In my column last month I echoed numerous dentists’ concerns with the Care Quality Commission’s registration process. At the very least, I had hoped that by the time my article was published that the CQC would have clarified issues for dentists who are being forced into the unwelcome new regulatory regimen. Unfortunately, one month on, we appear to be no further forward then we were back then. Information from CQC sources still appears contradictory and confused. Attending workshops run by CQC staff has not proved particularly helpful either as the regulatory staff themselves are not always well informed.
The British Dental Association has called for a delay in the process but it has fallen on deaf ears. Dentists from all over the country have written to their MPs asking for help in stopping the CQC juggernaut heading towards dental practice. In return, MPs promise to investigate further, but most tend to end up with replies from Andrew Lansley (or at least signed with his name) stating how the CQC will be regulating with a light touch and will require very little time from dentists to comply with all the paperwork. I suspect the letter has been drafted by a civil servant who will be strongly backing the CQC processes and would not want it to be scrapped.
To add insult to injury, the consultation document on the fees charged to dental practices has been issued. Unfortunately, this does nothing to dispel the concerns of the dentist, with fees of £1,500 being proposed for a single site. Of course, it doesn’t help that this coincides with the period when compliance with the essential standards for HTM 01-05 are due, in addition to all the other rising costs in dentistry as I have discussed previously. The GDP is facing an onslaught of costs at a time when pay rises have been denied to them from the start.
The proposed £1,500 single-site fee applies to single-handed practitioners and large multi-surgery practices. How anyone can see the fairness of applying the same financial pressure on one dentist compared to a possible sharing of costs between five dentists or more? To compound this unfairness, the larger practices will be able to make savings on the more sites it registers. Whereas a single-handed practitioner will have to pay £1,500 for the ‘benefit’ of registration, a 100 site company will only have to pay the equivalent of £240 per site which could be the equivalent of £48 per treatment room if each practice has an average of five rooms each. Compared to the £1,500 contribution from the single surgery dentist, it seems that fairness was not a consideration for the CQC. To take it one step further, how does the CQC expect the fee to be absorbed by a dentist who rents a room from a colleague for a weekly orthodontic clinic?
Unfortunately, the costs to be clawed in by the CQC are unlikely to be minimised much after the consultation closes. In my view, it will soon become apparent that the CQC is ill-equipped to fulfil its task and will end up demanding ever higher sums from dentists.
Let us hope that next year will bring some cheerier news for the dental profession. A year that we have been faced with HTM 01-05, CQC and another practically non-existent pay rise has left many dentists at their lowest ebb. Will 2011 be any better? Proposals for a new dental contract are due to be released this month. Let us hope that it will give us some cause for optimism!