Implentation Of Dental Reform In Wales

The former Minister for Health and Social Services announced last year proposals for a new contract paving the way for the reform of dental services in Wales and that we would follow the same timetable as England for implementation. This had been scheduled to take place from October 2005 to allow sufficient time for the dental profession and local commissioners to prepare for the changes.

In January 2005, the Secretary of State for Health, the Rt. Hon. John Reid MP, announced that more time was needed to ensure complete system reform and had therefore decided that full implementation in England will now take place by April 2006.

I have considered Dr Reid’s statement and the case for a similar deferment in Wales. In particular the NAO report on dental reform in England which acknowledged that “there is a strong rationale for reforming NHS dentistry” but raised concerns that local commissioners should have time to acquire the necessary skills and resources before the full commissioning of NHS dentistry was delegated to them. I am also aware of the need for the profession to be fully prepared for the changes. In Wales we have established a project group to oversee implementation of the new contractual arrangements and to provide a source of practical experience and expertise to inform the way forward.  

In light of these developments the Assembly Government has decided to similarly defer implementation so that the new contractual arrangements will now take place by April 2006.  

I have also been considering introducing Personal Dental Service (PDS) pilot schemes in Wales. PDS are based on the proposed new dental contractual arrangements and are subject to a service level agreement between those dentists and Local Health Boards who wish to move more quickly towards the new arrangements. PDS offers an opportunity for dentists to get off the so-called item of service "treadmill" now and to improve services through local contracting arrangements, adopting a more preventative approach to oral health and to be paid for quality rather than quantity.  

The Assembly Government is providing £5m for this financial year to fund the introduction of PDS in Wales. The funding will allow increased access to NHS treatment as well as improving quality. LHBs and dentists will be able to commission services in line with the needs of the local population and to address access difficulties.