Dental Tribune United Kingdom Edition

Lasers - Whitening - Cameras - Curing Lights Visit www.quicklase.com Call us 01227 780009 OFF o O QLQW40%Mag231211RG Upto a Whopping O ur ability to provide dentistry under a Na- tional Health Service is highly respected in some parts of the world, with many countries going so far as to emulate aspects of the NHS in order to protect their most vulnerable in society. How- ever, the uneasy amalgama- tion between healthcare and business clearly separates dentistry from the other ser- vices encased within the NHS. Whilst the blend between capitalism and socialism will always leave someone feeling aggrieved, the real question governments across the world have to answer is: “how can we meet the demands of the population without bankrupt- ing the country?” Despite the best of inten- tions, working within a budget throws up some serious con- straints. The financial real- ity of providing dentistry en masse must at some point in- fluence the front line service of dentistry. Now as a profession our obligation clearly lies with our patients’ health and this is supported by the GDC as seen in section 1.1 of the Standards for dental professionals, which states “put patients’ inter- ests before your own or those of any colleague, organisation or business.” Mission state- ments like these are common to many organisations with- in healthcare and the busi- ness world. Having codes of conduct which seek to govern the actions of those working within them is an admirable way of setting the standard, but it is more often than not the way that the system is structured that determines the likely outcome. In previous articles I have debated the impact of the 2006 contract, including the swings and roundabouts approach to financing treatments. The allocation of treatment options to one of only three bands carrying one, three or 12 UDAs coupled with an overall yearly target creates a situa- tion where dental practition- ers are unwittingly being ex- posed to “perverse incentives” – or an incentive that has an unintended and undesirable result which is contrary to the interests of the incentive makers. Perverse incentives are a phenomenon which is in no way unique to NHS dentist- ry. Here are a few examples found on Wikipedia: “In Hanoi, under French co- lonial rule, a program paying people a bounty for each rat pelt handed in was intended to exterminate rats. Instead, it led to the farming of rats.” “Funding fire departments by the number of fire calls made is intended to reward the fire departments that do the most work. However, it may discourage them from fire-prevention activities, which reduce the number of fires.” “19th century palaeon- tologists travelling to China used to pay peasants for each fragment of dinosaur bone Perverse incentives Neel Kothari on budgets, business and reality page 10DTà 9CommentUnited Kingdom Edition January 16-22, 2012