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!

Have a look here op, you should be able to find contact info for your local area. They might be able to advise you further - https://www.england.nhs.uk/contact-us/about-nhs-services/contact-your-local-integrated-care-board-icb/

This page has more info too - faq.nhsbsa.nhs.uk/knowledgebase/article/KA-02170/en-us#NHS

ICBs already know , they are the ones who withdrew funding earlier this month due to overspends elsewhere in health service . Read this

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.

I haven't read the thread apart from your original Post so apologies if there have been massive updates since then. I used to go to a dentist that was NHS. Inevitably later in the year after Oct, any appt I had made, the practice would phone me and my choice was either to cancel due to no more NHS funding or I would need to pay privately. This must be at least 15 years ago. I moved practices and now go privately. However, you are a registered patient with them. You are now pregnant and entitled to the various NHS. Exemptions and benefits due to pregnancy. I do think that is discrimination. That is not acceptable.I hope, if you complain, you receive the treatment that you need and are entitled to.

So the answer is to not bother complaining because the rest of the NHS is shit too?

OP is not pregnant they have come to end of exemption , so one year after birth of baby , and want a check up before exemption runs out.

The practice has run out of funding until April 1st so cannot offer appointment to non paying patients before then. Ops exemption will have run out by then .

In England and Wales there is no such thing as NHS dental registration. You are only entitled to an appointment if you are under a course of treatment.

I never said not to complain, but complain about the ACTUAL problem here. Which is not your dentist, it’s the lack of NHS funding.

If it was as easy as just asking for more money then we would have no issues whatsoever with the NHS. You wouldn’t kick off at a nurse for refusing to work for free because people need to be treated, you wouldn’t kick off at a bin man for refusing to work for free because your bin needs emptied, you wouldn’t kick off at a bus driver refusing to work for free because you need to get somewhere, you’d acknowledge that actually there IS a problem, but it’s not you or them, it’s much higher up than that.

They’re in a shit position, they won’t work for free and nor should they, they can treat you and have said they will treat you once they get their funding. Focus your anger in the right direction, and that’s the joke of the funding from the government, across the board.

And I did say that I'd complain to my MP, not the dentist.

How about you write and complain to your MP and ask what the government is going to do about the state of the dental system. Dentists can't be expected to do work for free and so they end up looking like arseholes in this situation.

I have literally said this multiple times over the course of this thread.

Would you work for free or for a loss? @zerogrey

You can complain to your local integrated care board and copy in the Director of Public Health in your local authority. Maybe also contact your local councillor. You should be prioritised rather than bumped off the list. I’d be cross!

There is no registration in NHS dentistry in England and Wales. OP will be seen but after April 1st when practice contract funding starts again.
OP just wants a check up before their exemption ends very shortly ie before April 1st .

ICB will already know what is going on as they are the ones who have just written to dentists to say promised funding has been withdrawn to prop up overspends elsewhere in the health service .

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.

Unfortunately in my experience that is sadly the case - my adult children and I are very lucky to have NHS dentist but Jan - April you cannot get an appointment as all their funding allowance for the year is used up. Ours have all been delayed three years on the trot for general check ups - booked months in advance. Absolutely crazy situation. We can transfer to private and have a same day appointment but not a chance in hell are we doing that £££££.
Call 111 - they are obligated to find you an appointment with a valid medical exemption - you may get sent to the hospital dentist.

But will you be complaining about inadequate funding or about your dentist not giving you an appointment? I think that’s the distinction @Mrsttcno1 was making.

But you’re said that would be to complain about your dentist, rather than the government funding. That’s the issue.

Yes it is. Thank you I was a bit worried I wouldn't be able to have it.

No I’m afraid 111 is there for dental emergencies not to find someone a space for a routine NHS check up.

Im also sorry to say that even with severe pain , in parts of the country , 111 cannot often sort a timely appointment , requiring multiple phone calls over many days , or travel of over 100 miles.

Yep exactly this. 111 is not for routine dental appointments, it’s for emergencies.

The chances are they are cancelling children's appointments. This happens to my colleague all the time, the kids appointments of often cancelled or moved.

She's lucky to have them here on NHS, we been at two different practices and they have both gone private completely and I can't even get an NHS dentist for the children. It's really bad where we live and just impossible to find a dentist who will take on new patients. I even asked the NHS to find me one and that I was willing to travel and they gave up after a year as couldn't do it.

Re discrimination you need to distinguish between direct and indirect discrimination.

Direct is not providing a service because of the characteristics e.g. Not serving black people. Indirect is putting a policy in place which negatively affects a particular group e.g. Not serving people with head coverings, which negatively impacts Sikhs and Muslims.

Some PPs are right that this isn't maternity discrimination as the law in this regard is limited to direct but not indirect discrimination.

The refusal is not because of the maternity itself but because of the exemption certificate. The refusal to provide service applies to all exemption certificates, not just to those pregnant/within the protected period.

However, I'd say it's still indirect sex discrimination since only women can be pregnant. Indirect discrimination can be justified if the policy is 'a proportionate means of achieving a legitimate aim'. Personally I don't think it is, but that's where the real legal argument lies.

No, they won't see you because they can't afford to treat patients for free, and they can't bypass the system that says your treatment is free.

They don't care whether you had a baby or not.

It's an NHS problem.

This

Op had a check up 5 months ago. Her next check up is due next month , which has been cancelled. She can make another check up after April 1st but wants to be seen before then as her exemption will have run out by then.

So OP is having their check up postponed by 1 1/2 months because the practice has run out of funding and can only see people who pay.

She has been seen, will be seen again when the practice has funding again .

I find it infinitely sad that in a situation where one of the few dental practices still doing NHS work and obviously struggling ,the majority of posters want to make thei practices life even more stressful by launching complaints, legal action etc instead of asking “who can we write to to try to get you more funding?” .

Especially as next year they will run out of funding even quicker because of the way tweaks to the contract were funded.

All of this because OP , who still receives regular NHS care having had a check up 5 months ago will have to wait an extra month and a half to have another, routine check up.

If your business was struggling to stay afloat against an indifferent government and NHS who still haven’t paid a below inflation fee rise from April last year how would you feel when , instead of supporting you in putting pressure on those who are removing money from NHS dentistry, people want to add yet more stress with complaints over something you have no control over?

Banks, suppliers,staff , laboratories still need paying , even if the practice has no income. It costs £140 plus an hour just to run one room in a practice , without the dentist being paid . How are they supposed to avoid bankruptcy when even what the NHS pays for a course of treatment often doesn’t cover costs and there is no other source of funding to pay costs it all comes out of what is paid for treatment?

I think you may.

I find this shocking (and even more so the very very ludicrous fact they're telling you your husband can still have his appointment at the usual NHS rate but you can't even have that, you'd have to be private). Leaving aside the shocking state of things if you're not getting the maternity care you're entitled too because there's no money left (and yes I do think that should be their problem to treat you and then take up their shortfall with whichever body provides their NHS funding), you're being ADDITIONALLY discriminated against by them saying 'because the computer has you down as having a maternity exemption' (computer says no basically), you can't even be a regular NHS patient for this check up you have to be private. I can see why you don't want this to be the hill you die on if you're concerned they take you off their books altogether, but I have the rage on your behalf at the dire state of things.

(And I don't have an NHS dentist either, when we moved house I couldn't find a practice accepting NHS patients in the whole county it seemed, so had to go private )