Ministers study cut in free dentistry on NHS

Most people's free dental treatment on the NHS could be limited to check- ups under radical plans being studied by ministers. The idea is to release funds to reverse a decline which has left nearly half of the country without an NHS dentist.

Ministers are considering reducing the number of dental treatments to those who aren't children, poor or elderly.Dentists might then be paid more to do the routine work. This,it is argued, would tempt them back into the NHS, so restoring national cover.

The plan goes beyond the restoration of free dental checks and eye check- ups for pensioners, reported yesterday.

Many patients have no choice of an NHS dentist in their area, and ministers are studying the idea of reversing the exodus from the NHS by dentists by focusing the money on areas where there is a shortage.

Expensive treatment on the NHS, such as bridge work at pounds 600, would no longer be available. Ministers have been urged by dentists' leaders to go further by focusing on care and treatment of children, the poor, and the restoration of a basic service, free of charge, for registration, diagnosis, advice and prevention for all adults. Funding for health authorities to tackle local NHS dentistry shortages was also supported.

The British Dental Association said it favoured "targeting for children and those on low income, and all other adults should pay full charges for everything apart from a simple diagnostic service [i.e. check-ups]".

The options are part of a fundamental review of health spending, and decisions have yet to be reached but "targeting" is on the agenda. Alan Milburn, the health minister, told MPs before the recess he would be undertaking with Tessa Jowell, the public health minister, "an important joint initiative to ensure that access to NHS dentistry is more widely available and that our resources better improve the oral health of the population".

He has told officials that the former Tory government's efforts to reverse the exodus of dentists from the NHS through "access" funds have not worked.

The pressure for action was intensified by figures passed to The Independent showing millions of people have been struck off official registers after failing to turn up at surgeries because, it is feared, the cost of dental care has driven large sections of the population away from dentists.

Currently, dental patients have to pay around pounds 4 for an initial consultancy, whereas it costs nothing for a basic appointment with a doctor. Dental patients have to pay approximately 80 per cent of the cost of any subsequent treatment they receive up to the value of pounds 330.

When the Conservatives came to power in 1979, dental patients were only obliged to pay for treatment which cost up to pounds 5 and check-ups were free.

The NHS has already reduced the scope of NHS cover from natural-looking porcelain crowns costing at least pounds 150 each. NHS patients have to settle for metal crowns.

Under legislation introduced by the former Tory government, people who fail to visit their dentist within a 15-month period are automatically deleted from the register.

Figures obtained by Harry Barnes, the Labour MP, show that 4.1 million people lapsed from the register last year.

Although others will have re-registered, the proportion of the population using a dentist is in steady free fall and only 21 million adults, 52 per cent of the population, are now registered.

The age group which is most readily abandoning dental care is the 25 to 34-year-old bracket, among whom there has been a 16 per cent fall in dental registrations in the past three years.

More alarmingly, figures produced by the Government's Dental Practice Board show that in some parts of the country, more than two thirds of children do not visit the dentist.

There are also areas where two thirds of the adult population do not see a dentist. The only section of the population among which dental registration is not declining is the over-75 age group, which normally does not pay for treatment.