A new layered pricing system could mean the end of the public's reliance on NHS dentists - and present advisers with a great chance to sell dental insurance, writes Kirstie Redford
April heralds a new era for NHS dentistry, with some of the most far-reaching reforms for decades being introduced.
The Government's intention is to clarify the current pricing system for patients and introduce new contracts for dentists that aim to attract more back to the NHS.
With many people struggling to find an NHS dentist, this sounds like great news.
Unhappy
However, recent press reports suggest many dentists working for the NHS have not signed the new contract, unhappy with the new funding framework, which will fall under the control of primary care trusts (PCTs).
• ew guidelines recommend patients in good oral health need only visit the dentist every 18 months, rather than six. This is to allow NHS dentists to see more patients and hit Government targets. However, many dentists disagree with the time periods.
There is still a huge amount of confusion surrounding the reforms and no one seems sure how many dentists are likely to sign the new contract and, if they do, whether access to NHS treatment will really be improved.
And this confusion does not end with the public. Roger Matthews, chief dental officer at insurer Denplan, says: "We recently held six focus groups of NHS patients around the UK and the result was that the level of public awareness was very low.
"However, even more worryingly, our research also showed that even some dentists are unclear about the changes ahead."
It seems that PCTs are also still grappling with what the changes mean. Having just moved house myself and contacted my local PCT to find out which dentists are taking on NHS patients I was told to phone back in the third week of April - they admitted they were still unsure how the new registration process was to be implemented.
The current waiting list was, I was told, no less than seven months, "so waiting a few extra weeks would make little difference".
Cold comfort
Cold comfort indeed. And I am not alone. This service, or lack of it, is what people up and down the country have been increasingly facing over the last few years.
The new pricing structure does have it merits. Under the old system, dentists had a list of around 400 prices for different treatments - the most expensive treatment costing £384.
However, no one really understood what they had to pay until they were at the till in the dentist's reception.
The new system has just three tiers of pricing. NHS patients in England will pay £15.50 for a basic check-up, including scaling and polishing; £42.40 for additional treatments such as fillings and root canal work; and £189 for more complex procedures such as crowns and dentures. In Wales, these banded costs are slightly lower - £12, £39 and £177.
This should mean patients are more confident about how much they will pay and those having more complex treatment should benefit from cheaper bills. However, the minimum charge of £15.50 could mean that some people would be paying more for basic check-ups, which often fell below this figure under the old system.
The pricing structure may also affect premiums for dental insurance and cash plans that include dental cover.
Raman Sankaran, director of strategic development at cash plan provider Healthsure, says the firm's underwriters have been trying to calculate how the new charges will affect claims behaviour and costs. "There's no doubt that the new pricing structure will mean that prices will be reduced for serious treatment," he says.
"However, on the reverse side, people that would be charged £6 or £7 for basic treatment will now have to pay £15.50 and it is these smaller claims that make up the bulk of our claims, so we are anticipating a rise in claims costs. This will ultimately mean that consumers will end up having to pay more for their cover."
Despite this, Sankaran is expecting to see sales increase by more than 25% next year, a rise he says will be fuelled by the uncertainty in the NHS reforms.
"We will see more people looking for peace of mind and turning to insurers for solutions," he says.
Denplan, which provides a dental-only product, is also predicting a steep rise in sales.
The insurer's corporate sales manager, Pam Whelan, says: "The increased press coverage about how hard people are finding it to be seen by an NHS dentist has helped to raise some important issues. And we're already seeing more demand - especially from employers who want to ensure dental cover is included under their health plans for staff. We've seen business steadily increasing over the last year and we are forecasting a further 30% increase this year."
These predictions are echoed by HSA, which believes the reforms will prompt a greater take-up of dental insurance and cash plan products.
Suzanne Clarkson, spokeswoman for HSA, says this is because they are making people consider their dental funding options more carefully.
"With an increasing number of dentists going private and the cost of treatment rising, there is a real need for help with funding for dental treatment. Cash plans provide a cost-effective way of doing this," she says.
HSA recently launched a stand-alone dental, optical and EAP product for companies that is designed to sit alongside private medical insurance (PMI).
Highlighted
"This provides 'visible' benefits that employees use regularly and therefore value - especially right now when the dental reforms are being highlighted. It's the perfect time for companies to show that they understand the changes in the market and want to help employees with funding," adds Clarkson.
Dental cover, in whichever form, has not been popular among intermediaries, mainly because it is not seen as a product that demands advice. However, with the confusion being brought about by the reforms, providers believe that advisers can add some real value to the sales process.
Sankaran says Healthsure's intermediary sales more than doubled last year. This, he says, is down to more brokers selling cash plans alongside PMI products.
"More advisers are selling cash plans as part of a wider package, combining it with PMI to offer a complete health funding solution and are proactively marketing them in this way," he says.
Even so, with dental cover such a low-cost product - Denplan's cover starts at around £13 a month and cash plans are often under £10 a month - commission levels can seem depressingly low.
It is this reason that makes Charlie MacEwan, spokesman for WPA, sceptical about how far intermediaries will really go to embrace the market.
"A lot of insurers do not offer attractive commission on dental contracts so advisers won't naturally go out and sell products. If you are selling a policy for £120, brokers are not going to leave home to sell it - their commission probably won't cover the cost of petrol," he says.
Sankaran says that although commission rates can seem low - Healthsure pays 15% initial commission and 5% ongoing - there is still money to be made.
"This may not seem like a high rate, but cash plans do have a long life expectancy. There is also money to be made in the corporate sector as commission for setting up, say 3,000 policies at once, can be substantial," he says.
Whether the dental reforms fulfil everything the Government is promising remains to be seen.
However, the public remains understandably wary. One positive is that this has raised the issue of dental funding and will prompt more people to ponder how they are going to meet dental bills if they are forced to go private.
If intermediaries position themselves correctly they could provide some much-needed advice during this time of change.
Kirstie Redford is a freelance journalist
