What's the answer to the loss of NHS dentistry in the UK

[Thottey]

600 practices have withdrawn completely from NHS dentistry in ten years.
My DC, both adults were told their dentist wasn't going to treat them any more unless they went private. They have registered as private patients elsewhere.
Private dentistry is hugely profitable but it used to be focused on cosmetic dentistry and serving the wealthy. Now their patients are from all walks of life.

NHS work doesn't pay and there needs to be an alternative.
Perhaps clinics where the dentists are directly employed by the NHS. Recruitment would be difficult at first but I think the vast majority of the population would abandon private dentists and use the NHS if they had chance. I'm aware there are a few of these already. The waiting list for the one in my area is four years.
So gradually the private firms would lose patients and there would be more dentists to recruit.

Also all costs have to be covered by the dentist from the fee generated.
GPs have many costs covered eg a computer system will cost a substantial five figure sum, plus for extra terminals , plus a monthly licence fee of £400 or more for the basic system. Add in eg text reminders you will be paying a few hundred more a month plus cost of texts .

All staff training is paid for by the practice , there is no protected time so all meetings , etc have to be out of work hours otherwise targets can’t get hit and money is taken away .

There are no NHS pensions for support staff and many clinical staff . The list goes on.

I think the post earlier about stressed dentists and aggressive service users is also a factor in why dentistry is not an appealing prospect for a graduate. A relative of mine is a dentist with 40 years experience, working primarily in NHS with some private patients. She saw a family for the first time the other day, a three year old with multiple decaying teeth. Suggested to parent they might want to limit sugary drinks and sweets. Their response? “I’m not going to take advice from you about my kid”. Relative retires in 6 months and bet she can’t bloody wait not to deal with people who put no value in the decades of expertise and experience she has.

Forgive me if I don't take the BDA figures as gospel. They are hardly an unbiased source of inmformation.

There may be a record number of registered dentists, but there is also a record population and one assumes therefore a record demand for services, coupled with the tendency for highly paid professionals to not work full time.

If what they say is correct then the dental practice I attend must be losing money as they only do NHS work (I highly doubt that or it would not exist).

Do they though? There appears to be an assumption that healthcare and dental provision in Europe is wonderful, but is it? I can find no shortage of people complaining about dental services in Germany by simply Googling. Hardly a scientific approach but I suspect other European countries are not providing a perfect service either.

How about this then , the average UDA value (unit of dental activity) is £28 in England .

A very experienced dentist in a low needs area can do 30 UDAs a day , on average . Of course this is not every day , working at 5 day week , with time off for holidays and training which is not paid for.

That makes £840 a working day coming in.

To run one room in a cheap area in a practice set up for mainly NHS work ( no practice does no private work) costs from £140 an hour without paying clinician etc . That includes lunch times,training days , sick days etc. So just to cover fixed costs is £1320 a day without clinician being paid.

Another way to look at it is the average payment per person per course of treatment , including patient payments is £39. How much time and equipment would that buy for a plumber or garage. There is no other money coming in to fund a practice and people , everything is funded from that.

Unless your practice was bought decades ago by the current owner has no mortgage or loans for equipment (equipment needs replacing very often and is massively expensive) or has a massively higher UDA it will do some private work to keep the lights on and pay clinicians . The large majority of dental work value is private across all practices.

Finally two of my friends gave up their NHS contracts this year to go completely private. Their NHS contract were well under a million yet both practices were losing a six figure sum on the NHS and they could no longer justify that degree of subsidy from the private side

”unbiased” news, mydentist is UKs largest chain. Like Bupa who closed 85 practices, they have also closed practices, have never made a profit and this year recorded record losses.
This is a report from a few years ago https://www.business-live.co.uk/retail-consumer/mydentist-deepens-losses-boosts-overseas-30415637?int_source=amp_continue_reading&int_medium=amp&int_campaign=continue_reading_button#amp-readmore-target

turnover of staff in many of the corporate practices is large and you have to ask why.

@Erin1975 does your practice really only do NHS work? Nothing else? No hygienist, no cosmetic dentistry like Invisalign?

Any given practice will have some different economics - for example, if the dentist owns the premises outright, that’s a big saving, especially if he/she can sublet space to a hygienist or whatever. or if it is in a lower wage area or employs family members.

But ultimately, even you don’t trust those sources and if the average dentist is £20 an hour short of covering their costs rather than £100 an hour short with NHS payments, the shortfall has to be covered somehow

"They are run utterly efficiently as there is no room for excess. Only 19% of practices are owned by corporates."

That tells you all you need to know. If dentistry was an easy licence to print money with a monster profit margin, the corporates would have moved in and taken over the vast majority of practices already.

Exactly mydentist, UKs largest corporate has never made a profit and has most recently posted record losses.

You say "once again" as though I've been throughly reading every post you've written. I haven't, and I'm not off to Google.your suggestion if you want to engage in a discussion about a difference of opinion, you need to do the work and summarise it, link it and tag me.

I think the NHS should provide excellent dentistry for children so they start off with very good teeth and can go on to a cheap private insurance scheme as adults.

many of us who had NHS dentistry in the 1970’s suffer from PTSD and had our teeth ruined by “drill and fill” dentists. I know NHS dentists are good now but I don’t think we can afford to provide free dentistry for 70 million people or whatever the population is now