Dentists have been forced into a new, shockingly bad form of practice by the government - no wonder so many of my colleagues are deserting the NHS
Before I bought the private dental practice where I have worked for the past two years, I had been working as an NHS general and cosmetic dentist for five years. When I bought the new practice, I approached my local primary care trust with the aim of introducing NHS dentistry there. To my great amazement, they told me that I could not provide NHS care because there was not enough funding available.
I probed further to see if there was any chance that this would change in 2009 when the contracts would be up for review. But again I was met with resistance. I was told that I was wasting my time, because if new funding became available it would be redistributed among the existing NHS dental practices in the area.
The sad reality is that approximately 15-20 patients call our practice every week asking if we do NHS work. We always have to reply "No". It is not fair on the patients, and it's certainly not fair on dentists. Many patients already battle with their fear of going to see us. It's sad to have to add yet another obstacle. The chief dental officer Barry Cockcroft's response to the problem at the Westminster Health Forum held in November last year was to "just direct them to the nearest NHS practice". But that is not the point. Why should I have to send any patient away? There is obviously a demand that needs to be met.
Dentists have been forced into a new form of practice that clearly does not work well - a system that defies all logic and where the emphasis on patient care has been lost. The new system, which groups all the fillings done - whether one or 20 - into the same fee scale is shockingly bad practice. Patients should not have to pay it, and dentists should not have to deliver it. Unless the government changes this new system more and more dentists will leave the NHS and more and more patients will go private.
Changes have to be made to encourage dentists back into the NHS and to ensure that new dental graduates have the confidence to work in the public sector. One option would be to scrap the new system and revert back to the old one. It was simple enough to offer an item of service fee for each treatment needed. (In other words, if a patient only needed a single filling, they would only pay for that one filling.) An alternative could be to introduce more bands into the current system that would better reflect the type and quantity of treatment given. These reforms would make for a fairer NHS - one that puts each patient and each dentist first, and ahead of bureaucracy.
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