It was reported in The Times yesterday that NHS dentists will be forced to pay back £120 million to the government for failing to fulfil their assigned quotas of cases seen. Once again we see evidence of government quotas creating a poor quality service, neglecting the areas which really matter.
According to the article, NHS dental treatments targets were missed by 5 million in the year 2007-2008. Previously, dentists were paid per treatment giving them greater economic incentives to provide a better quality service. But, under the current scheme dentists are given a set income for completing an agreed amount of NHS work. This set income minimises any incentives for dentists to provide a quality service, resulting in a ‘drill and fill’ scenario. As I have written before, the inefficiencies of the NHS mean that patients are seen as numbers, rather then people.
The inefficiencies of a quota system are clear, but if the dentists are punished for the governments failure we could see more and more dentists refusing to provide NHS treatment – already about 1,000 dentists have opted out of the NHS scheme meaning that 9,000 fewer patients have been treated – or a brain drain with dentists moving to countries such as the US where they will be rewarded more generously for their talents.
Left to the market this healthcare service would be provided in a much more efficient manner, with dentists responding to consumer needs both in terms of quality and volume of treatments.