To think maybe they need to make NHS dentist places means tested?

[dameofdilemma]

Reading about the shortage of NHS places and having seen it in real life….is the Govt going to do anything at all about it?

I’m fortunate enough to be able to afford treatment as a private patient but what about those who can’t? Dp is registered as an NHS patient and is even thinking of giving up his place and registering privately (if he knew if would go to someone who needed it).

I’ve had two dentist appointments recently, both times while waiting, a string of people were coming in to ask about NHS places. The local FB pages are full of desperate posts as no one can find an NHS place. They’re facing long, long waits for treatment at hospitals.
Having had agonising tooth pain recently, its debilitating, it effected my ability to sleep, eat and work properly. This isn’t a ‘nice to have’ treatment, its essential.

So maybe the NHS places should be reserved for those on the lowest (or no) incomes? It can’t make any practical sense to offer places to higher earners, if places are so scarce, if all that happens is people are then having to rely on (already overloaded) hospitals or being unable to work etc.

I know we don’t want as two tier system or a shift to private healthcare etc but reading some of the stories of people unable to eat and passing out from dehydration, the status quo clearly isn’t working either.

or IVF - double benefit, fewer people needing dental treatment.

Speaking as one of those people, I don't accept blanket denial of NHS dentistry to those in a certain income bracket. I'm not happy about the way others are being deprived of a service they pay NI towards now either, but aside from willingness to vote for tax raising parties to fund a better service there isn't much I can do to assist them. Whereas there are things I could do myself if I were forced out, such as ensuring the tax I paid to the Exchequer was reduced.

Surely the more you earn, the more tax you pay ... so your contributions into the system cover more

So you want those who pay the most in for the service to be stopped from using it?

Yes, that’s very unreasonable.

If my NI contributions were reduced then crack on but until then it will be middle earners who lose out again - earn too much to qualify for support but earn too little to be able to pay for it!

The Goverment have said there is no more money for NHS Dentistry. The exodus of Dentists from the NHS is happening. They have only commisioned NHS Dentistry for half the population and right now there are recruitment issues for NHS Dentists and nurses so there are many unfilled vacancies.

In an ideal world the NHS would set up and run NHS clinics but Dentistry is expensive to provide. They took out of hours care away from Dental Practices in 2006 to save money. It didn't.

Dental Practices run efficiently, we are good at it, you can't provide Dentistry cheaper than the way it is already provided in the UK. Don't compare it to other countries they are cheaper due to the local economy, the exchange rate, regulation differences.

As Bickles said NHS Dentistry needs urgent reform, the contract needs to pay Dental Practices reasonably for what is provided. It is completly inappropriate that Private Dentistry props up NHS Dentistry. Priority needs to be given to under 18s (they need preventative care and regular check ups to ensure they start with healthy teeth)and those on low income. There is also a need for affordable family Dentistry for others, not everyone needs high end cosmetic and implant work. The Government needs to be honest about what they want to do about NHS Dentistry, they are busy killing it at the moment.

Or just train more dentists?

We seriously need to have more doctors and nurses too.

@mumda the BDA doesn't think there is a shortage of Dentists it's mainly no-one wants to carry out NHS Dentistry.
I'm an NHS Dentist for the last 30 years but I'm broken, the demand is unrelenting and I feel like last man standing. I don't think we can afford to keep providing it for much longer; our lab bills, material costs, equipment costs are all rising significantly and the NHS contract doesn't increase at anywhere near the same rate.

It would also take around 10 years to produce more Dentists, most of the Dental Schools have no space to increase capacity so it would mean setting up new ones, then 5 years of training plus the requirement for Foundation training before anyone was able to carry out Dentistry so not a quick fix.

It is inexplicable to me that hairdressers and nail parlours charge more for their time than dentists. It is inexplicable to me that people think they have any say over what dentists who have effectively to run their own small businesses should and should not do. It is even more inexplicable to me that dentists even bother to explain themselves to people who don't wish to spend a few seconds trying to understand the impossible situation the NHS contract puts them in.

These days beauticians are what people want. So that is why they get what they deserve. Personally I think a good set of functional gnashers is about the best beauty treatment going, really sets off one's looks. And every penny and nanosecond my dentist spares on me is treasure indeed, we always have a great time at check ups, and I am always grateful.

So maybe the NHS places should be reserved for those on the lowest (or no) incomes?

Not read all the thread, but where does that leave people like us?
Who could no way afford private treatment but aren't on no income or the lowest either.

@MillyMollyMardy
Had you thought of moving or are you generally happy in your practice? I do clinical teaching now and absolutely love it, plus one day in a private practice.
Don’t let the NHS suck the life out of you, more to life than teeth.

We moved in 2020. We went to 8 NHS dentists - none would take us - none. One would put us on a waiting list - about 4 years. Many claimed to be NHS and I was told one dentist does one afternoon a week of NHS. So no chance.

a year later:

by sheer chance one afternoon up pinging a message on WA from a parent at my son’s school saying a dental surgery had taken on an NHS dentist - I happened to be off work on holiday and drove there straight away and she said yes taking on new appointments but you need to book in and register. I asked when we could and again by sheer chance a patient had just cancelled due to high temperature. I took the children and I straight in and done.

Within days they were full. They are brilliant too. None of this waiting 12 weeks for an emergency appointment. Bit like the GP if you want an emergency appointment you phone on the day and they have emergency slots.

we feel blessed.

The difference is not the paying aspect it is that it is capped at a fixed amount. A crown cost me I can’t remember £182 or something - private can be double that or more!

It should all be NHS as it once was. Everyone should have access to dentistry, it’s just as vital as any other medical treatment.

I agree with you OP. I have friends with annual household income c. £500k proudly talking about how they have nhs dentist spots - which I think could probably go to others on lower incomes who can’t get on the practice list. These friends whose monthly income is in the tens of thousands could easily pay £30/month denplan for a private dentist like I do and free up the precious nhs dentist slots.

We were a one wage family in Ireland and have only since I returned to work been able to afford trips to the dentist. Relatives who are on social welfare went insane when the govt lessened the amount of treatments available on the medical card. I didn't even know what to say I was so dissillusioned- I had a tooth still in my gum that I knew would be over a hundred euro to get taken out so it stayed there. When I finally went the tooth next to it was in bad shape because of it and I coudn't afford the root canal so had to get it taken out. As said above everyone should have access to affordable dental care

I do feel there should be an income cap on accessing free services with nhs. (Obviously dentist is not free)

Hairdressers / nail work - it's all a luxury that you can choose to opt in to.

Dentistry is healthcare - you're not supposed to opt in to have dental care if you fancy looking nice or you've got enough extra cash to 'treat yourself'. Where does that stop? In the future will you 'treat yourself' to cancer treatment?

People really need to stop comparing the beauty industry / building services etc to dentistry just because they use a similar business model.

What the government has done is shit to everyone but making access only for the absolutely poor is the most ridiculous idea. Access to healthcare should be done on clinical need only and prioritised accordingly. We should be fighting for the NHS contracts to change.

All services in the NHS? Are you suggesting some people should pay a lot of tax and never be allowed to access free healthcare?

My nhs dentist won’t take on children because they don’t pay a penny. Prefers adults as they contribute!

The problem with NHS de twister is the band payment scheme, that effectively makes it impossible for dentists to do NHS work without losing money.

I strongly disagree with OP- I have no desire to move to a US system where most people pay for themselves and only the poorest receive state-funded healthcare. We should be funding NHS dentistry properly through taxation.

Means test all NHS treatment. Oh wait, you mean privatise?

Let's not have a race to the bottom, how about doing something positive like lobbying your MP or starting a pressure group.

So you want them to pay for it, but not be able to use it?

That’s ridiculous.

And I think most people who "can afford it [private treatment]" would rather pay more tax and see a better funded system.

Or, rather than stretching average to good earners better, recover some of the fucking huge taxes being dodged. Stop renting stupidly large office buildings for government from their mates and put the money into citizens instead.