Biting back Payback time


with Arthur Dent I


was shocked to receive the “Dear Dentist” letter circu- lated to GDPs in early March by Practitioner Services Divi- sion (PSD). The letter was


headed “Duplicate Registrations – recoveries and underpayments” and essentially it outlined how alleged overpayments would be recovered from GDPs in the payment schedule for February paid in March 2013, which was due to be paid a few days after receipt of the letter. There was a theoretical


possibility of a GDP receiving compensation for past underpay- ments, but I have yet to hear of any dentist in this position; all GDPs seem to have had money deducted for alleged overpayment which might have arisen in a number of ways. A patient may have left Scot- land for another part of the UK or abroad, or a patient might have died and the dentist or PSD would have been unaware of this. However, the most common


reason for overpayments is likely to be a patient leaving one practice without notifying that dentist and registering with another GDP; in that situation PSD should have


been able to detect the change and stop capitation or continuing care payments to the previous dentist, however, all too often, PSD’s MIDAS computer has failed to do this and duplicate payments have continued to both dentists. In the past, prior to April 2006,


any duplications presented less of an issue because there was a registration period which would end after a maximum three years unless the patient returned to the practice to restart this cycle. However, with the introduction of “continuous registration” by the Scottish Government, there is now no default termination of a registration period, so the issues arising from duplicates are much more of a problem. What is clear from the letter


is that PSD’s systems have in the past been incapable or at least inef- ficient at detecting duplications and so on. It seems action has now been taken to improve accuracy and efficiency at PSD and GDPs will welcome this – dentists want to be paid correctly and promptly. However, the sting in the tail is that PSD has recently been reviewing


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“Very short notice was given to dentists of the details of clawbacks before


deductions were made, leaving no time for dentists to check or challenge PSD’s list”


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Column


dentists’ payments back to 2006 and are reclaiming any alleged overpayments made since then. This is unjust for a number of


reasons: • The situation was caused by the inefficiency of systems and proce- dures at PSD, not by dentists. • It was exacerbated by the Scot- tish Government’s introduction of continuous registration, with which most dentists disagreed. • Very short notice was given to dentists of the details of clawbacks before deductions were made, leaving no time for dentists to check or challenge PSD’s list. • PSD has taken far too long to correct any errors; waiting seven years makes it very difficult for dentists to check the list. • Deductions can only be taken from dentists who are still practising, many will have moved away, left or retired and will avoid clawbacks. It seems grossly unjust that


some hard-pressed dentists who remain loyally working within the NHS in Scotland are being penalised because of PSD inefficien- cies and Scottish Government policy decisions.


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