I wanna find a new NHS dentist

Willowrose_2

I have skimmed through the postings on dentistry. Forgive me if i have missed some essential pionts but some thinngs jumped out so I wanted to post again. Some people feel that they should have good quality dentistry cheaply because they pay large NI contributions. I could not agree more. We all pay NI in order to fund the NHS The general public feel quite rightly that dentistry is part of the NHS. Why doest someone tell the government that!!!
We have all been ripped off and i mean dentists(me) and the public. of course the public should have good quality dentistry but for years the public have had to pay for their own dentistry. Did you not realise that the fees you paid at the dentist were set be the government and that they put them up every year! The dentist NEVER got any more money for it - you just paid more and more. I presume the NI payments just went into medecine.
Most dentists just want to provide a good quality core service free of charge and let patients pay for cosmetic work. The trouble is that no government will allow this as it would mean that they had to admit that the service was not free. IT HAS NEVER BEEN FREE TO THOSE NOT ON BENEFITS. those on benefits can get EVERYTHING free crowns bridges veneers -the lot.
Apparently it would be political suicide to deny these people free treatment so every one else pays. At this moment in time if you pay you pay 80% of your treatment cost. This is a political issue and we should all stand together against ity but as far as I can see there is no party that would alter the situation so we are all stuck with it.
Postings from the general public on this site about fees for NHS treatment seem to be very strange. There have been a few postings quoting £100 for root canal treatment. This is rubbish. NHS treatment costs are set out in the SDR published by the DoH. NO root canal treatment on the NHS costs £100-Max for molar endodontics is £60. This is in itself a ridiculously low figure and the NHS dentists that do it for that charge are ripping no one off but themselves. Private charges for molar endodontics will be about £400 per tooth which is much more realistic for the work involved.
Please Poppy9 give up on your stupid assertation that dentists are so rich with ther 3 holidays per year etc etc Do you live in London? are you talking about private practioners verses young hospital house doctors. GP's earn about £90k per year the equivalent GDP earns about£55k--I know it is a lot of money for both of them but that is a different socialist argument and not what we are discussing here.
It seems to me that the clear thread is that the public would like to have cheap good quality dentistry provided by the NHS. There are very many dentists who would be happy to provide it but no government of whatever colour is willing to pay for it.They con the public in to thinking that it is available then blame the dentists for not providing it. All of you out there calling dentists greedy are just falling into the trap they have set you. That is exactly what they want you to do!

Willowrose_2

Have just read poppy9 reply to toothsmith it seems that her calculations on running a practice were made with no reference to my own posting on the estimated costs of running an nhs practice. I suggest that she re reads my posting on costs and refers to her own friends who are dentists and asks them how much their outgoings are per month before she decides to post again. Of course if what she says is true she could make her fortune by setting up a course which shows the rest of us at the coal face how to keep our costings down to her marvellous figures. I have obviously been doing it all wrong so far and would be happy to pay for her expertise to learn how to save my self massive amounts of money per month. Of course i would spend it on an enormous house and 3 holidays a year in order to become like her friends.
Yours
an nhs dentist with a semi det ,3 kids not in private schools and an old and small rover car and no foriegn holiday for a number of years!
What am I doing wrong???

Poppy9

As previously mentioned I live in Wales. My dentists friends do take 3 foreign holidays per year. Typically skiing in Jan - US - August and Canaries in October. Cars one has a jag and a people carrier. My own dentist has a car Mr P would die for - something sporty which always brings out the comment - aahhhhhhh look at that car from the men

Re £100 for root filling. I will be on the phone 1st thing to my dentist (or rather Mr P will). He paid 6 months ago a total of £126.45 (I am looking at the receipt now). He paid for a check up, scale and polish, x ray and root filling.

My biggest concern is for children. Are they to face a life of crooked teeth?

I did know that the charges were set by the government. I agree only core necessary work should be NHS funded not cosmetic. Just like I don't expect the NHS to provide cosmetic surgery (I understand there are exceptions in this area).

chpetros

Poppy9 wrote:

As previously mentioned I live in Wales. My dentists friends do take 3 foreign holidays per year. Typically skiing in Jan - US - August and Canaries in October. Cars one has a jag and a people carrier. My own dentist has a car Mr P would die for - something sporty which always brings out the comment - aahhhhhhh look at that car from the men

Re £100 for root filling. I will be on the phone 1st thing to my dentist (or rather Mr P will). He paid 6 months ago a total of £126.45 (I am looking at the receipt now). He paid for a check up, scale and polish, x ray and root filling.

Your friend paid 126.45 for a check up, scale+polish, xrays, root filling and then something on top of the root canal - either a simple filling or a crown. So thats 126.45 for 5 items of treatment, not for 1! 5 items that took at least 1-2 hours of a decent dentist's time and carried a lot of expenses in materials.
Now, 126.45 just for a root canal would also be a real bargain. With that kind of money it would be impossible to use NiTi files, thermally condensable GP and other contemporary materials, as you would end up with a bill far greater than the profit.
The problem is that the government just doesn't understand that it can't expect us to provide modern quality with 1950s fees. Most practitioners I know are tired of doing piecework on the NHS nand want to switch to private for the opportunity to work with a manageable number of patients, doing quality work, for the same income, not to get richer. A british dentist sees more patients than any other dentist in any developed country. At 30-40 patioents/day he soon becomes a hazard to himself and to his patients, but he has to keep doing to stay afloat on the NHS... the treadmill effect.

jinxsi

man goes to the shop buys a pound of tomatoes for £1.00, a pound of apples for £1.00 and a pound of bananas for £1.00. Comes out and says "Yikes, £3.00 for a pound of apples, thats expensive".....happens all the time.

jinxsi

Toothsmith

Poppy,

Someone once said, "It is better to remain silent and be thought of as a fool, than to open your mouth and remove all doubt."

You obviously have some sort of deep problem with dentists. Do you have the same problem with other people who study hard at school, get through university, work hard to improve their skills, take significant personal financial risk in borrowing a lot of money to set up a business, and then manage to enjoy the fruits of their efforts?

I became a dentist because it suited what I am good at. I also became a dentist because it is a secure profession, and the rewards are good (Both financial and personal) if you are prepared to put the work in. I was still a student when lots of my schoolfriends were out in the world earning. Since I have qualified I have probably paid more tax in total than all of them. I have easily repaid my training costs. I do not apologise for having financial security. Do you have a problem with that?

You still seem to have a problem with this monthly/yearly thing as you seem to think £200 000 costs £1000 per year. Prehaps you could introduce me to that bank?

Whilst we are on that subject, you show here that you have no business experience whatsoever, as you cannot get a 'mortgage' to buy a dental practice. You have to borrow money on business terms which is significantly more expensive.

<You are assuming that all working people have the same level of income as yourself. Take a family of 4 with just 1 parent working as say a school teacher earning £30k per year. Can they afford to pay the £56 a month extra? Why should they on top of NHS. Is dentistry a health service?>


I assume nothing, but yes, this is exactly who my patients are. When a practice goes private, it does not loose all it's old patients and have a new lot roll up in Bentley's and Ferraris. They are the same people. Plus, I haven't privatised kids yet. The only difference is the ones that stay probably have a better grasp of reality than you.

Just to give you some real numbers, I saw my accountant last Friday for my end of financial year talk. My Tax - allowable expenditure for 2003/04 (Not all expenditure is allowable against tax) was £125551. That means my 48 patients per week (Planet Poppy figures again)would need to pay me at least £50 per visit before that was covered. Then there's repayment of my loans - currently at about £200 000 and costing me about £1500 per month (This is not allowable against tax, only the £8483pa intrest is tax deductible) that's an extra £8 per visit per patient. Now, pay for me - Sorry - of course, I'm not allowed to earn anything am I :rolleyes: But let's just have a bit of fun and pretend I earn about £40000 - about the same as a decent plumber. That's about an extra £16 per patient per visit. Then there's a pension for myself, cos heaven forbid that I'd sponge off the taxpayer in my old age. One should generally aim to invest about 15% of one's income in a pension so that's an extra £2.40 per patient visit. Not all building maintenance costs are tax deductible, so let's add £2 to cover that, and an extra £3 to cover contingencies like equipment needing renewing, temporary staff, sickness, This all tallies up to £81 per patient visit. £162 per year = £13.50 per month. Pretty close to your quoted Denplan minimum monthly charge

This is for a practice with me full time, my associate 2 days per week, and employing a practice manager, one full time nurse, three part time nurses and two part time hygienists.

This is far from an accurate picture, but it is ballpark and it does blow £15000 per year expenses out of the water. Even I see more than 48 patients per week but there are many who need a lot more than 2 visits per year. There are NHS practices that, in order to survive need to get through in excess of 80 patients per dentist per DAY. God knows what the quality of that work must be like.

The public is RIGHT to be angry, but direct that anger where it is deserved.The Government is not trying to "Drive down costs" it is trying and succeeding in driving dentistry out of the NHS. With an election looming, now is the time to kick up a fuss. It will be too late in a few months time, as the lying B*****ds will have been elected again, and then the won't give a flying fig.

jimmylaff

Poppy9 :eek: :mad:

Imagine you are a fish and chip shop owner. You pay for potatoes, batter, oil, staff, equipment and the other usual business expenses, heat, light, phone, advertising, mortgage or rent, and waste disposal. (and boy, does this list go on!). And quite likely you had to buy the business itself too.

Unfortunately, someone else fixes the price at which you can sell your chips at. And it bears no relation to what the costs of making the chips are.

So you work faster, you sell more chips, trying to keep your profitability the same, despite the eroded margins. Then the price fixer slashes your fixed price, devastating your margins further.

So you work even faster, and you have to start to cut corners, as there is now absolutely no way you can sell the chips at a profit without.

And some of your customers start asking for new products: saveloys and curly french fries. You can command a premium price for these. And you can take your time preparing them; you present them beautifully, and the customers appreciate the time and care. You notice that your saveloy sales start to subsidise your chip sales. The saveloy customers don't!

Poppy****9, your gross generalisations about dentists are offensive in the extreme. My practice profit last year was £49k between 2 dentists. We have personally invested £140k to generate that income, and this is not giving us a decent living, never mind a return on the investment.

This is why dentists are leaving the NHS in droves, and your narrow minded poisoned vitriol will only increase my resolve to reduce my NHS committment.
By the way: I have zero private patients, but after reading your postings this will change. Why should I invest the amount I have, work 41 hours a week clinically, another 20 or so on admin, take home £25k a year and work like a dog. Just because you think I have a duty because the state (no, not the NHS: again, get your facts right!) PART funded my education. Get off your soap box and join us in the real world. A world where dentists make the personal investment to set up in practice, and then, not unreasonably, expect a lifestyle of some minor comforts.

If you can find any mortgage lender who will lend £200k for 1000 a month, please send him/her my way. They are as big a mug as me for continuing to provide NHS dental treatment.

Get a life.
Get some common sense.
Get your facts right.

Just
Get out of here!
jimmylaff

Poppy9

£1000 per year should have read per month as I am sure you are well aware.

From the example of my previous dental practice based on the number of patients they said they were taking on (in the letter clearly says 1000 per dentist - 4 dentists so 8000 current patients will be dropped)

Dental practice
Dentist 1 Dentist 2 Dentist 3 Dentist 4 Total
No. patients 1,000 1,000 1,000 1,000 4,000

assume all pay £14 per mth each dentist gross income per year is £168,000 multiply by 4 for whole practice =£672,000

Annual Income £672,000
Out goings
4 dental nurse 2 receptionist -£90,000 (see my 1st post)

Premises - either rent or loan -£12,000
Premises costs -£3,000
Fees and materials as quoted £5k per month by another dentist -£60,000
Total expenses -£165,000
Net Income £507,000
Income per denitst before tax £126,750

Jimmylaff - I find you rude and offensive. Nice 1st post.

Toothsmith - just because you don't like my opinion and choose to be selective in the reading of my posts no need to be so rude. do you assume I live on benefits. How wrong. I too benefited from further higher education. I too have a professional qualification. I too ran a successful business for 10 years. With regard to premises. Our dentists in this town are all located in residential areas. My current dentist in a 3 storey terraced house. Ground floor is reception, waiting room and 4 surgerys. Upstairs is rented out to alternative therapists. Purchasing a house means that you can get a mortgage. A capital and interest mortgage on a fixed rate until 2007 costs £1127 per month. Of course an interest only mortgage would be a lot cheaper. Interest payments are then tax deductable. Alternatively you could buy the house privately and then rent the house back to the business. All rent is a business expense. At the end of 25 years you own the property. If not your main residence you would of course have to pay capital gains tax. With regard to other assets you invest in they are form part of your capital allocation. Generally assets are depreciated over 3 or 5 years.

No I have no problem with dentists collectively just the selfish ones who try to intimidate patients into signing up through fear. I also object to Denplan being virtually compulsory in the surgeries I have contacted. Even other dentists admit to it being a rip off.

Toothsmith

You obviously know far more about all this than I do. Maybe you could get a job in the Department of Health - you'd fit right in there.

I've tried to put across what actually happens in the real world. Take what you want from my posts, I shall trouble you all no more.

Sheel

Hi

I realise that this thread has been on the I Wanna board for a few days now , but i've only just got me 'powers' back and I think it more suited to the Marriages , Relationships , Health etc board , so i'm moving this over there

regards , Sheel