Is NHS Dentistry effectively dead..?

welshdent

I dont know any dentists that were furloughed. Our practices were effectively closed for 4 months with minimal income to pay for the overheads but no one was furloughed. 

There is a major issue with standard operating protocols which reduce day to day capacity by a half to 2 thirds which really makes it difficult to get people in. There is no additional NHS funding to pay for staff outside the previously contracted hours so its either wait or see someone privately right now. 

Dizzy_Ditzy

My last NHS dentist was very good. Sadly, part way through a course of paid for band 3 treatment he died. NHS England were initially very helpful and said they were getting a locum in but they couldn’t get one and that practice will not reopen. Not one NHS dentist within a 20 mile radius of me is taking on new patients. When I eventually manage to find a new dentist I have to go through the whole process, and pay for it again 

Undervalued

Dizzy_Ditzy said:

My last NHS dentist was very good. Sadly, part way through a course of paid for band 3 treatment he died. NHS England were initially very helpful and said they were getting a locum in but they couldn’t get one and that practice will not reopen. Not one NHS dentist within a 20 mile radius of me is taking on new patients. When I eventually manage to find a new dentist I have to go through the whole process, and pay for it again 

Would that not be a valid claim on the deceased dentist's estate? You paid for a service he failed to complete.

brook2jack2

No as even part of the course would entail a band three charge , but to be honest I am astonished that anyone would even suggest that after a presumably sudden death . 

The sudden death of a dentist has devastating consequences for a practice, particularly if the dentist was the owner. The contract is automatically lost so no more NHS dentistry can be done and the relatives are left with a practice to sell that becomes, overnight, almost worthless , making staff redundant at a time when they are trying to come to terms with losing their loved one. 

 Unfortunately dental teams have got used to being thought of as machines not human beings and this has, no doubt, led to the massive increase in mental and physical health problems, early retirements etc during and after the pandemic. 

Undervalued

brook2jack2 said:

No as even part of the course would entail a band three charge , but to be honest I am astonished that anyone would even suggest that after a presumably sudden death . 

The sudden death of a dentist has devastating consequences for a practice, particularly if the dentist was the owner. The contract is automatically lost so no more NHS dentistry can be done and the relatives are left with a practice to sell that becomes, overnight, almost worthless , making staff redundant at a time when they are trying to come to terms with losing their loved one. 

 Unfortunately dental teams have got used to being thought of as machines not human beings and this has, no doubt, led to the massive increase in mental and physical health problems, early retirements etc during and after the pandemic. 

Really?

I don't doubt that there are many problems with the NHS funding system but that is not in the patient's control and is not their problem.

Are you saying that if you had paid a self employed tradesman up front for some work that had not been completed when he sadly died, you wouldn't try and recover the money from his estate? Any other creditor, including the state (if any benefits or pension he may have been receiving had been paid beyond the date of his death) would seek to recover the money so why should the client / patient be any different.

If the patient / client wants to be charitable that is up to them but they should not be criticised for insisting on what is rightfully theirs.

What about a private dentist who had been paid up front for a course of treatment that had not been completed if the same were to have happened. You expect the patient, who may well earn far less than the dentist, to subsidise his widow? 

ponypal

Where I live now the nearest NHS dentist is 2 hours away. Where my parents live, there are loads still taking on new patients. Feels like a postcode lottery.

Toothsmith

Death is not a 'get out of jail' cart for either debts or money owing. 

Anyone owed money by a deceased person has the right to make a claim on the estate. (This also includes dentists on patients who have died owing money on treatment or part treatment). The estate can also claim any money owed to the deceased. 

The water is a little muddy on NHS fees though, as these are owed and paid to the Government, not the dentist personally. The dentist is paid in a way that is independent of what actual NHS fees he collects. 

This is just my opinion, I haven't got anything to back it up - but as this money was not paid to the dentist, but to 'The NHS'. It was just collected by the dental practice on their behalf. I think your claim will be to the NHS, either to refund you or for them to find you a dentist who will complete the work. 

Undervalued

Toothsmith said:

Death is not a 'get out of jail' cart for either debts or money owing. 

Anyone owed money by a deceased person has the right to make a claim on the estate. (This also includes dentists on patients who have died owing money on treatment or part treatment). The estate can also claim any money owed to the deceased. 

The water is a little muddy on NHS fees though, as these are owed and paid to the Government, not the dentist personally. The dentist is paid in a way that is independent of what actual NHS fees he collects. 

This is just my opinion, I haven't got anything to back it up - but as this money was not paid to the dentist, but to 'The NHS'. It was just collected by the dental practice on their behalf. I think your claim will be to the NHS, either to refund you or for them to find you a dentist who will complete the work. 

Quite!

I have to say I was a bit taken aback by Brook's reply.

From the patient's point of view, they have paid c. £260 for an agreed course of treatment which cannot (through no fault of their own) be completed. I can understand them being outraged at being told "tough, you will have to pay the whole fee again just to get the last bit finished off".

If this was private dentistry (or indeed any other service) there would certainly be a valid claim against the estate. If, due to the oddities of the NHS different rules apply then I think it is appalling and should be challenged in court.

Yes, to those that understand the costs of running a professional practice, the NHS fees are sometimes a fraction of the true costs of providing the treatment. However to somebody earning a modest wage, just above the eligibility for free dental treatment £260 let alone £520 is a lot of money.

Very easy to say "but to be honest I am astonished that anyone would even suggest that after a presumably sudden death" when you are earning £100K plus a year from your private dental practice. Not so easy if you earn the NMW flipping burgers in McDonalds!

brook2jack2

I suggest you look up average earnings in dentistry which are no where near what you quote, in both private and NHS practice. 

In particular this is NHS treatment in a NHS practice which has had to close because of the death of the dentist. The practice will have to pay back all funding that has been underperformed . The treatment is part way through , the practice has no dentist and no contract , it is the health board who are responsible for finding a dentist to continue treatment . Due to extreme pressures on the system they have been unable to do this. The practice has carried out part of treatment and , as we know , you pay the same for one filling or five , so the patient is not due a refund . 

I still remain appalled by the suggestion of claiming from the estate. Perhaps because I have seen the utter devastation caused by a dentists sudden death , other dentists wanted to keep the practice going but on the death of the dentist the contract was lost and had to go back out to tender. The practice never reopened. 

It was a young dentist with a massive mortgage on the property , selling the building and equipment did not cover the mortgage because the good will had been lost and the equipment only raised a fraction of what it cost.

Most of the life insurance etc he had went to pay off bills. 

His widow and children live even more modestly now than they did after a couple of years of hell sorting out the mess. 

I , and most dentists I know, have never claimed from a patients estate we are aware of how hard it is on a family. I would hope that most feeling human beings would extend that empathy to a dentist. 

Undervalued

brook2jack2 said:

I suggest you look up average earnings in dentistry which are no where near what you quote, in both private and NHS practice. 

In particular this is NHS treatment in a NHS practice which has had to close because of the death of the dentist. The practice will have to pay back all funding that has been underperformed . The treatment is part way through , the practice has no dentist and no contract , it is the health board who are responsible for finding a dentist to continue treatment . Due to extreme pressures on the system they have been unable to do this. The practice has carried out part of treatment and , as we know , you pay the same for one filling or five , so the patient is not due a refund . 

I still remain appalled by the suggestion of claiming from the estate. Perhaps because I have seen the utter devastation caused by a dentists sudden death , other dentists wanted to keep the practice going but on the death of the dentist the contract was lost and had to go back out to tender. The practice never reopened. 

It was a young dentist with a massive mortgage on the property , selling the building and equipment did not cover the mortgage because the good will had been lost and the equipment only raised a fraction of what it cost.

Most of the life insurance etc he had went to pay off bills. 

His widow and children live even more modestly now than they did after a couple of years of hell sorting out the mess. 

I , and most dentists I know, have never claimed from a patients estate we are aware of how hard it is on a family. I would hope that most feeling human beings would extend that empathy to a dentist. 

As you well know the patient pays a fee (band three in this case) for an agreed course of treatment which the dentist is obliged to complete, then is under no obligation to see the patient again. So, what was contracted to have been done for that money has not been completed. The fact that they may, under other circumstances, have had to pay the same fee for far less work is neither here nor there. Sadly a patient on a very limited income may opt to wait until more work builds up rather than pay a band 2 or 3 fee every six months. Obviously not good for their teeth but if money is very tight it may be the choice they feel they have to make.

Everything else you list is completely outside the patient's control. Yes, the system may be far from ideal but it is entirely up to the dentist whether they work in the NHS system or not. They could choose to be mainly or entirely private as I think you have said is your choice. What they can't do is take part in the NHS system then bend the rules because they don't agree with them.

Realistically it would cost very little to have insurance to protect patients in, statistically, the very unlikely event of the dentist dying or being otherwise unable to complete the work. Surely any professional practice should do that?

I wonder what would happen if the patient had paid up front by credit card so had Section 75 protection. Presumably the card company would have to reimburse them and recover the money from the estate if they chose.