NHS Hygienist

boo-hoo

I know this subject has been discussed on here in previous threads but I haven't managed to find an answer.
My Dentist recommended I went to the Hygienist which I did. It cost me £40 for 10 minutes. My Dentist no longer does a scale and polish, which I know is included in Band 1 NHS costs. He still says I should see the Hygienist even though I don't have gum disease and he tells me that I clean my teeth very well. I don't understand why he won't do a scale and polish but insists I see the Hygienist. Is this just money making and can I insist on a scale and polish from the Dentist? After all he also says I only need to see him once a year as I'm doing well

KARO

Probably maximising his income.

If it's necessary the dentist should do it, or refer you, and it would come under one of the NHS bands for fees.

If it's not necessary, he's flogging you a private hygienist appointment.

brook2jack

If you have gum disease then you are entitled to have that treated on the NHS as part of a band one or two treatment.

If your gums are healthy and you just want a scale and polish for cosmetic reasons then you cannot insist on having one as NHS treatment is to secure health. You will have to see a hygienist privately.

If the dentist does an NHS check up and says you have clinical signs of gum disease that need treating they are obliged to offer it on the NHS. However that is unlikely to be with a hygienist it will likely be with the dentist, depending on how severe the problem is it may attract a band two charge. (Wales and England only . Scotland and NI don't use bands)

If your gums are healthy but you have coffee,tea,tobacco staining etc you would like removing then you cannot insist on having this done on the NHS and you will have to pay for a private hygiene appointment.

welshdent

Maximising their income? If I were to send you to the hygienist I would get nothing. Maybe boost practice income but not necessarily the dentists. Regarding if you should have a scale and polish or not. Well that's a different Discussion

KARO

It would boost the pracice income if they were to be sold private treatment as opposed to doing all necessary treatment for a stingy £50 NHS payment.

Laurensalive

I too get angry at having to pay for this treatment. This should be included with the treatment plan the dentist does.

Nick_C

Laurensalive wrote: »

I too get angry at having to pay for this treatment. This should be included with the treatment plan the dentist does.

Hear hear. I've always paid privately for dental treatment. I used to have a wonderful dentist who did everything in a 15 or 30 minute appointment. The check up, any necessary treatment, and a scale and polish. The process was very efficient.

When I moved, my new dentist doesn't scale and polish. I was paying for a 20 minute appointment, where about 5 minutes was chit chat and another 5 minutes for the check up. I had to pay separately to see a hygienist. Total bloody rip off.

brook2jack

KARO wrote: »

It would boost the pracice income if they were to be sold private treatment as opposed to doing all necessary treatment for a stingy £50 NHS payment.

Actually , on average, for England and Wales it's between £22 and £24 for a band one treatment total payment.

As said before if it is necessary for dental health then yes it should be included as part of NHS treatment. But if there is no sign of gum disease and someone just wants a scale and polish to eg get rid of stains then they will have to pay for that privately.

brook2jack

Nick_C wrote: »

Hear hear. I've always paid privately for dental treatment. I used to have a wonderful dentist who did everything in a 15 or 30 minute appointment. The check up, any necessary treatment, and a scale and polish. The process was very efficient.

When I moved, my new dentist doesn't scale and polish. I was paying for a 20 minute appointment, where about 5 minutes was chit chat and another 5 minutes for the check up. I had to pay separately to see a hygienist. Total bloody rip off.

Pre 2006 dentists were paid per item of treatment in England and Wales on the NHS. Post 2006 there are only three bands of treatment. A cheap practice in a cheap area will cost £140 plus an hour per surgery to run. A private practice will cost more to run per hour.

A band one treatment which may include check up, X Ray's, clinically necessary scaling , as well as other treatments will bring in , in total including patient charges, £22 to £24.

That will include not only the work you see when you are in the chair but covers all the costs of running a practice .

Appointment times also have to allow for the massive amount of paperwork that has to be filled out and sterilisation/decontamination between each patient which is certainly much more onerous and time consuming than a few years ago.

KARO

brook2jack wrote: »

Pre 2006 dentists were paid per item of treatment in England and Wales on the NHS. Post 2006 there are only three bands of treatment.

I wonder why they decided to change it.. they probably clocked on to the fact that if you pay a practitioner per treatment, there is obviously financial incentive for him/her to do more 'treatments'.

Or drilling for cash, as it came to be known.

If the current NHS contract is inadequate it's because some unscrupulous dentists in the past were milking the system.

brook2jack

Actually no.

The reason why the contract was changed was mostly it was difficult for the NHS to budget for. A dentist could do as much or as little work as they wanted and could open a practice , have several dentists working with them and so long as there was work they could earn a living. But it meant that spending on NHS dentistry was open ended and difficult to budget for.

Secondly with over 400 different charges patients found dental charging confusing and dentists disliked being on a treadmill of work faster and faster. The pilot schemes were popular with patients and dentists but proved more expensive for the NHS so the new contract was rolled out with changes to make it cheaper for the NHS.

Now surgeries have to have a fixed contract to provide treatment. They are only allowed to do precisely that amount of treatment , no more and no less. This means that the NHS knows precisely what the budget for dentistry is each year.

The big problem is more and more people are keeping their teeth , and need more and more treatment which is more costly to provide. The rate of dental inflation eg the cost of providing dentistry is going up by over 10% every year , but NHS fees have remained virtually static since 2006. The other problem is historically 50% of people do not go to the dentist, so a fixed budget is being used to treat more and more people in a setting where the costs of providing that dentistry is getting more and more expensive.

The net result is dental incomes have fallen 20% since 2006 at a time when the average dental student is going to graduatewith £75,000 debt