Disgusted By Dentists Behaviour!!!

[Windchangeface]

We moved home week before the pandemic and then non of the dentists were taking on patients.

This made me very nervous, I kept an eye out to jump as soon as they opened up.

Well...as of a few weeks ago 3/5 practises within a 15 mile radius of us put up notices on their websites ‘taking on new patients’ great I rang to register me, DH and small DS. But oh no, they aren’t taking on any NHS patients only private or Denplan! (Would cost us a minimum of £50 per month and I’m currently pregnant so should be free anyway). The receptionists at all 3 massively tried to sell me Denplan and actually made me feel like a total sponge for asking about NHS.

‘Most families prefer Denplan’ erm sorry Shannon but I highly doubt ‘most’ families prefer to spend £50+ per month on something that should be £20 a visit for them and free for their kids!

One of the receptionists even told me (in a very snooty tone) ‘no we aren’t taking NHS patients we’ve got enough of those) another stated ‘we’ve met our quota for NHS so are only taking paying patients’.

Given DH is a Dr who spends all day looking after hospital patients free of charge I’m at a loss to understand why dentists feel they’re above the NHS.

Horrible, elitist attitude excluding people who can’t afford to pay from adequate healthcare and forcing those who can to pay high premiums they shouldn’t have to!

A local doctor wrote that our ICU had a number of sepsis patients at the moment caused by tooth infections. Dentists are a basic form of care, not an option.

Yes basic dentistry is absolutely essential. Check ups should be free and easily accessible. There are just not enough dentists or nhs contract to go about.

If they were funded by the nhs I can just imagine the headlines ‘greedy dentists snatch cash from the public purse’ or similar. Dentists just cannot win.

www.healthcareers.nhs.uk/explore-roles/dental-team/roles-dental-team/dentist/pay-dentists

It doesn’t look like dentists are on minimum wage? Skill mix in the NHS has been totally reformed perhaps that needs to happen with dentistry. I know dental nurses and hygienists can train to do additional procedures but I’m not sure how common that is.

Only read page one, but astonished by the replies. I think dental and eye care should be on the NHS personally. They are hardly bloody optional extras.

[quote Easterhop]@Covoidofallhumanity yes a GP surgery is in many ways a better comparison. The differences as I understand it are that:
1)GPs are paid better per patient on their books to start with
2) there is no requirement for them to actually see the patient to get paid - they get the payments for those on their books regardless
3) dentists actually do treatment most of the time which is different to a lot of issues at the GP, which takes time to do
4) GPs actually get their premises paid for under the Premises Payment, and premises are one of the big costs for dentists
5) the dental equipment dentists need to have - x ray machines, OPGs ,dental chairs, specific air conditioning/filtration etc all are expensive and fully funded by the dentist only - whereas GPs need much less expensive equipment.

6)cross infection - how much cleaning goes on in between patients - even in normal times - in a GPs room. How many instruments does a GP need to sterilize on a per patient basis?
Add to that the dentists must have a nurse with them at all times under the rules (another salary per dentist to pay) and you can see how it works differently sadly. There's a myriad of other expenses that GPs don't have - and some similarities in that the CQC inspects them, they both need practice managers, receptionists etc but there are huge financial differences.
The reason its ended up this way is partly due to the different union strength and partly due to the fact dentistry is not seen as a priority for either the government or the public. The dental union had to fight to get dentists even recognised as key workers - so that tells you all you need to know.[/quote]
GPs get about £150 per patient per year and the average consultation rate is 8 per year, so they receive under £19 gross per consultation, out of which comes not only all the expenses of running a practice, but all the care that patients need between consultations - repeat prescriptions, correspondence, blood tests etc.

Dentists have very little responsibility for patients in between consultations. GPs have to act as co-ordinators for patients' care across all the healthcare services they use. There is also a big public health/preventative medicine role.

And the major difference is that - barring the odd £20 for a passport application or similar - GPs have no option to make up their pay with private work, whereas dentists can always choose to do so. The number of private GPs is small, and they are not based out of NHS practices, whereas almost all dentists who do NHS work also do private work from the same surgery - so it's not surprising the NHS does not fund your premises. Do you think the taxpayer should be subsidising your private work?

Lots of doctors on this thread have defended dentists. It's a pity to see dental staff trying to put the boot in to GPs, especially as you clearly don't know what you're talking about.

Whichever was you cut it, an awful lot of dentistry is actually an optional extra. Healthy nutrition can be maintained with surprisingly few teeth. (Goes without saying that dentists are vital to screen for very serious health problems though - check ups are not an optional extra)

@MissLucyEyelesbarrow - I did not put the boot in for GPs. I merely pointed out the differences as far as I knew them from a dental perspective. I am not dental staff - my husband is a dentist and I see the pressures on him and his contemporaries.

In relation to your point regarding premises - it's precisely because the government does not fund them that dentists do private work to keep their practices afloat. It is a chicken and egg situation. There used to be very few private dentists when the NHS paid them properly - like GPs. The reform of the dental contract created this issue - and it was not led by the dentists.

And actually dentists do also have a significant role in referring patients on for mouth cancers, ortho when appropriate etc. And their equipment which is compulsory, is significantly more expensive than GP equipment. Equally funding a dental nurse to always be with a dentist (and having a locum nurse for when they are off) is not something a GP surgery needs to do - a chaperone is an option, not a legal requirement. Dentists must also provide themselves, an out of hours service for their own patients. They do this themselves. Perhaps it is just my GP but theirs is outsourced to a local non emergency hospital.

The value of UDAs varies depending on the contracting region. It's generally not dissimilar to your consultation fees received. Except no shows are not paid, and doing dental treatment takes more time than a consultation GP slot. UDAs are inclusive of lab fees, materials and PPE - so again not expense free.

I have no beef in the game. We are fully private as my DH wanted to do the best treatment he could for his patients, which he could not do and make a reasonable living under the contracts offered by the NHS.

I did not put the boot into GPs - someone asked how on earth this had come about and I explained what I saw the differences from a dental perspective. In my view, you have an equal lack of knowledge from a dental perspective - but I did not make any aspersions to have knowledge of the GP sector.

And actually, unlike my GP who is still offering mainly remote services, that is not an option in dentistry. My DH (like so many NHS doctors) wears full PPE all day and comes home exhausted with marks on his face. Dentistry is as core a part of healthcare as GPs are. As I said, if they were funded in the same way as GPs then I think the situation would be different. But they are not. If the dentistry funding model is so ideal, perhaps GPs should have it.

Am bowing out of this thread. I categorically did not 'put the boot' in to GPs - I was explaining why dentists have been forced into this situation and the fact their union did not stand up for them effectively. I find it sad that a GP decided that someone saying they had negotiated better terms (and not in a pejorative way) is classed as putting in the boot.

@BuggerBognor

GPs have no option to make up their pay with private work,

Only within that practice though. We have loads of GP’s in our friendship group - only one works more than 3 days a week. They all do various other “side hustles” like aesthetics (dentists do that too I think), lorry driver medical, prison on call work and one runs an ambulatory clinic. All of which pays somewhat better than £20 a pop.

Sure, but they aren't doing it out of NHS premises, funded by the taxpayer.

And professionals needing to take a 2nd job is not usually a sign of being lavishly over-paid in their main role.

And professionals needing to take a 2nd job is not usually a sign of being lavishly over-paid in their main role

gp salaries start at 58k. Partners earn considerably more.

gP’s don’t take private work to supplement a full time Salary. As pp said, it’s a choice to work part time and take on private work on their days off as it’s more money for the same hours. Best of both worlds.

It's not the dentists fault, they are only going to take on the amount of NHS patients that they can secure funding for, they aren't going to work at a loss. I agree that the system should be overhauled, it's virtually impossible to register with an NHS dentist here and has been the same for years, they sometimes take on children, but only if an adult is also registered either as NHS or private. There should be more of a divide imo between health related dentistry and cosmetic.

I can’t comment with any great knowledge about dentistry, but I can about optometry. The practice ran at a loss with regard to NHS work, as they don’t pay enough to cover expenses. I’d earn £16 for an hour. I needed to earn £57 to keep the practice running.

Easterhop

@Covoidofallhumanity yes a GP surgery is in many ways a better comparison. The differences as I understand it are that:
1)GPs are paid better per patient on their books to start with
2) there is no requirement for them to actually see the patient to get paid - they get the payments for those on their books regardless
3) dentists actually do treatment most of the time which is different to a lot of issues at the GP, which takes time to do
4) GPs actually get their premises paid for under the Premises Payment, and premises are one of the big costs for dentists
5) the dental equipment dentists need to have - x ray machines, OPGs ,dental chairs, specific air conditioning/filtration etc all are expensive and fully funded by the dentist only - whereas GPs need much less expensive equipment.
6)cross infection - how much cleaning goes on in between patients - even in normal times - in a GPs room. How many instruments does a GP need to sterilize on a per patient basis?
Add to that the dentists must have a nurse with them at all times under the rules (another salary per dentist to pay) and you can see how it works differently sadly. There's a myriad of other expenses that GPs don't have - and some similarities in that the CQC inspects them, they both need practice managers, receptionists etc but there are huge financial differences.
The reason its ended up this way is partly due to the different union strength and partly due to the fact dentistry is not seen as a priority for either the government or the public. The dental union had to fight to get dentists even recognised as key workers - so that tells you all you need to know.

I found the above really interesting. It explains a lot.

UDA values differ but the average is £20-25 per UDA.
If you work on 3 UDAs an hour which is pushing it now but was doable before Covid, that’s the dentist earning £75 per hour.
Pay your nurse, maybe £10 per hour.
£65 per hour for your premises, expenses, indemnity which keeps going up, materials and to actually earn something! It’s fairly tight tbh.

Probably more than £10 an hour for nurses in lots of places - and deservedly so. Add in employers National insurance and pension, plus cover element for holiday/sick.
Throw in some no shows so no UDAs.
Hard going!

You haven't paid the receptionist(s), practice manager, hygienist if they do some of your NHS hygiene for you or lab fees yet.

All true!
No idea how anyone is doing NHS dentistry at all!

I go to a private dentist. I am on Denplan, mine costs an eye watering £40 a month and I was only eligible to go on it after I'd had about £2,000 of work done. I have really bad teeth (despite looking after them a lot better than my husband who never goes to the dentist and has no fillings) and it's only human nature to slightly begrudge the money.

That said, my kids go to a NHS dentist in a different town so I don't have to pay for their dental care.

@Diesse

I can’t comment with any great knowledge about dentistry, but I can about optometry. The practice ran at a loss with regard to NHS work, as they don’t pay enough to cover expenses. I’d earn £16 for an hour. I needed to earn £57 to keep the practice running.

So do the private patients effectively subsidise the NHS?

Yes, and private fee per item on NHS patients subsidises it too.

Sorry Foolingaround you asked about Optometry but it equally applies to Dentistry.

Tricky when the private is subsidising nhs work. If you have sufficient private patients, can see the attraction of ditching nhs work altogether - patients pay the same, dentists are better paid for their skilled job!