NHS Dentists - RIP?

bonnie_2

my dentist is taking no new nhs patients i asked to register my daughter but was told i would have to pay for her treatment from april it will be £15 for a check up and 42 for a filling what do we pay our taxes for.

Toothsmith

Especially when costs run at about £160/hour, and the NHS works on a rate of about £60per hour!!

Maybe it would help if I gave a brief description of types of private dental practices you're likely to find

1. Pay as you go - dear charges (£50 per check up sort of rate)

This sort of place will be able to survive with much fewer patients than had to be seen on the NHS. Therefore service should be very good, and you shouldn't have any problems about being able to be seen in an emergency, or with the dentist being able to spend time with you and really explain your choices/treatments available.

If you're on pay-as you go, you will have cheaper years, and (if a few things break down at similar times) you could potentially have some very dear periods. Don't whinge about the dear years if you have been congratulating yourself how much you've saved by not being on a monthly plan!!!

2. Pay as you go - cheap charges (£10 check ups etc)

This place is likely to exist in the poorer areas. To keep up with the overheads, the dentist will still have to maintain a good throughput of patients. Therefore, you may well find that the place is still quite rushed, and you may feel like you're on a converyor belt. This is the price you have to pay for your dentist trying to keep it affordable for you.

3. Private monthly schemes.

(Again, the prices here vary - but as above, cheaper tends to mean more rushed, dearer should mean more relaxed, better service)

3a. Capitation eg Denplan Care

A monthly payment that is mostly paid to the dentist. This fee is based on your 'risk' and is basically an agreement between you and your dentist that if you pay so much a month, he will look after your teeth. It IS NOT insurance, as nothing is ever claimed. There is a small insurance component which coveres dental injuries, or emergency treatment whilst away from home. The only time you pay a dentist anything extra is if you need something made by a technician, in which case you would pay the technicians charge, or lab fee as it is known.

3b. Maintenance Plan eg Practice Plan, Denplan Essentials, Dentist's 'Own Scheme'

These combine both bits.

A lower set monthly payment covers a set amount of routine treatment. Patients on the 'Practice Plan' would then get any work done outside of that set amount on a discounted rate from the dentist's Pay-as-you-go pricelist. This also IS NOT insurance, but it often has the same insurance bolt-ons as the capitation systems.

So basically, you pay your money and take your choice. Some dentists limit themselves to one scheme, some offer a variety. The more a dentist offeres though, the more admin his practice would need to stay on top of them all!

Over the longer term, a patient with the same dentist would spend about the same amount whatever scheme or payment method they went for. It all evens out over the long term - it's just what is the most convienient method of payment for you. Some like a monthly budget, some like to have the cheap years, and have enough money in savings to cover the dear years.

My biggest recommendation must be to choose the DENTIST first,and the payment method second.

Toothsmith

bonnie wrote:

my dentist is taking no new nhs patients i asked to register my daughter but was told i would have to pay for her treatment from april it will be £15 for a check up and 42 for a filling what do we pay our taxes for.

£15 for a check up and £42 for a filling is what THE NHS CHARGES will be after April 1st.

These fees COME OFF the dentists NHS earnings, therefore it is just another tax!!!! Like prescription charges!

You are right to be cross. dentists are fuming - that's why we're ditching it at a rate of knots. In a lot of cases it will be cheaper to be private - especially if you've been a regular attender.

rwgibson98

Mr Toothsmith, I'm grateful for the time you've taken to contribute to this thread, and in particular for your link to your explanation of the new NHS contract.

As I said earlier, this story must seem like Groundhog Day to many readers (and dentists!). I just wondered, following the letter from my dentist today, whether many other dentists are abandoning the NHS ship this time too.

If so, this might warrant an Official Money Saving report from Martin.

My conclusion from this information, is to sign up to the Denplan scheme. It's not ideal, it's expensive, but that's how it is.

Toothsmith

I abandoned the NHS ship in 1998. I kept kids and adults exempt from dental charges on the NHS though, provided they didn't mess me about by being persistantly late, or failing appointments (I even show the door to private patients who do that).

This time, due to the wording of the new contract, I am having to privatise children as well.

I personally think about half of the dentists left on the NHS will leave between now and April. They may well keep kids on the NHS for a little while and hope they can 'get away with it' simply because it is such a huge step to take your practice from fully NHS to fully private in one blast.

I think that most of the private dentists like me who see kids on the NHS will go fully private.

There are private companies setting up new NHS practices with largely foreign dentists - the biggest of these companies has an executive who used to be a government dental policy advisor (Anyone else smell rat??), but the Government's promise to recruit 1000 new dentists was only reached by severe cooking of the books, and only about 400 extra foreign dentists have actually registered with the General Dental Council (A requirement if they are to practice legally in this country)

I have my own opinions about these places, and I will be very surprised if they are still around in 2 years time, despite all the taxpayers money that have gone into them. I have no issue about the quality of the dentists involved - the few I've met are fine. But there are several who are very disillusioned with what they are being asked to do, and claiming that it was nothing like the life they were promised in the DoH travelling recruitment fairs! Several have even packed up and gone home already.

So yes, this is the end of the end of NHS dentistry as you've known it.

Personally I'm not sad. It is well past it's sell by date, and should have been quietly put down years ago.

As for a dental service for people who can't afford private care, or who just want the most basic of services, yes there is a good case for a tax supported safety net. I would gladly be a part of it.

The treatments available should be known and clear to all, dentist/politicians and patients.

The fees payable for those treatments should be based on the cost of providing them, and that SHOULD include a profit (yes profit) element for those who take the financial risk in providing those services. (Unless the government want to provide it as a salaried service, but where they try that - Access centres - it costs them 10 times more than high street dentists PRIVATE charges)

And a debate should be held as to which services the taxpayer should provide.

Nile

Thank you Toothsmith for providing useful information on dental charges and dental plans etc.:A

I'm sure this thread (and others you have contributed to) will help MSE users to make informed decisions about their dental health. Knowledge is power.

Kind Regards

Nile

rwgibson98

Toothsmith wrote:

...So yes, this is the end of the end of NHS dentistry as you've known it. Personally I'm not sad. It is well past it's sell by date, and should have been quietly put down years ago....

You were speaking fluent sense until you said that.

However, this was intended to be a Money Saving discussion, and not a political one.

Toothsmith

I go on to stress the need for a social dental policy. It's just the present system has been unworkable since the 80s.

I feel as it stands at the moment, it's probably done more harm than good, and that will have cost people money and teeth!

Fleago

I'd just like to thank Toothsmith for their explanations too - for years I've had Denplan Care and didn't really understand what I was paying for except that I had two dental check ups per year plus two thorough scaling and polishes from the very efficient hygienist I sometimes muttered about the £15 a month I pay, but the truth is it really is very good value for money.

I confess that I hate going to the dentist but perversely would go through hell and high water to save my teeth and it is reassuring to know that I can have whatever is needed done without having to worry about either the cost or finding a dentist to do it. The beauty of the care I get under Denplan is that I have a lot of preventative care which has meant that I haven't needed any other treatment whatsoever since taking out the Denplan. This, in turn, has lead to going to the dentist being an almost pleasant experience :T

I really admire people who can be dentists, dental nurses and hygienists - it can't be pleasant at times having to peer into gobs full of rotten teeth and rancid gums :eek:

My OH doesn't share my views though and believes that dentists burst forth, fully formed, from the seventh realm of hell where they were taught to purvey snake oil and to torment their patients with their cunning wiles and sharp instruments. Needless to say, my gnashers are MUCH better than his are :rotfl:

Fleago

Toothsmith

This, in my opinion, is what makes Denplan a win-win for us both.

Patients don't like lots of treatment. It is more expensive for the dentist to provide lots of treatment. So, by getting the preventative side of his/her practice working well, the dentist is operating at maximum profitability, and the patient has a nice healthy mouth which gives them the minimum of trouble.

Just to point out possible downsides though, before anyone else leaps in and flags them up, it would pay an unscrupulous dentist to ignore problems in the hope that he has moved on by the time the patient notices there is anything wrong. This again is why it is of vital importance to pick a dentist with whom you intend to build a long-term relationship.

Also, it flags up why a free-at-the-point-of-delivery, or tax subsidised healthcare/dental system will always be prone to failure. If the end user has NO motivation to keep their treatment needs to a minimum - and some element of cost is always a great motivator - then the system is doomed to spiral out of control as costs soar.