Dentist Fraud

akkers

Its been in teh news again recently, how some dentists have been ripping off customers and the NHS. What a surprise!

I have had so many problems with my dental practice its unbelievable. But I cannot leave as other practices in the city are not taking on patients. So where do I go?

Back in the 90s I used to go for dental checkups and treatment for myself and my family. They used to get us sign a NHS form with no details on (they said they would fill in details later!). If you asked for a itemised receipt they refused; they said that they only do that for private patients. This really got up my nose and I complained to Trading Standards at the time but they were not interested.

More lately, they have been doing fillings when not needed, probably; and often not honouring warranties.

I believe that the govt and NHS have been very soft with dentists and allowed them to fill their bank accounts at the cost of NHS and patients.

The patients have very few options to complain and to change dentists. The govt has to change this situation.

welshdent

Dont believe all you read.

One thing which is barely scratching the inaccuracies of the story is we allegedly are doing as many UDAs as we possibly can to rip everyone off doing "lucrative" procedures such as extractions.

Well firstly they dont mention that those wonderful UDAs are capped. We can only the amount they allocate. It is not a bottomless pit.
The contract says do 95% of the UDA allocation (we can make the remaining 5% the following year) or we claw back money from you. Missed that bit? Oh no they didnt write it in!

Did anyone mention that sure we get 3 UDAs for 1 filling, 2 fillings 4 fillings. 4 fillings 2 extraction, 4 fillings 2 extractions and a root filling?? Why on earth would any sane human being do fillings that were not needed in that case?!?

Extractions compared to root fillings - It is misleading to say an extraction is "more lucrative" than a root filling. A root filling actually costs the individual dentist more to provide than the NHS pay to do it. That is what the problem is not that extractions are more lucrative. I am not saying it is right but to say extractions are lucrative is just nonsense.

The dentist must do a diagnosis and provide all treatment clinically necessary that which you the patient are prepared to accept. You do not pay for extractions or root fillings. You pay for a course of treatment and the dentist is paid for a course of treatment.

Imagine you clean windows. You are funded to clean 4 windows on a small house which is cleaned every 4 months so minimal dirt.

You get the same fee if you clean 4 windows on this small house or if you clean 25 windows on a house that has not been cleaned in 15 years. No argument. No discussion. That is it.

Dentists are NOT employed by the NHS we are contractors and the NHS dictates the terms of the contract. Remember the fuss made by junior doctors about Jeremy Hunt wanting to impose a contract on them?? Well the Dental contract was imposed 11 or so years ago. Dentists did not want it. I personally have not had any form of pay rise in 10 years despite exponential increases in costs. No one gives a damn because I am "greedy money grabing crook" etc. I am not moaning about this by the way just making the point - although I can assure you I am none of the afore mentioned descriptors. Fed up disillusioned and despondent perhaps.

I did chuckle somewhat ironically when you say the government has to change the situation. Who do you think created it in the first place?? The government love it. They have complete control over how much they spend on dentistry and when the public have a moan it is directed at the dentists. If you were the health secretary would you do anything?

DomRavioli

Go private? I pay £14 a month, and only pay for cosmetic dentistry (white fillings etc).

Works out not that much more expensive than NHS charges, and my dentist is genuinely nice.

akkers

Believe or not but I had one filling done by my dentist 5 yrs ago. Part of that filling fell out weeks later and I went back to ask for it to be corrected under warranty. My dentist refused saying that he did not do that filling. I got so annoyed that I tried to join another practice but no one was taking NHS patients in my city; so I asked the practice to allocate me to another dentist at the same place.
The next dentist took me on. I was due for another filling. When he was planning to do that I asked him if he could do the other one (fill in the part missing filling). That would have been convenient me for me but he would not do it and said that the cavity was that not great. He did not want to do 2 fillings under one treatment.

I wish I could remember the number of time they have pulled the fast one on me or my family.

brook2jack

The ways to complain for NHS patients http://www.which.co.uk/consumer-rights/advice/how-can-i-complain-about-a-dentist

1 in writing to the practice. They have to reply in reasonable time and if you are not satisfied they have to give you the details of how to escalate your complaint. This will normally be to the CCG, LHB or local equivalent.

2 depending on what your complaint is the CCG , LHB can then escalate your complaint to any one of the over 50 agencies who are responsible for inspection and overseeing dental practices.

3 complaints may be ultimately referred to the GDC , police , tax authorities etc which have the ultimate sanctions.

If restitution of money is involved then people also have the option of engaging lawyers to seek legal redress.

So where does that leave us?

A dentist in the UK is more likely to be sued than anywhere else in the world including the US. They are twice as likely to be sued as UK doctors.

At any given time 20% of dentists have investigations pending by the GDC . The vast majority have no case to answer but the personal and financial consequences can be devastating.

UK dentists are thirty times more regulated than any other dentists in the world.

So patients are not happy because NHS dentistry is not providing what is promised and dentists are not happy living with toxic levels of regulation .

No amount of even more regulation can fix a NHS system chronically underfunded making promises that are I,possible to keep.

akkers

Yes the option for legal readdress is there but the option to find another dentist is not.
If you complain against your own dentist or take legal action, then chances are you will be thrown out. And the possibility of finding another dentist that will take you as a NHS patient are zero (around here anyway).
So there is always that deterrent not to complain against your dentist unless its very serious.

Floss

akkers wrote: »

Yes the option for legal readdress is there but the option to find another dentist is not.
If you complain against your own dentist or take legal action, then chances are you will be thrown out. And the possibility of finding another dentist that will take you as a NHS patient are zero (around here anyway).
So there is always that deterrent not to complain against your dentist unless its very serious.

But if nobody complains then serious professional standards issues will arise and be allowed to increase.

Also, why assume that you have a warranty for any dental work? I pay for private treatment and if a filling fails I don't demand a "repair under warranty", my dental insurance pick up the bill for the repair. It isn't done for free. I don't think any dentist could reasonably provide warranties.

akkers

Why not?
We pay through the nose for their services, so it should be guaranteed. This does at least force them to try to do a good job first time around as they wouldnt want to waste time on people coming back.
I am surprised your insurance pays for correcting work that has been done incorrectly recently. I am not sure any insurance company pay for botched work.

Floss

Erm, because it's medical and also because something could fail for reasons other than poor work, such as amalgam, patient misuse or unknown damage to the tooth.

TBH the only fillings I have had fail are both at least 15 years old. I know that I had to go back for further work after part one of root canal last year as the root hadn't all been cleaned out. I wasn't asked to pay, the insurers picked up the whole bill, some of which could be classed as an unplanned part of the work being done. Then again, I have been going to the same dental practice for 10 years and DH has been with them since 1991.

Have you looked at whether your local CCG has an NHS dental clinic you could attend if you are so dissatisfied with the dental practice you attend?

brook2jack

akkers wrote: »

Why not?
We pay through the nose for their services, so it should be guaranteed. This does at least force them to try to do a good job first time around as they wouldnt want to waste time on people coming back.
I am surprised your insurance pays for correcting work that has been done incorrectly recently. I am not sure any insurance company pay for botched work.

As you know NHS work is guaranteed but only in certain circumstances.

It has to be the same dentist doing the work (not even another dentist in the same practice)

It has to be exactly the same filling ie no more tooth has broken off , no more tooth surface involved and the same material used

The dentist must not have recommended another treatment eg a crown and you decided to have a filling instead.

It must be as a regular course of treatment not emergency treatment. Emergency treatment is not guaranteed.

You know most of this because in previous postings you talked of the dentist using technicalities to avoid doing a replacement.

In the end anything you use to replace tooth is never going to be as strong as the tooth itself. The tooth broke or decayed and a filling , crown etc is a second rate substitute for your own tooth. A filled tooth is a weakened tooth and the conditions in the mouth , the extremes of pressure, hot , cold , PH, enzyme called action etc are extremely demanding on materials and techniques.

Your local CCG will have a list of NHS dentists and it is best to ring around to find out availability rather than rely on websites which are often out of date.

welshdent

Sorry but you do not pay through the nose. Try getting dentistry in other westernised countries. I know people that have found it cheaper to fly back from Australia have their dental treatment done (privately) then fly back. I know of people that have had emergency treatment in the USA and spent a few thousand when all they had was an extraction and a quickie denture. NHS fees are even lower. And before we have a discussion about why we have to pay for it at all - co payments for NHS dentistry have been around for some 60 years. It clearly doesn't look like the government plan on changing things anytime soon but we have had long enough to get used to it. When dentists from other countries hear about the remuneration we get in the uk they are usually gob smacked. If they define insanity as doing the same thing repeatedly hoping for a different outcome, how about we stop blanket blaming the dental profession for things that are clearly out of their control??

Yes when someone has high needs the fees can escalate but remember the dentist did not cause the decay or gum disease in your mouths. They are trying to fix it. It's not wear and tear usually. I am in my late 30s. I have one small filling and have never needed a scale and polish. I have seen 80 year olds that have no fillings and have spotless mouths. They don't pay through the nose. In Wales they get free check ups because they don't need any work. I have treated people that needed stacks of things fixed and paid under £200. That fee bears zero reflection on how much it cost to provide them the work. How else are the practices meant to remain open and the staff paid if the dentists do not generate income?? The NHS does not employ any of them. Dental practice over heads are massive yet by and large people get good treatment from caring professionals every day. Yet despite all this we just get a constant barrage of allegations of greed, fraud, cheating , extortion etc etc. All any of us are doing is working with the contract imposed on us! Frankly all this rubbish is increasingly doing my head in. Thankfully my own patients by and large seem to appreciate what I do for them!