MORE than 43,000 people across York and Selby are facing an uncertain future in NHS dentistry after new figures revealed nearly a quarter of the region's dental practices are going private.

The alarming statistics released by Selby and York Primary Care Trust (PCT) show that 11 of the area's 45 dental practices have refused to sign controversial new dental contracts, which come into force on April 1.

A further 11 have yet to make their decision, but have less than three weeks to do so before all existing NHS dental contracts end and the new ones come into force.

The 11 practices which are definitely leaving the NHS would affect 10,000 patients.

Bosses at the troubled PCT today said they expected some of the remaining 11 practices to sign up to the contracts, which could save 26,500 of the 43,000 uncertain places.

But they predicted at least a further 6,500 patients are at risk of losing their NHS dentist because their practices are still discussing the contract with the PCT.

That means about 16,500 people either have lost their NHS dentist, or are at serious risk of doing so. They face the prospect of going back on to the waiting list.

Today, former British Dental Association chairman Dr John Renshaw, whose own Scarborough practice went private over the new contracts, said the situation in York and Selby was "grave".

He said: "The impact on the service is really very serious, because the service in the York and Selby area has been struggling for some time.

"I would have said 40 (practices) would have signed up by now. Eleven, 25 per cent, have definitely said no. I would have said four to five would have been enough to cause trouble.

"Any more defections into the private sector are bound to have a damaging effect. The service is already under tremendous pressure."

Just over half of the population - 151,168 people - in the Selby and York PCT area are registered with an NHS dentist, and 23 of the area's 45 dental practices have agreed to the new contracts.

That means 71.4 per cent of people who are registered with an NHS dentist have now been catered for.

But it leaves the rest, some 43,200 people, with dentists who have either quit the NHS, or are still deciding whether to stay on.

A spokesman for the PCT refused to provide details of which practices had turned down the contract, but today the Evening Press can reveal that Beeches Dental Practice, in Acomb, York, has confirmed it had decided to go private - and letters had gone out to patients informing them of the decision.

Two York practices, Clock House, in Heworth, and WS Inness, in Haxby, told the Evening Press they were accepting the new contracts.

Selby MP John Grogan said: "The next couple of weeks are clearly going to be very worrying for every NHS patient until the York and Selby picture becomes clear.

"I urge the 11 practices who are still considering their options to sign up along with the 23 who have already done so.

"I understand the average dentist will be getting more than £80,000, plus very generous expenses.

"If they don't sign up, I think the PCT will have to seriously consider using the money which will then be available to bring in dentists from overseas to fill the gaps."

Health Minister Rosie Winterton said the new contracts were a "good and fair offer to dentists".

She said: "The public have every reason to be confident in the future of NHS dentistry.

"The new contracts offer dentists with a reasonable commitment to the NHS an average income of £80,000 (after expenses are taken into account). This income is guaranteed for three years. All this for at least five per cent less work than under the old contract."

What Selby and York Primary Care Trust says:

"From April 1, 2006, if a dentist leaves the NHS the dental budget will remain with the PCT.

Our main priority is to agree a new contract with each practice but if a practice does decide to leave the NHS we will be able to commission alternative NHS dental services for those patients.

It will also enable PCTs to target dental resources to those areas with the greatest need.

To date, we have had 11 practices that have confirmed they will be leaving the NHS at the end of March, 2006. Most of these 11 practices were already mainly private practices and operated relatively small NHS lists.

Anyone who requires an NHS dentist can register with the PCT's dental register, either online at www.sypct.nhs.uk or by phoning 01904 724107.

Of the practices that have not yet signed but we are expecting to sign, the practices have until March 31, 2006, to return the contract and we have no reason to believe this will not happen. From our discussions with these practices, we are confident that these practices will be signed by the end of March."

- A Trust spokesman said it was possible not all of the patients whose dentists had decided to go private would end up on an NHS waiting list, if they decided to stay with the same surgery but accept private treatment.

The PCT would not say which practices had opted out of the NHS, saying it was up to each to inform its own patients and some may not yet have done so.

Case study 1

Peter Mikola, of Copmanthorpe Dental Practice, York, said he had not yet decided whether to accept the new contract.

He has about 1,900 NHS patients on his books, but sees private clients as well.

"It's basically a glorified cost cutting exercise for the government," he said. "They want to squeeze patients out of the NHS but they want dentists to do it for them.

"The whole thing was meant to get rid of targets but it's totally target driven. It was originally supposed to allow dentists flexibility and more time with patients.

"If I do stay with the NHS, I definitely won't be taking on any more NHS patients. There's no incentive to do so. It's the patients who will suffer in the end.

"It's a very sad day for NHS dentistry. I have been a loyal NHS dentist for 27 years and this is how they repay me. I feel hurt and offended."

Case study 2

YORK dentist Keith Lofthouse, who owns Wigginton Dental Practice, went mainly private in 2004 but kept on seeing children on the NHS and has about 600 on his books. He sees about 2,000 adults as well.

Mr Lofthouse said he was still negotiating with the Primary Care Trust (PCT) over whether to carry on seeing child NHS patients only.

The PCT has said it will offer dental contracts to dentists with children-only NHS lists but where a practitioner currently offers NHS dental care to all categories of patient they would be expected to continue doing so.

But Mr Lofthouse said despite the offer of a children-only contract, the practice was still likely to turn its back on the NHS and go completely private.

"We're trying to negotiate a reduced contract," he said. "We couldn't work to the targets - they're far too high.

"We're obviously really upset. We're being forced into this situation.

"It's the Government which has put the PCT into this difficult position."

Updated: 10:01 Wednesday, March 15, 2006