Private dentist abusing NHS

Welshspacechick

My private dentist wants to x-ray my mouth but doesnt have the machine he needs so has told me to go to a NHS hospital to get an x-ray that I can give to him so that he can finish the work and get paid a lot of money. My question is are private dentists allowed to use NHS facilities and equipment when the public pay for these? Is this an abuse of the NHS?

I have queried why I can't register as NHS and he has advised that be is no longer taking NHS patients as its 'too stressful' and a 'life /work balance choice'. 

Is it fair for him to send patients to use NHS equipment that he then makes a profit on?

Please dont advise finding another dentist who will take NHS as they simply dont exist in this area.

diystarter7

Does not sound right.
Tob be clear, your dentist has an xray machine but not the very complexed one?
However, he is not forcing you and you have a choice to go to another private dentist.
All dentists have xray machines but this must be a more complex one.
NHS would not just go ahead and xray your teeth/mouth via A&E unless it was an emergency.
You'd need a referral IMO and the waiting lists could be on a never, never date.

I guess someone that works in a dental practice or has similar experience will confirm/etc.

Welshspacechick

Yes he has the basic ones but says because it's an extraction he has to get the whole mouth x-rayed. Hes given me a form to take to the hospital to get an x ray, apparently I just rock up with the form and they'll do it and says then they'll give it to me to bring back and he'll charge me a small fortune to do the extraction.

No one else seems shocked by this, the NHS is on its last legs and hes sending me to use their equipment...just doesnt seem right to me. 

brook2jack2

If the dentist does not have an NHS contract the hospital will bill him for the x Ray , which I presume is an OPG x Ray. 

The dentist is billed directly. 

Eg from this NHS hospital https://www.bedfordshirehospitals.nhs.uk/our-services/imaging7/

This is an extract 

Bedford Hospital 

We offer a wide range of examinations (scans and x-rays) for both NHS and private patients at the request of authorised referrers (a GP, for example). We also offer some other useful services listed at the bottom of this page. We are happy to accept NHS and private referrals from outside Bedfordshire as long as they come from an authorised referrer. Please follow the link below for full details of our service for private patients and private referrers

Floss

OP, your dentist may well add the cost of this private x-ray to your bill, so be aware - as @brook2jack says he will get billed for it.

Undervalued

Welshspacechick said:

My private dentist wants to x-ray my mouth but doesnt have the machine he needs so has told me to go to a NHS hospital to get an x-ray that I can give to him so that he can finish the work and get paid a lot of money. My question is are private dentists allowed to use NHS facilities and equipment when the public pay for these? Is this an abuse of the NHS?

I have queried why I can't register as NHS and he has advised that be is no longer taking NHS patients as its 'too stressful' and a 'life /work balance choice'. 

Is it fair for him to send patients to use NHS equipment that he then makes a profit on?

Please dont advise finding another dentist who will take NHS as they simply dont exist in this area.

That is almost certainly not what he is doing, as Brook2jack2 has explained.

Some years ago, for various reasons, I saw an eye specialist privately at a private hospital. He needed a specialised test doing which could only be carried out at a large NHS hospital. I was billed several hundred pounds by the NHS and this was ultimately paid by the private health insurance I had at the time.

In England certainly (might be different in Wales) there is no such thing as being registered with an NHS dentist. You can book with any NHS dentist who has space to take you but their only obligation is to complete any prescribed course of treatment. After that they don't have to see you again. Obviously that doesn't help if they are all fully booked and availability varies wildly from area to area.

Toothsmith

You don't mention if you are then going to be billed by the dentist for the 'NHS' X-ray? If you are, then that is certainly wrong.

But take a step back. 

You are a UK resident entitled to NHS treatment. OK - you can't access NHS primary dental treatment due to the well reported problems within that service, but should you need to be referred for any secondary services, then you certainly should be entitled to them if they are available. That would include specialist radiography services.

I have basic x-ray equipment at my practice, and as I refer out things I consider more complicated - I pretty much always get by with those. A few years ago, I did need such radiographs of a couple of my patients in quick succession. At that time, the radiology services at my local hospital were happy to provide them for the patient and post them to me. I haven't had an NHS contract since 2006.

They didn't charge me, they didn't charge the patient - and I didn't charge the patient anything for it either. 

It might have changed now. I've not needed to do it again since.

If it's for a procedure that would normally not be available on the NHS - like for planning an implant treatment, or planning cosmetic dentistry - then the NHS unit charging for the X-Ray would be justified I feel.

But if it's for something like planning a surgical extraction of a tooth, or even to help planning and treating gum disease - then I feel that the X-ray should be available on the NHS for that patient to then take to their private care provider.

Welshspacechick

So I'm getting exactly the same treatment as a NHS patient but because of my dentist opting out of taking NHS patients (his words) I have to pay privately? 
In my opinion if he's going to charge me a ridiculous amount of money to do the work he should at least fork out for the equipment he needs or charge me at the NHS bands level. 

brook2jack2

He cannot charge you at NHS levels because the amount the hospital will be charging him will be way above the NHS fee and you are not a NHS patient It Varys from hospital to hospital but my local hospital will charge £150 for an OPG referred privately. The NHS fee , on average , will , in total , be around £25. 

To buy an OPG machine you need to have the space to install it (many practices do not ) and you need to do sufficient numbers of OPG x rays to make it financially viable . To buy a machine and the equipment to scan the X-ray onto your computer you will be looking at £20,000 to £45,000 plus the annual costs of software licensing , upkeep of machine,servicing and annual inspection. 

If it is a CbCT scanning machine , which is even more specialised , you are looking at £40,000 to £80,000 plus annual costs like software etc  . Also dentist has to undergo extra training to prescribe and interpret CBCt scans . A really cheap course will be £300 and this needs to be updated. 

Theses machines don't last forever and will need replacing every few years. All of this would have to be economically viable which is why many practices do not have them as the costs they would have to pass onto the patients would be unfeasible. 

Toothsmith

Welshspacechick said:

So I'm getting exactly the same treatment as a NHS patient but because of my dentist opting out of taking NHS patients (his words) I have to pay privately? 
In my opinion if he's going to charge me a ridiculous amount of money to do the work he should at least fork out for the equipment he needs or charge me at the NHS bands level. 

If he had, on site, every piece of equipment he could ever possibly need then he would need to charge you (in your opinion) an even more ridiculous amount of money!

If he makes sensible use of services he can sub-contract certain aspects of the treatment or diagnostics to, then he can keep it down to just (in your opinion) a ridiculous amount! 

And you are not getting 'exactly the same' treatment as you would have if you were an NHS dental patient, as you've said, in your area, if you insisted on NHS treatment, you would be getting no treatment. 

silvercar

I'd think of it differently.

Whether private or NHS, a patient needs a specialised X-ray that only the NHS can provide. The patient is entitled to use the NHS. The NHS provision of this equipment is such that patients can just turn up on the day. 

You complain that your private dentist then makes a profit on the extraction that he can do based on the NHS x-ray. Dentists are a business, they need to make a profit to run their practice.

Consider from another view point. Say you had an NHS dentist. You have this x-ray, your NHS dentist looks at it and says the extraction is complicated and is beyond his expertise within his NHS practice. You then have 2 options, wait however long for an NHS hospital dentistry referral or go to a private specialist dentist. You choose the latter, the end result is the same - a private extraction following an NHS x-ray. The only difference is that you have arguably used more NHS resources to get to the same point.