Asked for Dental NHS Scale and Polish.Told "Go to Hygienist at £25 extra"

Savvy_Sue

brook2jack wrote: »

Contact and ask your dentist. If you really are allergic to the antibiotic it is very important they know and they will advise you further.

especially as there others you could take, if necessary. who prescribed these, GP or dentist?

boozercruiser

Brook2Jack..."Many dentists left the NHS after the 2006 contract because we could not see how we could offer the same service that we had before without going bankrupt.

The lie is that the government tells you that all treatment necessary is available on the NHS when it is clearly not. NHS has severe restrictions and the only people who are aware of it are the patients and practitioners.

Pre 2006 on the NHS we routinely sent people to the hygienist, we routinely gave anaesthetic where needed for periodontal treament and we routinely gave multiple appointments for periodontal "gum" problems. We still do the above but are now a mostly private practice as a result of being unable to practice dentistry in the way we think is right. One of the most depressing things I have heard for a while is that dentistry is so little valued that

a) practitioners are cutting costs to the bone to stay "NHS" so much that even local anaesthetic can be considered not necessary."

With great respect Brook2Jack your comments only confirm my fears that the actual overall care that many Dentists now offer inside the NHS Band Scales is nowhere near as good as it was pre 2006.

What a rather damming and disgracefull admission to have to make!

"Practitioners are cutting costs to the bone to stay "NHS" so much that even local anaesthetic can be considered not necessary,and treatments which are supposed to be available, but would bankrupt them if offered on the NHS, are not".

When around 3 years ago it happened to me for the first time an ANAESTHETIC was not used, and I felt some pain I decided next and every time to SPECIFICALLY request that an anaesthetic be used for a filling. Fair enough this has been done.
However, I know a 72 year old lady friend of mine who WILL NOT NOW GO TO THE DENTIST because of this, and in fact has not been to the Dentist for around 2 years. God only knows what problems she is storing up for herself. I have told her to request an anaesthetic, but she is a little frightened to actually ASK.

This situation makes me so angry.:mad:

To think that people are going through ANY amount of discomfort, or perhaps PAIN simply because " Practitioners are cutting costs to the bone" is an absolute SCANDAL (Considered disgracefull).

If I where a Dentist, I would be too ashamed to admit this truth.

You further confirm that the Hygenist and many other situations used to be included in NHS care but now the regular move is to 'shunt' the patient off to the Hygenist at an extra even though these services which you freely admit are "treatments which are supposed to be available".

Your other point Brook2Jack "b) patients automatic response is to get as much as possible for as little possible and their default position is that the dentist is out to "rip them off".

If patients do think that way....in view of what you have said....is it any wonder then?


May I respectfully suggest that any NHS Dentists who have followed the rout that you outline should, as lots have on principle, quit the NHS, go Private and link up with the services they have already shunted there.

Cheers.

brook2jack

boozercruiser wrote: »

You further confirm that the Hygenist and many other situations used to be included in NHS care but now the regular move is to 'shunt' the patient off to the Hygenist at an extra even though these services which you freely admit are "treatments which are supposed to be available".

May I respectfully suggest that any NHS Dentists who have followed the rout that you outline should, as lots have on principle, quit the NHS, go Private and link up with the services they have already shunted there.

Cheers.

Well put. However the corollary to this is that eg in our instance, although we do not earn much more than we did on the NHS the cost to the patient is higher as we spend the time with them that is necessary. We see alot less patients in a day.

Most of us feel that the NHS is a vital service but one in which costs have necessarily to be curtailed. We as a nation have to decide what really is necessary on the NHS and what isn't. Ie would a core service of fillings,extractions and dentures and everything else private, keep a lid on expenses ,sort out access problems and finally sort out what is and isn't available on the NHS?

welshdent

booze I would really ideally like to be fully private however the option isnt really there for me. There is a big misconception that there are all these money hungry shark like dentists swanning off to this fully private oasis. Its not the case. In wales they introduced an inspection service to make sure private practices were governed more.... the problem is that so few actually were totally private and as such outside the NHS inspections etc that it was not cost effective to set up ... sooooo they applied it to ALL practitioners in wales regardless of them providing NHS services or not. That I hope highlights how few fully private dentists there are in wales overall. Generally you can only "go private" if your practice owner decided to convert or if you gradually over time start to withdraw service. As an associate it would be difficult to do. I have applied for a couple of private jobs and the best I was offered was one morning a week. Thats all they had. So as I said. I would gladly go private but its not that easy! lol

boozercruiser

welshdent wrote: »

booze I would really ideally like to be fully private however the option isnt really there for me. There is a big misconception that there are all these money hungry shark like dentists swanning off to this fully private oasis. Its not the case. In wales they introduced an inspection service to make sure private practices were governed more.... the problem is that so few actually were totally private and as such outside the NHS inspections etc that it was not cost effective to set up ... sooooo they applied it to ALL practitioners in wales regardless of them providing NHS services or not. That I hope highlights how few fully private dentists there are in wales overall. Generally you can only "go private" if your practice owner decided to convert or if you gradually over time start to withdraw service. As an associate it would be difficult to do. I have applied for a couple of private jobs and the best I was offered was one morning a week. Thats all they had. So as I said. I would gladly go private but its not that easy! lol

Welshdent. You always enlighten me as to why some things are exactly as they are. The points you mention I find very interesting, particularly as I live in Wales. However, as a patient it doesn't make it right for me knowing that standards in NHS Dental care have been falling ever since 2006.

Someone mentioned that the whole system of NHS Dental care is under review and that perhaps changes are to be made in 2012.

I won't hold my breath that NHS Dental Care will be improved by it though....either from a patients point of view, or the Dentist.:)

boozercruiser

brook2jack wrote: »

Well put. However the corollary to this is that eg in our instance, although we do not earn much more than we did on the NHS the cost to the patient is higher as we spend the time with them that is necessary. We see alot less patients in a day.

Most of us feel that the NHS is a vital service but one in which costs have necessarily to be curtailed. We as a nation have to decide what really is necessary on the NHS and what isn't. Ie would a core service of fillings,extractions and dentures and everything else private, keep a lid on expenses ,sort out access problems and finally sort out what is and isn't available on the NHS?

With respect, your question "would a core service of fillings,extractions and dentures and everything else private, keep a lid on expenses ,sort out access problems and finally sort out what is and isn't available on the NHS? is very interesting.

However, I feel that the tide towards this is well on the way to happening, as per my many previous 'Thoughts of Chairman Boozercruiser':D!

Speaking as a patient of course...I would not agree with things OFFICIALY going that way as per a contract...even if they appear to have flowed at least half that way AGAINST the present contract!

Cheers.:beer:

welshdent

Honestly, I bet few would notice a core service if it was in place. Certainly most of my patients have by choice what equates to a core set up. A core service is basically extractions, prevention etc. It would however prevent the "expensive" things such as certain types of denture, molar root fillings and posterior crowns.
The problem is there simply is not the money to fund a comprehensive system. Many years ago the techniques and materials we have at our disposal now simply did not exist. As such the expense was lower because work was easier and cheaper as the options were not there. No government will openly admit that they can not fund a complex system, nor should they IMO. In dentistry you can have many equally effective options to treat the same problem. The problem is that some are significantly more expensive that others. £40 for a metal crown or £140 for an all ceramic white one. If the metal one will attain health then I dont see why the tax payer should fund the rest because you could pay for 3.5 metal crowns for 1 white one. Lets also bear in mind that the dentist is given 1 fixed amount to fund the lab fee AND the clinical costs AND earn some money for themselves. IMO the contract was typical of labour. Tell people they can have loads of things but not give the providers any support to meet the demand! (political rant over!).

At least with a clearly laid out core service patients would know exactly where they stand. The service would be the same so you wouldnt have to rely on trying to find a generous dentist. I suspect that if the complex treatments were exempt then it would lead to a better arrangement. Due to demand I think dentists would need to either better their skills to meet the private need or accept their limitations more readily as opposed to being effectively forced to provide treatment they are not capable of doing (happens more than you think!). This would lead to more appropriate referrals IMO. It would be clear and above board and I also think you would encourage dentists back in because most DO want to provide a good service and help those in need contrary to the bad press.

An alternative for me would be to tell patients they can have whatever lab work they want provided they pay the lab costs. Allow the NHS commissioners to fund the dentist and eliminate these external costs for work provision. THEN we could say you can have whatever crown you like here is the price list you can pay the lab.

We just need the politicians to be honest about what they can and can not afford.

brook2jack

As a country we spend an average per year per person treated around £30. How much complex dentistry will thus buy?

Given that more people are keeping teeth longer (30% of all adults in the 70s had no natural teeth left compared to 10% England 17% Wales now) and given no more money will be put into NHS dentistry ( look at your LHB accounts they are in the red and need to cut services as do all LHBs in Wales) how do you provide services.

Ireland stopped all NHS type treatment in May overnight. We don't want that but we need to think how to provide a dental health service rather than a comprehensive service which is what the government pretends we have now.

brook2jack

[QUOTE=boozercruiser;



Speaking as a patient of course...I would not agree with things OFFICIALY going that way as per a contract...even if they appear to have flowed at least half that way AGAINST the present contract!

Cheers.:beer:[/QUOTE]

So given that less than 1% of NI goes to dentistry and in your area of Wales £28 per person treated per year is spent on NHS dentistry in total including patient charge what would you suggest?

There is no more money for dentistry.What should people expect from dentists for £28 a year? If as a country that is all that can be afforded what is it that is important to protect? Complex treatment that is expensive to provide and maintain? Or a basic service for everyone that provides enough to keep people out of pain and healthy ( you only need 20 teeth to be healthy) and basic preventative work but they have to go private for anything else.

boozercruiser

Welshdent......... "We just need the politicians to be honest about what they can and can not afford"

First we have to find an honest politician!...........

Looking for The Scarlet Pimpernel springs to mind! They seek him here, they seek him there, they seek that honest politician everywhere! ................lol