NHS Dentists - RIP?

Toothsmith

I thought I was getting well into the arguments!!!

I enjoy it and don't take any of it personally. I hope it's the same for my 'adversaries'

It is a hugely complicated area. The way dentistry has historically been linked into the NHS has never been a happy marriage, and it is becoming a very messy divorce.

summerday

Hello,

My dentist is currently one of the few NHS dentists left in our area. I don't mind going to the dentist at all, only ever go once a year for a check up and have never needed any fillings etc (I am a chocoholic but believe that dental hygiene is very important so am fastidious about brushing and flossing!) Can anyone tell me how much I'd have to pay for Denplan if my dentist went private and whether such a plan is worth it fore someone whose teeth are in good condition?

Thanks, sarah

Toothsmith

Look at the last paragraph of post #50

You can only join Denplan if your dentist goes private via the Denplan route. There are lots of similar schemes and companies.

Wait until it happens, (If it does, but even if it doesn't you may feel you would like to transfer to a private practice once the 'new ways of working' start to affect your care, and the new charging regime is costing you nearly as much as a private practice anyway) and see what scheme your dentist goes with and what he/she recommends.

Toothsmith

Ok Ok - I'll come clean!!!

Go over to 'Funny Money' HERE to see the real reason we're leaving the NHS

Sithicus

Hello. I'm a dentist as well. You think NHS is bad - you shoud see what's happening in Polish NFZ. I've decided to move to UK with my wife (she's a dentist as well). Thanks to you I know that we should avoid working for NHS. I've got some friends that moved to UK and are working now for NHS. They were ask to do substandart work treating NHS patients. Sad but true.
BTW - I'll show some of your post to my friends that are still here. It'll help them to make some decisions.

Tajak1000

As an NHS dentist I feel almost compelled to give my opinion.

As Toothsmith said, NHS dentistry has on the whole not worked well for many years. The relatively low fees have encouraged many dentists to work longer and see more patients to make up for ever increasing overheads and government imposed regualtions. In real terms the money dentists were paid for doing a filling has decreased year on year, whilst the costs associated with running a practice have increased. You can only do so much treatment in a day and keep your standards up. Long hours, and working too many days is a recepie for disaster - you get a stressed, worn out dentist, who invariably becomes ill, physically and mentally. The dentist works more and more hours, treating too many people, doing more and more treatment, with a waiting list that gets longer and longer. This helps nobody, and is what Toothsmith described as the Treadmill. A dentist should not have to look after more than 2000 people....... many NHS dentists presently have 5-6000 on their books. The dentist generally just gets worn down by this, which is why as a profession, the suicide rate of dentists has always lingered around the top three. The top one is currently vets.

Some dentists give up and went private, not so much to earn more money, but to slow down, get their lives back and in many cases prevent going bancrupt. Many have families they would like to see. 20% of NHS dentists in this country are in financial difficulty, with 5% close to bancruptcy. Many NHS dental practices have actually been kept afloat by the dentist taking out equity from their homes. This could not continue, but at least the dentist had the ability to treadmill a bit faster to earn a bit more money to pay for something that broke.

Dentists have a right to enjoy what they do. If you don't enjoy your job then you shouldn't be doing it. For many dentists, privatisation is something of a last resort

I wabt to repeat something Toothsmith stated. According to the Inland Revenues own figures, the average private dentist will not make much more than the average NHS dentist.

Here are the problems with the new system

1. You will hear that the governemnt consulted with the profession about the new contract. This is true, except they completely ignored all the advice given by the profession
2. The proposed contract is untested, and for the majority of people will result in an increase in NHS charges
3. Control of NHS dentistry has been devolved to the local level. Primary Care Trusts (PCT
   ), who know little about proviiding dental health care have been lumbered with a short deadline just at the time they themselves are undergoing major reorganisation - the whole thing is a complete and utter mess
   • The contracts are purely aimed at providing access for those who presently do not have a dentist. This will be at the detriment of those who presently attend regularly
   • There is nothing in the new contract that provides a preventive service for people. The whole emphasis of the NHS should be preventing dental disease, which in 95% of cases is a purely preventable disease.
   • Many Primary Care Trusts are treating their dentists with utter contempt and are quite literally trying to shaft them by getting them to sign up to extremely harsh contracts. The dentists quite rightly say "stuff you" to their new pay masters and remove themselves from the NHS therefor keeping their status as independent contractors
   • Any dentist that was working under treadmill conditions in the old scheme will be in an even worse situation come the new contract. This is why many dentists plan to retire early
   • All NHS registrations will be cancelled. What many people don't know is that you will have no right to dental treatment unless you are presently undergoing a course of treatment with a dentist. Toothsmith is wrong on this. As long as a dentist is meeting his targets he can treat who he wants as long as he doesn't discriminate against anyone
   • The Chief Dental Officer, who is the governments representative to the profession has stated in writing that cosmetic treatments can not be done in the new contract
   • In the past a dentist could set up an NHS practice wherever he wanted. Now practices will only be placed where PCT's want them to be, and only if the PCT has any spare money. This will not improve access.
   • Many PCT's will waste money setting up access centres which cost over ten times the amount of money to treat people as an NHS dentist presently
   
   The money for PCT's to provide NHS dentistry is currently ring fenced and based on the average practice earnings for the dental practices in their catchment area. This money will be ring fenced for three years, which means it can only be spent on dentistry. AFTER THAT 3 YEARS IS UP, THE PCT CAN SPEND IT ON ANYTHING IT WANTS. You think if there is a crisis in Cancer care, dental money won't get redirected. You think if the PCT is on the brink of bacruptcy, as many of them actually are, dental money won't find itself being redirected. If a PCT can close a hospital ward down, it won't think twice about cutting the budget of a dental practice. You think a practice owner who has bills to pay, staff to pay and a family to feed doesn't realise this.
   
   You cannot blame an NHS dentist for protecting his livelyhood. The reason private dentists dont earn a great deal more is that they invest the money from greater fees into their practices, staff and themselves through post graduate training. And a private dentist will not have the uncertainty that maybe the PCT won't pay him next month. We are not doctors. We paid for our own premesis, we pay for our own satff, our own expenses, our own materials. We are a business, and for a business to surbive, we need certainty. The governemnt have just removed that certainty by devolving the money we are paid to PCT's who are in financial and reorganisational turmoil. Treatment will be led by targets instead of need.
   
   Saying all that, you will be surprised to hear that I am stying in the NHS. Why? Because I have a good PCT who know how to work with dentists to get the best for our patients. They are flexible on the contract and have allowed me to make alterations to the worst aspects. This allows me to control the running of my practice, to keep costs under control, and to look after my existing patient base. They also know that I am more than ready to go private should they suddenly start to mess me about. I have always operated my NHS practice on a model differnat to that of the treadmill, which has left me in a very comfortable position
   
   You can blame the dentists if you want, but it doesn't change the fact that we didn't ask for this contract, we don't want it, and in three years there probably won't even be the money to pay for it.

Grogg

Tajak1000 wrote:

The dentist generally just gets worn down by this, which is why as a profession, the suicide rate of dentists has always lingered around the top three. The top one is currently vets.

Not strictly true. The government do not record suicides by occupations only age and sex so information is gathered by various mental health organisations to try to provide figures by jobs.

Mind


Suicide and employment

Men in unskilled occupations are four times more likely to commit suicide than are those in professional work.[16]

Certain occupational groups such as doctors, nurses, pharmacists, vets and farmers are at higher risk of suicide. This is partly because of ease of access to the means of suicide.[17]

Tajak1000

rwgibson98 wrote:

Is your £10/month paid direct to the dentist, or to a company?

I can't help feeling that a large proportion of the monthly fees is going straight to a company's bottom-line profit, and not to my dentist.

You will be pleased to know that it's less than 10%

payless

My denist now told us its £11.25pp pm ( kids free)
to include 2 checkups and 2 scale/ polished each year ,( xrays & accident cover) but other work chargeable ... how does this sound compared to others ??

I hate scale & polishes - Think I would rather have a "all in plan" or a totally pay as you go option.

Yorkielass

I always went to the dentist when I was younger and went to the orthodontist at the hospital for years too and had a 'train track' brace for 3 years, which lead to a couple of little fillings when the metal bands came off my teeth.

Anyway while at University I went to the dentist back where my parents live (nearly 300 miles away) during holidays but I've now settled in the city where I studied and have been trying to get onto a dentist here for a couple of years and am on the local PCTs communal waiting list.

I'm now having a couple of problems with my teeth and need to see a dentist and I accept probably the best thing to do is register with a private dentist.

Any advice on how to do this - do private dentists generally charge by treatment or by paying a certain amount a month. What's the best way of finding a private dentist?

Sorry if these all have obivous answers, any advice would be appreciated.