuade a patient to have a decayed tooth extracted rather than undergo the more complex procedure of restoring it'. The soaring number of extractions under general anaesthetic comes even though the British Dental Association advises that such strong anaesthetics should only be used in hospitals.


Australia: Public hospital bed shortage as deadly as road toll

HOSPITAL emergency department overcrowding is responsible for at least as many deaths every year as occur on Australian roads, doctors say. In a damning series of reports in the Medical Journal of Australia, emergency medicine specialists suggest about 1500 Australian deaths could be avoided each year. The specialists say caring for patients waiting for a hospital bed represents about 40 per cent of the workload in major emergency departments, and up to 70 per cent in some.

They are critical of politicians and bureaucrats who deny that hospital overcrowding has major adverse effects on patient care. Ideally, for a hospital to function effectively, the doctors say occupancy should be no more than 85 per cent to allow for fluctuations in demand. But the Australian Medical Association says hospitals such as Townsville, in Queensland's north, operate at more than 100 per cent capacity "most of the time".

Australia has 2.6 hospital beds per 1000 people - far short of the average of 3.9 per 1000 for countries in the Organisation for Economic Co-operation and Development. A snapshot of overcrowding in accredited Australian emergency departments at 10am on June 2 and September 1 last year, found more than half the patients in non-NSW emergency departments were waiting to be admitted, three-quarters of them for more than eight hours.


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