To be raging my dentist will only see private patients for routine checkup

[VeniceQueen2004]

My daughter is overdue for her checkup. My dentist is now making routine appts for private patients but not NHS. I asked if I could pay private for her as a one off, and they told me that if I do that Ilwe'll come permanently off their NHS list and go onto their private plan (they would never accept me back as an NHS patient).

I ranted a bit on local FB group and it turns out this is common practice!

Is it just me who thinks this is shameless profiteering?

I'm a mainly NHS dentist in England. My practice is not yet doing check ups. I haven't done a check in in six months, and no we are not sitting there doing nothing. We have seen and sorted out patients that had problems during lockdown and now we are plodding our way through cancelled treatments and seeing and treating others who have developed problems.

English dentists can do check ups but it really depends on how the practice has chosen to prioritise care. We've chosen to prioritise those with pain, problems and postponed treatment. This means that as we are treating people, by the time we've added an hour of fallow time and cleaned and socially distanced our patients, doesn't give much capacity for check ups.

I managed a whole five treatments today, spoke and e-mailed several patients and wrote referral letters. Previously I would have seen 20-25 patients in one day so our capacity is very reduced.

As Mrs Morton says people have the power to keep their own mouths healthy; low sugar intake, excellent hygiene including cleaning between their teeth.

Private and mixed practices operate very differently, they will prioritise check ups as these are straightforward and will help them generate income and fulfil their commitment to patients on payment plans that continued their payments during lockdown.

The only fully NHS practices are community clinics, all the rest of us are able to use the portion of the time that is not contracted to the NHS to carry out private work including check ups. The practices offering private check ups are not breaking any rules just offering their private capacity where it's available.

YABU
Your dentist is probably skint and may need to pay bills to stay in business
Not their fault how dentistry in the Uk is funded

I’ve got toothache. I can’t get seen until next week as I don’t have an abscess, that I can tell anyway. There is a crack in my tooth near the gum line and painkillers aren’t taking the pain away. The nerve has gone, I was halfway through getting a second opinion on root canal or extraction but it looks like extraction now.

A bit of one of my molars broke off the other week so I called my dentist- I'd been to them week before to get a bite guard fitted. I was told when I tried to book that they weren't doing any NHS treatment at the moment, but that the dentist would see me to discuss private options if I was agreeable to that. I didn't want to risk further issues so agreed to come in on that basis.

After having a bloody massive filling I went to pay, and they asked if I got NHS care and I said yes as DD is still less than 12mos. That was ok and I wasn't charged- happy days.

Unfortunately this seems to be an example of a practice triaging and trying to dissuade NHS patients from seeking treatment. I understand not doing check-ups in the current circumstances (I mean there are people still waiting cancer treatment and organ transplants at the moment, your dental check up can wait) but for actual treatment? Just seems a bit dodgy.

Dentistry has been effectively privatised. For years. If you voted Tory then fuck you and the boat you came in on. You fucking ushered this in. Cunts the lot of you.

I had to have an extraction two weeks ago, it was done on the NHS, my dentist is still only doing emergency work. I rang for an appointment at 9.00, was in the chair by 10.00 & tooth out by 10.20. Don't ask me what the dentist looked like, I couldn't identify him in a line up, he had so much PPE on including a gas mask & bunny suit.

What we need to do is forget the idea of an “NHS dentist.” A dentist is a dentist, they are not solely private or NHS. Practices are funded by the person/people that own them. NOT THE NHS! The person/people that own the practice can choose to have a contract with the NHS to receive a chunk of funding to see X amount of patients (broadly speaking)
This could amount to 1 day a week, 3 days, 5 days or however long it takes that dentist to fulfil that contract. The rest of the time, they are free to see patients on a private basis, the same way a hairdresser or other private business does to pay their bills. NHS contracts are like gold dust.
I’m a dentist. If I set up my own practice tomorrow, I would have all the rates and costs to pay and no NHS contact, so would have to earn money privately. I could bid for an NHS contract, but there may (will) be none available.
I hope this helps explain how dentistry works from a business perspective. If your practice has a contract with the NHS to see 2000 NHS patients, the dentists within the practice share that workload between them, and then have to make up the rest of their income by seeing private patients. Or they could shut the practice certain days a week when not busy.
It is a bizarre system but there you go! Dentists don’t choose this system, the NHS sets its rules and if you have a contract with the NHS you have to stick to those rules for the NHS patients.
All the dentists on this thread are explaining this! Saying “but my child hasn’t had a check up!” repeatedly won’t change the system!
We know! We’re doing our best! Most of the country has not had a check up!

A little conundrum for the doubters:
If I have 5 NHS slots per day (which I do now) and ten people call the practice per day/per dentist, how do I fairly distribute those appointments? Because five people of those ten are not going to be seen that day.
Do I see the person in agony who is in tears on the phone? Do I see the three people with broken teeth but no pain? The three who have moderate pain but are managing but worried the problem will get worse? The elderly lady whose denture has snapped? Or the two people demanding check ups?
Bearing in mind once those five appointments are filled, I’ll get ten more similar phone calls tomorrow.
If I get a day when I have spaces 🤣 by all means I will call people who are waiting for a check up to offer them a slot. After I’ve called the hundred or so who were cancelled mid treatment in March.....

Not all dental problems are preventable. I take really really good care of my teeth, have not needed a filling for a very long time and my dentist always comments on how clean my teeth and gums are. But in the past 10 years, even I've needed two wisdom tooth extractions. The dentist told me that they would have needed to be removed at some point no matter how careful I was.

True @greenteafiend. So if you had those issues and needed an emergency appointment during a pandemic when services are extremely limited, wouldn’t it be even more frustrating if you had to wait as all the spaces were filled with people who had problems that were preventable, but they didn’t prevent them?

My 3 year old hasn’t seen a dentist since September last year and his next appointment is now June next year! They refuse to see him any sooner unless he has any problems.

I think you have a very valid point, however it is supply and demand. I personally don’t think dentist should never have been privatised.

Pat is a self employed cleaner (as most are) She has a list of clients who pay her individually to clean their houses. She also has a contract with a school to clean there 10 hours a week. At the school she has to use the cleaning products provided and clean exactly as instructed. At people’s houses she adds nice finishing touches and uses different products according to what the client prefers.
One of the staff at the school asked Pat if she will do a couple of hours per week at her house. Pat would have to give up a couple of hours at the school to do this but agrees. After a few weeks , the client decides it’s getting too expensive and stops Pat’s services. Pat approaches the school to request her hours back. They have contacted the hours out to a different cleaner.
Nat is a self employed dentist (as most are)...
Swap school with NHS, cleaning with dentistry and repeat above. Hopefully this helps explain your situation @VeniceQueen2004

Dentists have always been privatised as someone has put it and it’s Tony Blair who totally screwed over the profession.

NHS dentistry was introduced in 1948, alongside general NHS provision. It was free at the point of delivery. Within two years charges were brought in for dentures and ceramic work. By 1951, patients had to pay for treatment, albeit a small amount (20%) was subsidised.
Point being, very very quickly, it was realised that dentistry is expensive. The NHS couldn't sustain the cost 70 years ago, and today is no exception.
It's been a constant battle over the years. Private work helps to find the NHS. The two systems are symbiotic.
NHS dentistry simply doesn't work at the moment. A small NHS amalgam filling usually costs @£20 here in Scotland. At present, this wouldn't even cover the cost of the PPE, let alone the fallow time required.
Emergencies will be prioritised before routine work.
In our practice alone, we had over a thousand calls during lockdown. The practice are doing their best to get through that pile.
Meanwhile we have thousands and thousands of patients waiting in the wings for normal NHS services to resume.
We anticipate a massive dental health crisis next year, like we've never experienced before- missed, progressive oral cancer cases, rampant caries in children, huge waiting lists for kids GA's as a result, untreated periodontal disease, resulting in mass extractions, all to name but a few.
I normally work five days a week, and due to work bubbles in force, I'm
Only in now two days out of five. This is how most practices are operating. Whatever way you look at things, there is a massive reduction in capacity. Dentists have bills to pay, and are far more inclined to do private work that will keep them afloat, rather than nhs work which actually just now costs them.

@milklady02

But again, this isn't about them not having space. If I go private, they will suddenly magically have an appointment. And I can't go private just for this course of treatment, they'll take her off the NHS list for good.

It is literally just bullying people onto the private plan because this is more profitable than the NHS. And it isn't because they "can't" see non emergency NHS patients, because other practices in the same area can. The document someone linked to above said all primary care practices in England can now do AGP and non AGP treatments if appropriate safety gear and protocols in place. Which, if they can do it for private patients, they can do for NHS patients. But they won't because it's not in their financial interest. Which is what's wrong with dentistry being a private practice rather than a public sector service.

All your stuff about this being a situation they have been forced into and not of their own making I would buy, and I'd cough up on this occasion. But they are manipulating the situation to force us off the NHS list, which I know wasnt policy before Covid, when I had an NHS check up and then a private treatment because I didn't want a black crown. So they are absolutely using people's desperation to line their own pockets, not just doing what they can within the constraints placed on them by their NHS contracts.

@MilkLady02

The difference being cleaning is not an essential health service I am not qualified to do myself. And dentists are skilled professionals in high demand, unlike min wage cleaning ladies. Spurious comparison.

The system is not the patient's fault either. I've always been able to countenance the private/public system on the basis that basic care was available to everyone, and if you wanted bells and whistles you went private (eg my vanity not wanting a black crown so I choked up several hundred quid - back when I used to have that kind of money! - but if I had been poor I could still have had the crown affordably, but not the vanity).

Now the situation literally is that basic services are available or not depending on how rich you are. There is no way o can get my daughter's teeth checked without going private, but my rich friend can get her daughter's teeth looked at tomorrow.

This is nothing to do with safety and everything to do with dentists taking the opportunity to do what most of them want to anyway - exclude or jettison their NHS patients in favour of well-heeled private patients.

So whether it's the system that's wrong, or the practice that's wrong, makes little difference to me - it's just wrong.

At very least there ought to be an alternative approach for children. I suppose a rabid libertarian might say I deserve lesser treatment because I haven't earned enough money to deserve better; but children can't help who their parents are. They shouldn't be systematically ranked in terms of access to healthcare based on their parent's paypackets.

@VeniceQueen2004
I do understand your frustration, but all I can say is that we have to follow NHS policy if we are to keep our NHS funding. The NHS are allowing our practice to provide 4 nonAGPs and 1AGP per dentist per day. And no check ups. I can’t speak for other practices and how they are running things, but we are overwhelmed with just emergency patients with this level of appointment availability. The NHS have to be seen to be doing things properly and mitigating risk as far as possible, so we have to have between 30 and 60 mins of fallow time between appointments where the room is left empty. Hence fewer appointments. This takes me from 8:30am- 4:30pm including phone calls to patients in fallow time. I see private patients outside of this contracted time, the NHS won’t pay me for seeing anyone outside those hours. I have to fulfil my NHS obligation first. The comparison I was trying to make above is that dentists are indeed running a business. No dentist has any obligation whatsoever to work NHS. If they choose to take on an NHS contract, they fulfil that contract and then use the rest of their time to make profit for their business. If you chose to swap to a private patient, you lose your NHS space as someone else on the waiting list will take it. They can’t leave a space open for every patient to decide if this time they are NHS or private, there’s too much demand. As a PP said, most NHS treatment runs at a loss so if we did no private work, all practices would go bust and no-one would have a dentist. Essentially, if you want NHS dental treatment, you have to wait in line because demand way way outstrips supply. I know this sucks but it’s the situation we are in after decades of underfunding. If the dentist saw your child for a check up for free during their private hours they would make zero money and would then have to see all check ups as soon as word got around. Yes they have the time and space to see more patients, but the NHS won’t pay them for it. You can’t run a dental practice as a charity. It’s unbelievably expensive to run properly.

If you are raging, rage at your MP. Dentists did not create this situation, government did. We are as fed up with it as patients!

Plus, there is a pandemic, so yes, basic, non essential services have been cut back drastically.

They have said you can go private though and be seen so you have a choice. If you don’t want to pay, then like most things in life it limits choice.

They need to do what they can to stay open so that we have their services. I’d rather go without other things and prioritise things like dental care etc.

The dentistry system is ridiculous and has been for ages. In some areas people can't find a dentist taking on NHS patients. However, in London and other major cities-often those with a dental school-finding NHS dentists is easier.
Myself, DP and DD are all going this afternoon for a check up, NHS patients.

No, it’s standard. You pay for private insurance, you usually get a better standard of care. It happens all the time. That is the benefit of paying insurance premiums for years.