Select Committee on Health Appendices to the Minutes of Evidence


Memorandum by the Clinical Dental Technicians Association (D2)

  This submission represents the views of the Clinical Dental Technicians Association regarding the Governments strategy Modernising NHS Dentistry.

  The Association would also wish to participate in giving oral evidence, to the Health Committee, at the appropriate time.


  Clinical Dental Technicians (CDT's) are qualified dental technicians who undertake further training in the clinical procedures required to provide removable dental appliances directly to members of the public. At present CDT's are legislated for in some EU countries, USA, Canada, Australia and New Zealand. The legislation in many of these countries requires CDT's to be members of the dental team but allows them to work independently of dentists.


  Dentistry is regulated by the General Dental Council (GDC), in partnership with, Government. The previous Conservative Administration has accepted that CDT's would provide an enhanced service to patients in providing removable appliances within the framework of the NHS.

  The present Government and GDC have also accepted the need for CDT's to be statutorily registered and is in the process of introducing this profession.

  Whilst we applaud the Government's initiative on modernising the delivery of dental care to patients we are not convinced that dentists will be able or willing to deliver the full range of NHS dentistry. It is a fact that patients are finding it extremely difficult to find a dentist who is willing to provide treatment under the NHS. Many patients are either forced to accept private treatment (often at very high cost or by purchasing private dental cover) or travel considerable distances to gain access to a limited number of available NHS dental treatments.

  We further feel that the GDC, and to a certain extent Government, has missed a golden opportunity to facilitate patient access for patients receiving dental appliances through the NHS.

  Current proposals, from the GDC, will allow CDT's to work remotely from dentists. The proposals also accept overseas qualifications for CDT's. At present there are a number of CDT's in the UK who have undergone a comprehensive and internationally recognised training programme delivered by George Brown City College, Toronto, Canada. However, the GDC has agreed to limit CDT's in a restrictive manner. These restrictions are;

    1.  CDT's will not be able to charge patients for the work they undertake. A patient will be required to pay the dentist for any work undertaken and the dentist will then pass on, to the CDT, any fee deemed appropriate. This system is open to obvious abuse where a dentist may well charge a patient a high fee and only pass on a small fraction of this to the CDT. We have evidence to support this claim, which is already being abused even before regulations exist.

    2.  Patients will be required to attend dentists for a prescription before having access to a CDT. We believe this will inconvenience patients and is yet another barrier in a patients right to choose where they obtain treatment from an appropriately qualified professional. We are currently seeking Queens Counsel Opinion on this restriction under current Human Rights Legislation.

  We are aware that CDT's would be able to provide a comprehensive range of NHS dental appliances more cost effectively and of higher quality than the present system allows. Indeed, where CDT's are established in other countries they are known to provide appliances at up to 30 per cent less than provided by dentists.

  We welcome the inquiry by the Health Select Committee, which may lead to large numbers of dental patients once again having access to a comprehensive range of dental treatments.

January 2001

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