Dental services are one of the most widespread forms of healthcare, with most of the population using the General Dental Service (GDS) at periods throughout their lives. Under the GDS scheme, a core of important healthcare is delivered very efficiently by hardworking professionals. But in addition a sequence of reports from the 1960s onwards, both for Government and by independent bodies, have pointed out that the GDS remuneration system has serious drawbacks. The GDS is based on piecework - a dentist is paid a fee for each individual aspect of care provided for a patient. Drawbacks identified in the past include a possible perverse incentive for dentists to undertake more activity than is necessary or that does not best meet patients' health needs, wasting public money, and an inability to distribute dentists to parts of the country on the basis of need.
The main reason for carrying out the current study was that the problems with the GDS system, pointed out in detailed reports from the 1980s onwards, have not been fully addressed. By contrast, the regulations on corporate bodies are changing. The Audit Commission may revisit this issue in the future.
Included in this report:
- access to services - has the Prime Minister's pledge been met?
- inequalities in health
- charges
- unnecessary costs and quality problems
- why the problems exist
- what is being done
- what needs to be done
- recommendations