Select Committee on Health Minutes of Evidence



  There are approximately 57,000,000 people resident in the UK at the beginning of the 21st century.

  There is a dental NHS gross annual spend, without the huge costs of administration, of £1.635 billion which is totally inadequate and is, as proved by another paper published in January 2000, a gross underspend since 1990 of 59.8 per cent in the fee-scale compared to what the DDRB intended and thought to right and fair. This represents, therefore, an annual shortfall of £870 million which would produce an annual minimum of £2.5 billion.

  The vast bulk of claims that are made for treatment carried out do not reach £660, even on an annual basis and at present day costs. It follows, therefore, that a 50 per cent rise in the fee-scale, would represent a level of remuneration that most GDPs would consider adequate and would raise that £660 level to £1,000 per annum.

  In the past a private dental insurance scheme DENTOPLAN, run by Cornhill Insurance provided £1,000 of annual cover for a premium of £60 and at a fee-scale of 150 per cent that of the NHS—so it provides the perfect base.

  If 57,000,000 people had to pay £60 each a premium income of £3.42 billion would be required. Twenty five per cent of this applies to adult patient who are, at this moment, not exempt form charges = £855,000,000. This group would be required to pay their own premiums and thus £2.565 billion would be required from other sources.

  The liability could be further reduced if those in work pay the premium for their families, whilst others pay according to their ability to pay. This is not a decision for the GDPA to make.

  There are other statistics to be considered at this point.

    1.  Half the population are children.

    2.  Less than 50 per cent (the Dental Practice Board [DPB] say 45 per cent) of the adult population go for treatment each year.

    3.  Very few of those who do attend would involve a cost of the order of £1,000. The DPB say that the average adult claim is of the order of £50.

    4.  To produce a worst case scenario let us suppose that each and every adult makes a claim of double = £100 and that fees were raised by 50 per cent = £150 then £150 x 28,500,000 (the total adult population in UK) = £4.275 billion.

  However, in the reality only half are likely to attend which gives a liability of £2.17 billion. [This coincidentally is about the current spend £1.635 billion plus the 33.3 per cent rise Mr Blair promised].

    5.  The annual cost for the treatment of children (DPB says 63 per cent attend) £400 million with an average cost per annum, per capita, including capitation of £23.50. Again, with 50 per cent fee increase the liability is £600 million.

    6.  This produces a worst case scenario liability of £2.73 billion.

    7.  It should be borne in mind that the costs of DPB are substantial and not included in these figures.

  There would be considerable savings from its demise.

  It can be seen from what is written above that raising the fees and keeping the present system or a compulsory insurance scheme with all patients being private show little difference in cost. Furthermore, the choice between a private insurer or the State acting as it's own insurer would, also, bear little difference in cost to public funds.

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Prepared 27 March 2001