We must be careful how DoH accountants work out “national capitation figures” and how carrying out private care at the patient’s choice will affect the capitation payment. These money men are also twitchy about capitation producing vastly reduced clinical activity and made efforts during the process of planning the contracts, to try to produce a list of expected activity, but hopefully this has been successfully rebuffed.
Running capitation pilots for a period of 12 months will not produce evidence of success or failure but will only point to how patients and dentists start to be influenced by such a contract, but we must all resist knee jerk reactions, sadly the time scales will be dictated to fit with the White Paper hopes of the Coalition and dentistry will just have to match the time frames.
Once concluded we enter the difficulties of transitional arrangements transferring nGDS contracts into new arrangements and protection of the “losers” in such changes.
We have seen the dental budget attacked by financially afflicted PCTs , here in Birmingham we have lost £3 million recently of supposed ring fenced money as a result of PCTs pulling new access contracts when Chief Executives realise it’s easy money to divert into other pots, claw back money has been used this way too.
When 2014 produces new contracts the DoH are adamant there will be no new money, we have already lost substantial amounts of the apparent new money that was meant to be added to the budgets of 2006. In the times we are in, it’s hard to see how capitation if successful in pilots will get the money it will need to make it successful countrywide.
We are about to take off in the spring, where will we land, and when we get there will we have enough to spend?
Eddie Crouch

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