Dentists wishing to operate as independent contractors and planning to establish a new dental practice or surgery would generally fund the facilities themselves and secure an appropriate return on their investment from their annual service contract with their primary care trust (PCT) to provide an agreed level of national health service dental services. However, PCTs may offer dentists assistance with the start up costs of establishing new dental practices at their discretion, if they consider this appropriate and necessary. The Government have also made £100 million capital funds available to PCTs over the two years 2006-07 and 2007-08 to give them additional scope to help dentists modernise or expand dental practices for the benefit of NHS patients.
(2) what the cost was of dental provision per head of population in the strategic health authorities covering (a) the five most deprived areas in England where water is fluoridated and (b) the five most deprived areas in England where water is not fluoridated in the latest period for which figures are available.
The information requested is shown in the following tables. Fluoridation of water offers the best prospect of reducing inequalities in oral health, but comparisons between expenditure levels in different areas are affected by a number of factors. There is no simple and direct relationship between expenditure levels and relative oral health needs. The legacy of the previous general dental service contract is that the pattern of services largely reflects where dentists previously chose to set up in practice, and how much national health service dental work they chose to undertake. In addition, levels of patient demand for dental care may not necessarily reflect levels of oral health need. The Department has no data on the levels of private dental care provided in different areas. Expenditure per head is calculated from resident population figures, but patients may attend dental surgeries outside their areas of residence.
Primary care trust (PCT) 2006-07 gross expenditure on primary dental care (£000) 2006-07 gross expenditure on primary dental care per head of population (£) Manchester 22,797 50.44 Heart of Birmingham teaching 12,473 45.99 South Birmingham 18,047 53.22 Birmingham East and North 14,871 37.53 Notes: 1. Expenditure figures are based on the aggregate gross expenditure on primary dental care reported by PCTs with their 2006-07 end of year accounts. 2. Expenditure per head figures are based on the aggregate gross expenditure on primary dental care and the Office of National Statistics 2006 mid year population figures.
SHA receiving proportion of fluoridated water supplies 2006-07 Gross expenditure on primary dental care per head of population (£) SHA Receiving no or few fluoridated water supplies 2006-07 Gross expenditure on primary dental care per head of population (£) West Midlands 44.52 North Western 48.83 North East 50.59 London 45.75 Notes: 1. The five PCTs which receive fluoridated water supplies and have the highest deprivation scores are South Birmingham, Heart of Birmingham Teaching, Birmingham East and North, and Wolverhampton PCTs (within the area of the West Midlands SHA), and Hartlepool PCT (within the area of the North East SHA). The five PCTs with the highest deprivation scores which do not receive fluoridated water supplies are Liverpool, Manchester, and Knowsley PCTs (within the area of the North West SHA), and City and Hackney Teaching and Tower Hamlets PCTs (within the area of the London SHA). 2. The distribution of fluoridated water supplies is not entirely uniform even across those SHAs which have the highest proportions of fluoridated areas.