Dentist cancelled because of maternity exemption

[Acc0untant]

This isn't a huge deal in the grand scheme of things but I feel a bit put out regardless.

My dentist has cancelled my appointment next month and when I queried why the receptionist told me that they aren't seeing any patients who are exempt at the minute. In my case I have a maternity exemption certificate (runs out in March). She said it's because they aren't receiving any NHS funding for it at the minute.

The point of the maternity exemption is that due to pregnancy you can have additional things needing work (pregnant gingivitis etc) and you aren't unfairly penalised by having to visit often. In this case they're saying I can't be seen until I start paying the NHS prices again in April.

Not going to pull the discrimination card (although being told I can't use their services until I no longer have an exemption due to pregnancy certainly feels like it) but would like to hear the thoughts of others on this too!

I’d be writing to my MP for starters.

I’ve had results before by doing this

The practice will go under if they work between now and April (when there is a new pot of money from the NHS) for free. If the dentist did want to work for free who is going to pay their assistants, receptionists, energy costs, rent on the building, costs of materials etc?

I've already said about my MP.

Honestly what I expect is to have my appointment honoured and the dentist and/or whatever health board it falls under to sort the funding out with the government. I'm the dentist's customer, not the government's.

I don't think the problem should be passed to the end consumer when it is something like healthcare, private healthcare excepting.

Also if OP needed treatment not only would you have to factor in running costs of surgery at £140 to £200 plus an hour but also laboratory fees which can run into hundreds of pounds .

Even for a check up the dentist would be better off handing op £20 to find an appointment elsewhere.

NHS dental funding is fucked.

It's crazy you can't pay for an NHS appointment.

The timing is unfortunate that you won't have the exemption after they get their new funding.

And... I know this is whataboutery... but I can empathise. I didn't get to use my exemption at all with DC3 because of Covid. My teeth definitely shifted a bit but I can't afford to now get it fixed where it would have been covered (I am told).

Tough shit seems to be the universal answer.

Or accept the fecking tax rises and economy bashing the government are working on to sort out public finances. But that's a whole other thread!

Honestly the whole situation is ridiculous, I had 4 years of exemptions (2 pregnancies) and couldn't find a single dentist that would see me with it, so never once could use it! Like many posters there's no NHS dentists at all here, private only. The whole system needs changing.

So you expect the dentist to pay out of their own pocket to treat you?

Ahh of course, they just ask for more money and be given it, it’s that simple! Someone go tell that to the rest of the NHS, with cancelled appointments, surgeries, huge wait lists due to lack of funds- just go ask for more money! You’ve just solved all of our issues with the NHS, I don’t know why nobody thought of just getting more money as the simple solution… oh wait

If you wouldn’t work for free, don’t expect the dentist to work for free.

Have you not read this ?

KO: How do the financial challenges faced by ICBs affect dentistry?
EC: At the outset of the year, ICBs were informed that they ought to ring fence the dental budget. So, if dentists in a particular area weren’t delivering NHS dentistry at the levels that they want, the ICB could use some of the underspend to recommission services in that area. This was welcomed by the profession – the money wouldn’t be lost to other areas of the health service as it has been done previously.
But in November, NHS England wrote to ICBs and said that the government would not be bailing out overspends and if they had any unspent or unallocated money, they would be expected to use that to prop up the overspends elsewhere. It’s meant that a lot of plans for dentistry have been stopped – if they hadn’t committed the money to the projects, those projects are not going ahead – which is hugely upsetting.
One of the things suggested at the beginning of the year was that ICBs could fund more activities than the dentists had in a contract. They could fund an additional 10% activity and many colleagues believed that was an offer that they were working to.
But now the ICBs have reversed that decision. At least 12 ICBs have written to dentists about this. In some cases, they are doing no dentistry at all for one or two months before the end of the financial year because they’ve run out of funding.

There is no negotiating for many , there is no more money . The dentist has no control over money or funding and when it costs £140 to over £200 an hour to cover just the costs of one room in a dental surgery no dentist can offer any treatment if they are bankrupt.
Will suppliers,utilities,staff , laboratories etc agree not to be paid so NHS patients can be seen for free?

Haven’t read the full thread so apologies if duplicated, but is this anything to do with the closeness of your last appointment? I still have an NHS dentist, been with him 22 years but ever since Covid check ups have only been every 12 months so I can’t have them six months apart even if I want them.

I need treatment for osteoporosis but I need a dental exam first. I don't have a dentist and haven't for a long time and my teeth are not in a good condition. I cannot find an NHS dentist within a 40 mile radius. Can't afford private.
So don't whether I can have the treatment I need.

This doesn't sound right and is ethically wrong. Call NHS England and ask for their view on this!

I would like to add that talking about being a “registered patient” won’t help if you take it further with the MP. You are only registered as a patient for a single course of treatment and when that course of NHS treatment is closed they are under no obligation to see you again at all. They only have to see you whilst that treatment plan is active. This was part of the contract changes brought in in 2006 with funding. I think a lot people still believe they are “registered” but this hasn’t existed in many years. It is up to the dentist’s discretion that they see patients on a recurring basis but technically they could stop seeing someone at any point as you aren’t technically “registered”.

@Acc0untant For info: https://www.nhs.uk/nhs-services/dentists/how-do-i-complain-about-my-dental-treatment/

Thank you for volunteering to fund the OPs treatment! I’m sure if you write the dental practice a cheque to cover the costs they will happily see the OP!

I respect dentists who are performing NHS work. In their shoes I’d probably have gone totally private years ago. But I’m greedy like that.

The gov is at fault here. In England. Not sure if it’s different in Scotland and Wales. The best way to conplain is via the MP-. I appreciate that’s been discussed already.

NHS dental funding is ridiculous - but frankly so is this. OP, it's not right at all that you're being treated this way. They've been shady to let you tag along like this rather than admit this is how they do things and let you find another dentist (I know they're like hens' teeth but still). What are you meant to do?

Definitely write to your MP and maybe local paper or similar? The BDA should be making more noise about this tbh - I know they do protest and have said the current status isn't working but it feels pretty crap to, as a professional community, simply say 'well I guess our only solution is to systematically deny dental care to pregnant women'.

Wales is the same as also has capped UDA (units dental activity) targets .

Scotland and NI still work on fee per item but as they both still have registration waiting times tend to be astronomical and it’s difficult to get on a list as well. NHS dentistry is just as much in a crisis as in England and Wales.

Do dentists have PALS or similar? You could contact the local PCT/CCG/ICB or whatever it’s called now and see if they can advise you on next steps. Certainly your MP would be interested but try the PALS route too.

Whatever the other issues, here, it's perfectly possible to discriminate against different groups of people - and that absolutely doesn't make it OK.

Just like in a workplace, they couldn't say that, yes, they don't employ women of childbearing age as they don't want the hassle of maternity leave; but it's OK because they also don't employ gay people, so it's not just one protected characteristic that they're discriminating against!

Who would you write to though? Presumably the people who aren’t giving the dentists enough funding. They won’t care; they’re the ones rationing treatment.

You’ve shown in this response that you simply don’t grasp the actual situation here so it’s really not worth trying to educate you.

They are cancelling all exemptions due to lack of funding, EVERYONE with an exemption has that same issue. If you can’t see the difference between that and your examples then you’re never going to get it and that’s fine, but unless you’re writing a cheque for the treatment you have no right to ask anyone to work for free.

Would you work for free?

OP has been told they can make an appointment after April 1 st when new contract year starts.
The professional community is not denying treatment to anyone , but it cannot supply treatment to anyone if it is not paid. Suppliers,utilities, staff, laboratories , banks etc won’t wave payments because you are treating people for no payment .

The BDA etc have been campaigning for decades , there have been parliamentary enquiries , campaigns etc https://commonslibrary.parliament.uk/research-briefings/cbp-9597/

But it suits the government , the NHS to blame “greedy dentists” and it fits well into the general U.K. publics near pathological hatred of dentists.

The profession has been campaigning for years , organisations like Toothless in England have got onboard more recently but dentistry is not at the back of the queue , it can’t even see the back of the queue.

Read my other links but underspend in NHS dentistry from practices handing back contracts is used to prop up overspends elsewhere in the health service.

Inflation in dentistry is running at over 10% but the fee rise awarded last year was just over 4% ie a pay cut. Or it would be if it had been paid , as we speak it still has not been paid almost 10 months later.

Is it the alendronic acid? I couldn't afford to see a dentist so my oncologist said just to start taking it and sort out a dentist at another time. Its been 3 years now...

In that case you would need to report all healthcare practitioners that don't offer NHS care because that is what the practice are doing until their new funding cycle starts on 1st April.