NHS Treatment turned out to be private?!!!

alison999

I didnt realize it was just a consultation, i thought you'd been back and fourth having treatment.

The only thing that puzzles me is who decides how much a service is "worth"?

cleo1299

alison999 wrote: »

I didnt realize it was just a consultation, i thought you'd been back and fourth having treatment.

The only thing that puzzles me is who decides how much a service is "worth"?

" It is up to dentists what they want to charge on the basis that it is agreed with the patient before treatment starts." (Hugh Smith, head of the Dental Complaints Service, quoted in an article in "The Independent" 12 Jan 2008)

In this case, it wasn't the cost of treatment but the cost of the initial consultation that led to the dispute. But it's the same principle: the seller states the price, the consumer decides if he or she is willing to buy for the stated price.

And after all, it's not like I'm trying to get something on the cheap. I reckon they should have told me what it would cost at the time the appointment was made. They've AGREED that they should have told me what it would cost at the time the appointment was made. They've apologized, they've thanked me for drawing it to their attention, they've done everything but correct the bill. I'm darned if I'm going to lay down now and let them go ahead and squeeze out their money that I never agreed to pay them. Not without a fight, anyway.

sue.b1

Any suggestions with this?
My husband is registered with an NHS dentist, he needs a filling replaced (it fell out) & a crown replacing (that fell out) the dentist has suggested a bridge. The dentist though refuses to do the treatment on the nhs & will only do it privately as he says its not "financially worthwhile" to him to do it on the nhs...

Toothsmith

If a treatment is 'necessary' then it is available on the NHS to an NHS patient.

Your dentist cannot only do things that are 'financially worthwhile' and that is a very bad thing to say to you.

Had he said that a tooth needed removing, and he would replace it with a denture on the NHS - but if you wanted you could have a bridge done privately - then that is fine. He has given you a perfectly acceptable NHS option, but made you aware that you could choose a private upgrade if you require one.

If he is telling you that the tooth needs removing, and a bridge is the only way to fix it, but he will only do that privately,then you have him banged to rights. If you complain to the PCT, they will have a quiet word with him about giving his NHS contract to a dentist who's prepared to abide by the rules of it, and you should soon get a phone call telling you that the dentist has seen the error of his ways and will now be perfectly happy to provide the 'necessary' bridge on the NHS.

Good luck! Keep me informed.

sue.b1

The dentist has said he will refer him to hospital to get the bit of tooth out that the crown was attached to, then said there is nothing more he can do for him. (Didn't offer to replace the lost filling.) Just charged him the £16ish fee. Husband has other crowns that the dentist feels need replacing, hence the dentists suggestion of a bridge. He reiterated that he had told him to get private insurance if he wants work done like bridges. He will only get £198 off the NHS for doing that work & it will cost in the region of £1500 to carry out, hence his refusal.
Surely if crowns needs replacing that should be done on the NHS? Should he have replaced the lost filling?

jugglebug

sue.b1 wrote: »

The dentist has said he will refer him to hospital to get the bit of tooth out that the crown was attached to, then said there is nothing more he can do for him. (Didn't offer to replace the lost filling.) Just charged him the £16ish fee. Husband has other crowns that the dentist feels need replacing, hence the dentists suggestion of a bridge. He reiterated that he had told him to get private insurance if he wants work done like bridges. He will only get £198 off the NHS for doing that work & it will cost in the region of £1500 to carry out, hence his refusal.
Surely if crowns needs replacing that should be done on the NHS? Should he have replaced the lost filling?

This is the problem with the NHS contract and why I can sympathise with him, whilst still being annoyed at his behaviour.
If a bridge is clinically necessary then he should offer to do it on the NHS. If another mode of treatment is adequate then that can be provided and the rules have been followed.
It is true his funding is fixed per course of treatment. But the other side of that coin is that some treatments that attract the same funding (£198) cost him considerably less to provide. There are swings and roundabouts in the system which means it is fundamentally flawed.
It seems he is trying to keep the swings but lose the roundabouts. Human nature after all.
However If you accept a contract you should abide by the contract.
As was said earlier. He can offer a bridge as a private "upgrade" but to say you *need* a bridge, then refuse on financial grounds will get him in trouble should you pursue it via the PCT.

Bottom line is the NHS system is rubbish, he is trying to make it work for him, but he is cherry picking the good bits. Few as they are

Toothsmith

He should have done anything necessary to secure and maintain his dental health.

£198 is the patient fee - not what the dentist will get. The dentist will get 12 points towards his contract target, which, in financial terms will be roughly 12 x £22 = £244.

Still nowhere near the cost of providing a big treatment plan - but that's not the point. The point is he's signed a contract to say he will provide NHS dental services, and those were the terms he signed up to, and is receiving taxpayers money for.

If a patient comes in and just needs one tiny filling, the patient charge is £44ish and the dentist gets 3 funding points or £66. Very few NHS dentists say "That's far too much money for 5 mins work - I won't claim it!"

The idea is (and it is a very stupid idea) that the short easy treatments will balance out the big rebuilds.

That's never going to be the case with the funding available, and all the untreated disease out there, and NHS dentists are on a hiding to nothing.

BUT - they signed the contract, and are taking the money - so they should abide by the rules, and not just cherry pick it to their own advantage.

If more dentists had refused to sign it, there would have needed to be a radical rethink, and a different system brought in.

There are ways to play the system more carefully - by not telling people that they 'need' complex treatment, and taking out a lot more teeth and making cheap plastic dentures. Figures are showing that complex treatment has dropped right down, and extractions and dentures are way up on the NHS now.

With this dentist though, he's not been that clever, and has told you you 'need' complex treatment, but isn't prepared to do it.

Ring up the PCT and complain.

jugglebug

Toothsmith is absolutely correct in his explanation, but you should know that the £22 he quotes as UDA value is the national average.
There is at least 1 practice I know with a UDA value of only £16.
Mine is higher.

Postcode NHS at its sneakiest

2 dentists in the same town can have wildly different values

cleo1299

Toothsmith wrote: »

The idea is (and it is a very stupid idea) that the short easy treatments will balance out the big rebuilds.

That's never going to be the case with the funding available, and all the untreated disease out there, and NHS dentists are on a hiding to nothing.

BUT - they signed the contract, and are taking the money - so they should abide by the rules, and not just cherry pick it to their own advantage.

Toothsmith, I wonder if you can answer a question for me.

Until about 18 months ago, I was seeing a dentist as an NHS patient, and this dentist was very much a "cherry picker". I have really serious issues over the way I was treated by this dentist. I have since "gone private" as I could not get the treatment I needed on the NHS.

My question is, is it possible that dentist is still benefiting from having my name on her register? Do I need to "de-register" in order to make sure she doesn't get a penny from the PCT for the service she refused to provide? Or can I assume that since I no longer go there, she will not get any public money "in my name"?

Thanks for any info.

Toothsmith

No - Nobody is 'registered' with an NHS dentist now, and there are no fees for anything other than courses of treatment.

Would be worth ringing up the PCT and letting them know what was happening though. Might help those that are 'stuck' with her.