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

boozercruiser

NHS Dentist practice and policy within Gwynedd

A Freedom of Information request to Gwynedd Local Health Board by Tracyb

The request was successful.
Tracyb

29 March 2009

Dear Sir or Madam,

I would be very grateful if you could confirm under which
guidelines, policy or practice can a NHS Dentist refuse scale and
polish treatment to a patient.

R.E: Can a person be denied scale and polish treatment if they are
a smoker.

Yours faithfully,

Tracyb

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Helen Adams
Gwynedd Local Health Board

31 March 2009

Dear Tracy B

FOI 09 143

Thank you for your request for information about NHS Dentist practice and
policy within Gwynedd which the LHB received on 30th March.

We are processing your request under our Freedom of Information scheme and
will write to you shortly. If you need any further assistance please do
not hesitate to contact me at the address below.

Yours sincerely

Helen Adams

Cyfarwyddwr Cynorthwyol Gwybodaeth Gorfforaethol

Assistant Director Corporate Information

Bwrdd Iechyd Lleol Gwynedd / Gwynedd Local Health Board

Eryldon, Ffordd Campbell / Campbell Road,

CAERNARFON, Gwynedd LL55 1HU

( 01286 674202 (Llinell Uniongyrchol / Direct Line)

Ffacs / Fax: 01286 674197

Unless specified, any of the statements or comments made above should be
regarded as personal and not necessarily those of the organisation. The
information contained in this message is intended for the named recipients
only and may contain sensitive or confidential information. If you have
received this email in error please notify the sender immediately.

It should also be noted that the contents of this e-mail may be subject to
public disclosure under the Freedom of Information Act 2000. Therefore,
the confidentiality of this message and any reply cannot be guaranteed.

References

Visible links
1. http://www.gwyneddhealth.org/

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Helen Adams
Gwynedd Local Health Board

22 April 2009

FOILHBPublicLeafletV2 English.doc
547K Download View as HTML

Dear Tracy,

Request 09 143 under Freedom of Information Act 2000

Thank you for your request for information regarding the provision of
dental services which we received on 29^th March 2009.

Under the terms of the Freedom of Information Act 2000, we are pleased to
enclose the information you requested.

An NHS patient is entitled to & should receive ALL treatment necessary to
establish & maintain oral health, and if they need it this also obviously
includes a scale & polish. If the treatment is beyond the competency of
the provider, then they should be referred on for it, with a form to state
what NHS charges have already been incurred.

If the patient is a smoker, and needs a scale and polish then it must be
provided.

If you are dissatisfied, either because the information was not provided
to you or with the way your request was handled by the Local Health Board
(LHB), you have the right to request a review. This will be dealt with in
accordance with the LHB's procedures for dealing with FOI requests and I
enclose a copy of our leaflet for your information.

If you are still dissatisfied at the end of the review, you are advised to
take your complaint to the Information Commissioner, who can be contacted
at the following address:-

Information Commissioner's Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

SK9 5AF

Yours sincerely

Helen Adams

boozercruiser

Welshdent "Dental practices are all private businesses that are subject to ever increasing financial costs on various un neccessary government dictats. Within this they need to make ends meet on a cash limited budget from the NHS when they agree to carry out work on the health service."

I am very sorry to hear that Dentists are struggling to make ends meet on a cash limited budget. Perhaps this is why the recent times SCAM of "Go to the Hygienist at a cost of £25 to £50" (More cash in the Dentists pocket) is needed by some obviously hard up and unscrupulous Dentists instead of providing it under the NHS.

Dentists in general obviously earn far more than any patient earns, and those that do this should be ashamed of themselves when they pull this CON.


Many dentists earn over £200,000

Access to NHS dentistry is a long-running problem


Nearly 1,200 dentists in England and Wales earned over £200,000 in the financial year 2007-08, official figures show.

The NHS Information Centre statistics show 382 dentists - nearly 2% of the total - earned more than £300,000 in the year.

Average take home pay for the 19,586 registered dentists was £89,062.

The Liberal Democrats said the figures would "astonish people" who were still seeking NHS dental care.
DENTISTS' EARNINGS
More than £300,000: 382
£275,000-£300,000: 113
£250,000-£275,000: 159
£225,000-£250,000: 228
£200,000-£225,000: 291
£100,000-£200,000: 4,418
£50,000-£100,000: 8,699
Figures for taxable income, after expenses have been deducted


The figures cover earnings in the second year of the new contractual system for dentists.

However, the NHS Information Centre said they could not be compared with the previous year's earnings, which were calculated differently.

Chief executive Tim Straughan, said dentists' earnings varied greatly.

Dentists running their own practices who had a contract with the local primary care organisation to provide NHS services earned on average £126,807.

But dentists working in a practice without such a contract earned on average £65,697.

Since the start of the 1990s dentists have been increasing the amount of private work they do, resulting in problems for many people in accessing NHS services.

As a result, the government introduced the new contract in April 2006 in a bid to improve NHS access.

The aim was to end the "drill and fill" culture, which critics said had developed because dentists were paid for each individual treatment they carried out.

Under the new system dentists are paid for agreeing to do a set amount of courses of treatment over a year.

It was structured so that dentists would get the same amount of money for treating slightly fewer patients.

However, further tweaks to the contract are now planned after ministers accepted that their reforms had failed to improve patient access as hoped.

Working hard

John Milne, chair of the British Dental Association's general dental practice committee, said: "These statistics reflect a time when dentists were working hard to overcome problems with the new arrangements and make them work for their patients.
The amount of money some dentists are earning is staggering
Norman Lamb
Liberal Democrats


"Many practitioners were contending with the uncertainty of potential clawback of their contract values.

"Dentists, almost uniquely in the NHS, carry the business risk of their surgeries and are responsible for providing premises, equipment and staff.

"The picture the statistics paint is one of earnings settling and the expenses of NHS practitioners rising slightly, although, as the Information Centre itself points out, it is hard to make comparisons with figures from previous years."

Norman Lamb, health spokesperson for the Liberal Democrats, said: "These figures will astonish people who are struggling to find an NHS dentist.

"The amount of money some dentists are earning is staggering.

"It is vital that the NHS can compete with the private sector to secure the best staff.

"However, we need to know that we are getting value for money."

Health minister Ann Keen said: "NHS dentistry is improving and many dentists are now keen to expand their NHS work.

"Today's report confirms that NHS dentists have good levels of earnings.

"Access to NHS dentistry is continuing to improve, following record investment, an expanding workforce and a continuing increase in the amount of services being bought by the NHS."

And don't forget that the above figures are for 2007/2008.....God only knows what the earnings are now!

welshdent

<<sigh>> ... despite asking a leading question the FOI seems to back up what we have said ..
"
An NHS patient is entitled to & should receive ALL treatment necessary to
establish & maintain oral health, and if they need it this also obviously
includes a scale & polish. If the treatment is beyond the competency of
the provider, then they should be referred on for it, with a form to state
what NHS charges have already been incurred."

I will draw your attention "necessary to
establish & maintain oral health" which .... is ..... exactly what we have been saying to you from the start. This thread was nothing to do with any indication that someone is being declined a scale and polish on the basis of being a smoker. Therefore if the dentist feels that on examination a scale and polish is not necessary to secure or maintain oral health then the do not have to provide it.

Ann Keen knows more about claiming expenses than she does NHS dentistry and I am yet to meet any primarily NHS dentists earning 200K. Even if they did ... this is not a salaried profession. Even if they did that would just mean they were providing work to the amount of 200K. The NHS pays dentists money for work done so if they do the agreed amount of work then they are duly remunerated by that amount. If the government do not wish to spend that sort of money then they should not agree to such a contract. Dentists are NOT like any other NHS worker who has a set salary. But as I say, I dont know any dentists on anything like that money. I have a lot of patients earning more than me also ... not that it is remotely important

boozercruiser

Welshdent "Ann Keen knows more about claiming expenses than she does NHS dentistry"

Well Welshdent......thank you for your further input.....and I can certainly agree with you on that comment!:D

coldstreamalways

When I worked onthe NHS, I had a number of patients exempt from charges who earnt more than me.

Hey ho, we're all bug9ers though. It's possible the easiest and least stressful job in the world so maybe we should all just do it for free with the hundreds of thousands of pounds we all have.

I can't wait to retire because of attitudes like this, it's so demoralising

alison999

boozercruiser wrote: »

I rest my case and will not add anything further here as I better get a life while I still have the will to live. LOL!.

What happened to this?!

Toothsmith

A few weeks ago boozecruiser an 'NHS Dentist' featured in C4's 'Secret Millionaire' program.

http://www.channel4.com/programmes/the-secret-millionaire/episode-guide/series-9/episode-1

Seema would show up as one of your 382 'NHS dentists earning more than £300k'.

Her fortune, however came from her property developing business, not her dentistry. And her husband is a very successful cardiologist.

The skills involved in getting appropriate high-grade 'A' levels, surviving 5 years of a very intense, highly academic, but also highly practical university course and then buying and running a very complex small business tends to attract people with certain entreprenurial skills, and develop those skills. There are very many dentists with successful 'other' businesses. But their earnings tend to get lumped together and put under the label 'dentist'.

But dentistry is democratic - it's not like the monarchy! Anyone who is prepared to put in the work can do it!

My dad fixed lorries, then had his own tyre and exhaust business.

In 1998, when I'd had enough of the NHS, my choice was go private, or take over his business as he was retiring.

I decided to stay in dentistry and enough of my patients liked me well enough to appreciate the value of the way I do it, and pay a bit more so I can carry on doing it the way I want to rather than the way the NHS would have told me to do it.

I think you need to decide what you want boozecruiser.

If you want the way the NHS does it, then you need to accept the rules. If you want it done 'your way' - you need to find someone like me.

boozercruiser

19th March 2010

To further illustrate what is wrong with the present sysem.....below is my original complaint letter to Denticare at the start of this fiasco. AND, I now have this afternoons appointment for the Scale and Polish, plus present the Dentist with the small pea filling which has already come out.:D

I can tell I wouldn't win any popularity contests with some of the nice people who come here.....BUT....please pray for me!:D

8th January 2010
The Practice Manager
Denticare

Hello,
Some days ago I telephoned in and said "I have an annual check up appointment booked for Monday 1st. February 2010, however I have had a filling come out of the back of a front tooth. Would it be possible to bring that appointment forward so I can have the tooth looked at?"
I was first asked if I could make a visit to the Dentist later that afternoon because of canceled appointments, however, I could not do so and was given an appointment for today at 11.50am.

At today's appointment Dr. Andrez Gaza advised me that the tooth needed a filling, but he would put in a temporary filling for now, and then a proper filling at my usual check up on
1st. February 2010. So he put in the temporary filling.

However at the reception desk I was charged £12 on the grounds that this was an emergency appointment, and that I would still be liable for a £39 charge for the filling at the appropriate time.
Please note that I have written on the bill paid to you "Paid under protest" on the following grounds.

1. I did not request a so called emergency booking, only that my annual check up be brought forward
2. Particularly as people have been canceling and there did not appear to be any pressure on time, I would have thought that the filling could have been done today?
3. And if it could not, then why should I have to pay an extra £12, particularly as it is not my fault this work was not done today?
4. At my telephone call I was not advised that the appointment would be classed as an emergency, and therefore would attract an extra fee of £12.
5. To my mind today's situation should have been properly included as per below:-

Simpler charges for NHS dentistry from 1 April 2006
• If you are exempt from NHS dental charges, you will still receive free treatment and care.
• If you pay for NHS dental treatment, there will be three standard charges.
• You will pay one charge even if you visit more than once to complete a course of treatment.
• The amount you pay will depend on the treatment you need.
You will pay one of the three charges below:
£12.00
This includes an examination, diagnosis and preventive care. If necessary, it will include X rays, scale
and polish and planning for further treatment. Urgent and out-of-hours care will also cost £12.00.
£39.00
This includes all necessary treatment covered by the £12.00 charge PLUS additional treatment such
as fillings, root canal treatment or extractions.
£177.00
This charge includes all necessary treatment covered by the £12.00 and £39.00 charges.
I am therefore requesting that the £12 already paid be included within my normal expected charge of £39 because of the filling.
Please also note that I am requesting a scale and polish at the 1st February appointment which is included in that charge.
Best Regards

I Received this E. Mail back....

Unfortunately the receptionist relayed the wrong information and put your appointment as an ‘urgent’ one when you requested that you examination be brought forward. Because if this, I will waive the fee of £12 that was incurred on 8th January and you will be charged the £39 for the examination and filling which will take place on 1st February 2010.

As you have paid the £12, you will only have a fee of £27 charged to your record once you have had the treatment.

I hope this meets to your satisfaction

Regards

Perhaps someone will notice that the ONE filling was changed to THREE fillings by yhe next DIFFERENT Dentist.

8th January this started.....and I am STILL not sorted. Perhaps today...eh!:D

Alison 999
Quote:
Originally Posted by boozercruiser
I rest my case and will not add anything further here as I better get a life while I still have the will to live. LOL!.

What happened to this?!

Well spotted Alison 999. If only my recent DentistSSS were as efficient in spotting discrepencies in both charging, and Dental care ....the world would be a lot better wouldn't it?

Besides......but I really do feel honoured that some actual Dentists are takeing the time to have an input here, and in spite of differences of opinion I have great respect for them. On reflection, I felt that perhaps it was a little bit disrespectfull NOT to reply.

BUT, I am afraid that we are coming from different directions after all.

A bit like the British Airways dispute if you like!

welshdent

hypothetically, had they looked at the tooth and said to book back in for a filling and done nothing how would you have felt then? Just playing devils advocate her ... you are the dentist and patient a requests a sooner appointment as they are having a problem. So this is not the original appointment this is a slot reserved for people with problems hence being able to get in so much sooner. You manage this problem as an interim measure because you were under the impression the patient was having a problem and wanted it addressed ... would you not wish to be remunerated for work carried out? Band 4 treatments are a grey area indeed however from here

http://www.opsi.gov.uk/si/si2005/20053477.htm

SCHEDULE 4Regulation 4(5)


Urgent Treatment under Band 1 Charge
(a) examination, assessment and advice

(b) radiographic examination and radiological report

(c) dressing of teeth and palliative treatment

a temporary filling is a dressing. So one could easily see why a dentist may charge a standard NHS Band 4 fee

welshdent

another situation that may be viewed as questionable in wales ... what if you are over 60 and your dentist says to you I am recommending a scale and polish to you but would like to charge you privately 9.50 to do this? What would your immediate feelings on the matter be?