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MPs back our calls to sweep away 'Dogs breakfast' NHS dental patient fines system

Blog Author Charlotte Waite

Blog Date 03/10/2019


"A dog's breakfast".


That was the concise verdict from Meg Hiller MP, Chair of Westminster's top spending watchdog, as it published its damning report on NHS fines last month.

We have led the campaign to sweep away a system that has hurt our most vulnerable patients, and continues to eat into clinical time.

And now the Public Accounts Committee (PAC) has backed our calls for nothing less than wholesale reform of a system they've dubbed "unfit for purpose".

We made our case directly to MPs in July. We set out simple steps Government must take to protect patients fully entitled to claim and those who have struggled to navigate an incredibly complex system, and to stop dentist being forced to act as the 'Fines Police' at appointments.  

And now the committee's official report sets out clear cut recommendations to make our calls a reality.  

They joined us in taking aim at the system's sheer complexity, its reliance on a 'presumption of guilt' among claimants, and for failure to offer meaningful action to target persistent offenders. a

The PAC's recommendations matter. It is a tribute to their sway that in the last Parliament 80% of their recommendations were acted upon. They want action from the Department of Health and Social Care, alongside updates on progress.

And they have attacked not merely a chaotic policy, but the complacency that has left vulnerable patients including, those with learning disabilities receiving £100 fines when claiming support towards healthcare costs, some for simply ticking the wrong box on a form.

We are now waiting on the government to table their formal response. But we are not taking a wait and see approach.

There are worrying signs from statements made in Parliament that the Department is still unwilling to let go of the presumption of guilt when an anomaly is identified. That they aren't prepared to simplify the notoriously complex system of exemptions for those who are unclear on their entitlement. 

We want to see a system where genuine and repeat fraud is tackled head on. Where those capable of proving their entitlement escape automatic fines, and - as is the case in Scotland and Northern Ireland - where those who have made honest mistakes have the chance to pay their charges in full without being tarred as fraudsters.

This matters. The recently published NHS dental statistics continue to show a fall in attendance among exempt patients, with 2.2 million fewer dental treatments delivered to patients exempt from NHS charges since 2013/14 when fine volumes started to snowball. 

This heavy-handed policy has been all too happy discouraging claims and attendance from some of the patients who need us most. Keeping costs down and patients away is not the philosophy that should guide our NHS.

Thanks to Meg Hillier and her colleagues, we have momentum. We intend to build on it and secure a fair and focused system that works for dentists and our patients. 

Charlotte Waite, Chair
England Community Dental Services Committee



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