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​Dentists urge government not to retreat from wholesale reform of failed NHS fines system

20 September 2019


The BDA has urged government to act on Public Accounts Committee (PAC) recommendations to deliver wholesale reform to the discredited NHS fines system. 

The spending watchdog has dubbed the system as "unfit for purpose", taking aim at its sheer complexity, its reliance on a presumption of guilt among claimants, and for failure to offer meaningful action to target persistent offenders. 

The BDA, which first exposed this scandal, has backed the calls for root and branch reform, but expressed deep concern that the government appears fixed on delivering minimal change.

The policy has seen vulnerable patients including, those with learning disabilities receive £100 fines for claiming support towards healthcare costs, some for simply ticking the wrong box on a form. The National Audit Office (NAO) revealed earlier this year that 30% of healthcare fines issued since 2014 – 1.7 million notices, with a cash value of £188 million – were withdrawn following challenges from patients fully entitled to claim.

Statements made in Parliament suggest the Department of Health is not preparing to remove the presumption of guilt when an anomaly is identified, or to simplify the notoriously complex system of exemptions for those who are unclear on their entitlement. 

While those capable of proving their entitlement may escape automatic fines, there appears to be an unwillingness to follow policies in Scotland and Northern Ireland, which the PAC has identified as successful, which grant those who have made honest mistakes the chance to pay their charges in full.

The BDA had warned that the tenfold increase in fines issued since 2014, alongside aggressive campaigning effectively discouraging claims, has prompted a collapse in attendance among groups entitled to support with treatment costs.

The latest NHS dental statistics showed a fall of 2.2 million dental treatments delivered to patients exempt from NHS charges since 2013/14 – falling by a quarter (25%) in 5 years.

Charlotte Waite, Chair of the BDA's England Community Dental Services Committee said:

"A system that's hurt our most vulnerable patients, and treated millions who've made honest mistakes like fraudsters requires more than tweaks.

"Ministers shouldn't be profiting from patient confusion. Families across England will keep paying the price until we get a fair and focused way to protect NHS finances.

"Dentists call on government to do right by our patients, and follow these recommendations in full."