When the NHS was formed in 1948, it had a tripartite structure with dental services in each part. Hospital dentists specialised in dental surgery or orthodontics (straightening), and were graded in the same way as hospital medical staff. Some worked in dental departments of general hospitals and others in specialist dental hospitals. The School Dental Service was established under the 1944 Education Act. These dentists were employed by Local Authorities. Principal School Dental Officer organised the services and their remit was to provide free dental inspection and treatment for all children in stated maintained schools, and also provided care for the dental health of the mothers and children of pre-school age. Dentists entering the new general dental service scheme had resisted successfully government attempts to house them in health centres as salaried staff. The result was that general dental practitioners were given independent contracts and remunerated by ‘item of service provided. Flood gates opened and enormous amount of dental care provided. During first five months of scheme, 4.2 million teeth filled, 4.5 million extracted and 33.4 million sets of dentures were made!
NHS dental services now are provided by hospital and community trusts. These services are purchased or commissioned by the District Health Authority. Contracts are made between purchasers and providers as to number of patients to be seen, type of treatments etc. Although GMP fundholders are purchasers too, do not purchase dental services. General Dental Practitioners are outside this arrangement. Administrative payment details are dealt with by the DHA which has now merged with the FHSA (previously the FPC). Withdrawal of dentists from NHS has led to some Health Authorities employing salaried dentists to enable residents to access national heath service care.
The organisation of dentistry in the UK Dr D White