The British Dental Association Scotland has said the higher fees for examination announced this week will do little to address the colossal backlog of unmet patient care that has accumulated during the pandemic.
While apparently a positive move on the face of it, the reality is that many dentists will have very limited capacity to increase examinations as they already have an enormous number of patients awaiting treatment. Colleagues have reported that they continue to focus on urgent treatment and that it will be several months before they can see patients for routine treatment. With high Covid transmission rates, continued restrictions in how dental practices operate, and many staff self-isolating, dentists are a long way from returning to "business as usual".
These examinations will also require additional time (especially where a full periodontal charting is needed) which will negate the higher fees. This demonstrates a lack of understanding of how dental practices operate. The BDA's Scottish Dental Practice Committee have continually asked for the methodology Scottish Government uses to determine fees. The new examination fees will purchase around 8 minutes of clinical time from when the patient enters the practice until they leave; if the consultation exceeds 8 minutes, practices will incur a financial loss. The BDA has repeatedly stressed that the Government needs to discuss proposals at an early stage and to take account of dentists' feedback.
Despite the Scottish Government's claims, it is not clear how the new fees will help to tackle inequalities. While BDA Scotland welcomes the extension of fluoride varnish applications (from 2-5 year-olds to 2-12 year-olds) – which the BDA had previously called for – and the Government's recent announcement of additional resources for children's oral health, frontline dentists have advised that the expansion of the Childsmile programme to include older children may not be practical in dental settings.
David McColl of the BDA's Scottish Dental Practice Committee said:
"The new examination fees barely scratch the surface of massive underfunding.
"They are well short of the £37 examination fees paid to optometrists and do nothing to compensate for the woefully low fees elsewhere in the SDR.
"The Scottish Government needs to significantly increase these fees as part of an interim funding model to ensure NHS dentistry remains viable for dentists and our patients."