Reply With QuoteProbably is about the money to be honest.
I went for a check-up today (NHS) for the first time in many years. I was lucky to get that.
Anyhow, as I was about to go, the dentist told me that she was leaving in a few months. It also transpired that they were currently struggling to fill four NHS positions they had vacant and that, when I rang up in a year for the next check, it was to be hoped that they had the dentists available. In the meantime, even emergencies would now have to be treated on a private basis.
The conversation then touched on the money that dentist earned - NHS versus private. I was met with a prompt rebuke that it wasn't about money. It's because of the way that the NHS treats dentists.
I am here to be educated........in what way can a dentist be treated badly by the NHS? I am genuinely curious.
Whatever, the future is looking bleaker and bleaker!
Probably is about the money to be honest.
Probably - this:
https://www.theguardian.com/society/...n%202014%2F15.
Thanks. So reading between the lines, it's an issue with gov funding of the NHS dentistry sector? I must confess that I do not know how that all works, what I do know is that my surgery is looking for four NHS dentists so the funding is there at NHS pay rates (which are not shabby imo - I'd love to have earned what even a junior dentist earns). But they can't find anyone to do NHS work......though the dentists (who obviously do physically exist) are happy enough to do private work.Originally Posted by blackal
Of course it’s the money. That’s not to say I think dentists are turning greedy or suchlike, it’s more that payments to dentists for NHS work is actually quite low for all the costs involved (labour, materials, premises costs etc).
My NHS dentist has just gone private only, he already has several Ferrari's
I have never met a poor dentist, it’s about the money and has been for many many years.
"Bite my shiny metal ass."
- Bender Bending Rodríguez
I've a friend who's a dentist and was adamant he would remain as an NHS
dentist.
What's he gone and done? Yes gone private because there's more money in it. 🦷
It's a bit of a self fulfilling cash grab isn't it.
Enough dentists stop doing NHS work = creates a market of people who need a dentist = sell work privately for ££.
If they were required to do NHS work all the dentists would still be dentists, they'd just cost less.
Can't blame them, we all want to get paid right?
Off to Spain next week to get my broken crown replaced. No chance of getting an NHS dentist here. My 3 year old grandson could only get on the NHS list of a local dentist if both his parents signed up for the monthly private scheme. The Spanish dentist is charging less than half the price I was quoted by the dentist here in Somerset. Amazing state of the art facilities and top class EU standards of care in sunny Castellon. Cheap flights make it feasible but I am lucky that I have family in the town so can double up the visit by seeing the Spanish grandchildren too! I am a great fan of the NHS but the provision of Dental services is a disgrace.
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I guess I am fortunate - I still have an NHS Dentist.
Was there on Monday for a 6-monthly check-up.
Check-up and two X-rays - £11.04.
The government has cut funding per patient just like they have done with Doctors…… and here we are.
Impossible to get an NHS dentist in my area
One of my relatives has just spent over £5000 on two tooth implants so Im guessing they are making a fortune on private work.
Its a massive rip off and i advised them against it since they are near 80 years old but they went ahead anyway.
Been private for 10-15 years. Most of the treatment I’ve had isn’t available on the NHS, or if it is it uses inferior materials.
£140 every six months for check up and hygienist is worth it IMO.
But the NHS don’t do implants and £2500 each is pretty good value.
I had one implant done quite a few years ago. It did cost two or three thousand (ouch), but the treatment was night and day compared to NHS.
My wife and I are far from rich, and it would be yet another hit on our monthly income, but I think we're maybe going to have to look into a plan with the private dentist I used back then.
It's depressing to realise that, unless there a miracle, the writing is on the wall for NHS dentistry. I am holding off thinking too much about the implications for the 'bigger' NHS as that is a 'society collapsing' type of thing.
By heck that’s cheap! Had my 6 monthly NHS checkup, (no X-rays), last week and I thought I got a bargain at £23. Before we moved here 14 years ago our NHS dentist where we lived had decided to go private 6 years prior to our move and there were no NHS dentist places anywhere around there.. Cost £49/month for a plan for both of us back then. I shudder to think how much a similar plan would be now!
We were lucky to find an NHS place where we live now, and that’s a short car journey or 2 busses away.
Best Regards - Peter
I'd hate to be with you when you're on your own.
No clue what an NHS dentist is, Guessing like OHIP for Canadians. I present my card and check up is free
Not so for dentists though unless you have a dental plan through work
I paid $300 Canadian to get a filling repaired. Dropped in to make an appointment and turns out someone canceled. Got it done right away
2 weeks later. Cleaning and xray as a tooth was a bit sensitive to dental pick, but no cavity. $194.00
Been with her for 22 years and never a complaint
There was something new for seniors by the government, but I make too much money in retirement to qualify
Chimes with my own experience of dentistry here. I had an implant done, front upper tooth, required additional bone grafting, costa touch over a 1000 euro. Luxury, healthy maintained teeth.
There are no NHS dentists anywhere near where I live in the A-se of Beyond. I had two replacement fillings and a scrape and polish last year at a cost of £950. Total time in the chair over the 2 visits about 45mins.
Due my 6month check up with scale and polish tomorrow, it will be under £20. Scotland do seem to be fortunate with regards to this.
I have an NHS dentist, not sure how. still getting my root canal sorted but hopefully finalised on the next visit which will be the fourth. £70
I have an NHS dentist although the surgery I attend is mainly private.
I'm sure the ones that do NHS are newbies and there is quite a high turnover too.
Cheers,
Neil.
Assuming we are talking about the same scope and broadly the same methodology: implant, bone grafting, abutment, screw, crown, imaging, suture removal, checks, how on earth can it cost €EUR1000 in Spain yet £3000 +/- £500 in the U.K?
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My sister and her husband were both dentists, they did private and NHS work. My sister retired at 55, her husband carried on and was set to retire at 60 in 2020 but tragically he caught covid and died.
Toward the end of their working lives they both said that if they were starting out now there was no way they would take NHS work due to the hoops the NHS was making them jump through in terms of regulations, paperwork, audits etc and were only sticking it out for their pensions (no use for Steve now of course).
I've no idea, but if younger dentists no longer get the gilt edged pension my sister enjoys that alone may make it not worth it for them?
Just read a piece on it there.
Says average price in Spain is £1450 as opposed to £2450 in UK
I'd say that figure was a bit low for UK so possibly a bit low for Spain too.
Says Spain is the 2nd most popular destination for dental tourism after Hungary and that Germans,Austrians,Swiss etc go there for some cheaper dentistry.
Theres a perfectly good explanation of the issues on the other post, Its come from Rob then itll be right. Who else would take on work given those circumstances…i know i wouldnt.
NHS terms may be crap, but private dentists set their own fees and they aren't exactly known to be budget friendly, so at the end of the day it's still about money isn't it.
I don't blame them, who wouldn't market their labour for the going rate.
It’s more about working conditions than the money in reality.
When you are working in a system that doesn’t/can’t afford to buy the best materials because the UDA system doesn’t really cover those costs then there’s a problem.
When you need to see patients for as little as only 10 minutes in some NHS practices for a check up, then you might understand that a more comprehensive 20 minutes check up privately is going to cost more.
Local to me some 5,000 people still can’t get on an NHS dentists lists. There’s a reason various dental insurance products are available, or you can simply go private and hope for the best.
It's just a matter of time...
I've been private for 30+. My payments have just gone up to £23 per month and I get 4 visits with the hygienist and 2 check ups per year plus any minor work that needs doing inc X Rays. They have just excluded fillings from the scheme but until now they were included. More importantly I can get an appointment anytime.
A new dentist took over the practice a few years ago and has fitted it out with state of the art equipment which I presume doesn't come cheap.
I've very recently had the misfortune to lose my two (lower) front teeth. I had an argument with my young Labrador about whose Ice cream was who's and my two front teeth lost!
Having a plate made (nothing fancy, no implants or anything) cost the thick end of 2 grand but that did include the removal of the root that Bella didn't manage.
I had to go private as there is simply no NHS dentists available in Torbay, none that will take on new patients at any rate. My old dentist de-registered me because I missed appointment that THEY kept cancelling due to COVID. Surprise surprise, that dentist is now solely private, but I wouldn't go back there at any price (except NHS price naturally :) ) as they weren't very good.
My new dentist is Spanish, a lovely chap and I can honestly say, I never felt a thing and the care was MILES better than I have enjoyed with the NHS tooth manglers. I didn't enjoy the bill but the service was great!3
Call me pedantic but they can't have deregistered you because there's no such thing as being registered with an NHS Dentist. NHS Doctors yes.
That's strange.
https://www.nhs.uk/nhs-services/dent...n-nhs-dentist/
Once you find a dental surgery, you may have to fill in a registration form at your first visit, which is just to add you to their patient database. But that does not mean you have guaranteed access to an NHS dental appointment in the future.
There is no continuous registration. You sign the electronic FP17 & you are in a contract for that course of treatment. Once the course of treatment is completed we sign it off & there is no obligation for the dentist to treat you again, other than from a potential discrimination aspect. In practice we practically always do but we do not have a list of registered NHS patients. Trust me, I've been doing this for 40 years.
Edit...that's totally in line with what you quoted Kingstepper.
Last edited by trident-7; 9th March 2024 at 19:28.
Yes, here just seems to mean being on (and poster being taken off) practice database .
By a miracle I recently managed to get with an NHS in South Manchester. Yesterday I had two crowns completed for £307.
I dread to think what this would have cost privately.
That’s great value. If you’d had one crown done it would still have been £307 (£306.80 actually), three crowns would still be £306.80, six crowns, which does happen, would still be £306.80. £306.80 is the most that you can be charged in England for a course of NHS dental treatment.
Laboratory charges, which the dentist has to pay out of that fee vary, but I pay £155 per crown so I would have had to pay out £3 (£310 minus £307) for those two crowns & have done all the work for nothing, plus pay all my staff, rent, materials bill, heating etc. etc.
I could find a cheap technician but they’re usually cheap for a reason & I wouldn’t want to compromise my standards.
Fair play to your dentist though.
Further to my last post, what the patient pays isn’t necessarily what the dentist gets paid….& when I say gets paid, they have to pay all of their staff wages, rent, heating, materials, laboratory bills, registraion fees, indemnity insurance, etc. etc. out of that fee.
The currency in NHS dentistry is UDA’s….Units of Dental Activity.
UDA’s have a monetary value which isn’t the same for every dentist. I can only speak for myself & my UDA value is £25.55
A case involving lab work, like the two crowns quoted above, is called a band 3 treatment which attracts 12 UDA’s.
So if I did Lammylee’s job he would pay the NHS band 3 charge which is currently £306.80. It cannot be any less or any more.
I would get paid by the NHS £25.55 x 12 =£306.60, so that’s very close but a bit less than what Lammylee paid.
That really is crazy. No wonder there are so few NHS options about these days, just nonsense financially to engage in it.
Be nice to your dentist.
He has fillings too.
@trident-7
So, in the examples you've given, roughly.......you (or your practice) get paid £300 by the NHS and also £300 by the patient?
Let's not go into your expenses etc - I get all that.
So - what is the solution? a fairer recompense for NHS work (obv) , and what would incentivise dentists to offer NHS treatment as a percentage of their business?
Or - has the back been broken of NHS treatment and there is no way back?
I'm sure you and colleagues will have discussed it and have a better idea than most - on what might work.
Haha, oh no! In fact in my own case I have to pay back the NHS 20p because the patient pays £306.80 but I am ‘allowed to receive’ 12 UDA’s of value which, in my case, is 12 x £25.55 = £306.60
The NHS is paying out nothing at all in these cases.
Last edited by trident-7; 10th March 2024 at 10:27.
I am clearly missing some part of the puzzle!
You're saying that the patient pays you his £300 and that's it. That's all the money your practice receives. And you have to pay the lab £300 for the two crowns.
So, you're basically running at quite a loss for that particular patient/treatment given your general operating costs. For the half an hour that it took at least.
All I know it that NHS practices have existed for all of my life and the surgeries I attended - for like decades - seemed to do very well. One of my dentists at some point even had his own private aircraft! It has to have been a very lucrative occupation somehow.
I think I'll do some 'deep' research about all of this. Things do not add up. The NHS has to be subsiding dentists somehow or what are we paying NI for - or does dentistry receive no NHS funding?
Last edited by Mouse; 10th March 2024 at 10:48.
It’s all about the contract. See my builders thread https://forum.tz-uk.com/showthread.p...ll-me-about-it
I actually think that the government have engineered this to privatise dentistry, with the intent of dentists getting the blame.
There’s no way back to the NHS for me. I see a few kids as a courtesy to their fee paying parents & of my friends but I don’t take any new ones on.
I teach a cohort of 5th year dental students one day a week. We recently opened a brand new Dental School. One of the changes was that, at the old dental school we were under the umbrella of the NHS, but at the new dental school we are overseen by the University. I got told that I had to change my old NHS lanyard for a University one recently.
The point is that, once this change had taken place the students had a lecture about how NHS dentistry worked. I had several students telling me about it with dropped jaws, they thought it incredulous. Under the current contract I don’t think many of them will be looking for a career involving a lot of NHS Dentistry.
Back in the old days we used to do a job & get paid a fee for it. The fees were low but at least it seemed fair.
The current tinkerings around the edges will have little effect. Personally I think it’s too late for NHS Dentistry, the chickens have flown their coops.
There may be salaried dental jobs in clinics treating kids & emergencies.
Yep that is correct. I’d probably spend 2 hours on that job btw.
Quite a few NHS patients are exempt from charges so they pay nothing in these circumstances and the NHS pays the £300.
Thanks for that - Yeah, I think the govs have screwed around with doctors and dentists over the years (even before this mob) and agree- how the hell do you get dentists back into an NHS system.
Even with a fairer fee for NHS work now - the private market is established.
How do you get doctors and dentists to move to or remain in - an area with low or stagnant property value growth. If you have a choice - you want your mortgage payments to work for you.
The public (if facebook rants are anything to go by) already blame individual doctors for retiring "early" or cutting back to 3 days/week - completely oblivious to the fact that most people want to retire when they can afford to.
Like I said - I sure as hell don't have the answer, but I'm not sure there is one.
Thanks for that.
I did look at some online info and I'll say that I still don't fully understand how it all works (I'll keep trying though!). I guess it all used to be a simpler and fairer system (for dentists and patients alike) and that's been eroded by 'tinkering' with the NHS over the years.
Yep, I can't blame anyone for wanting to earn a decent living and it looks like that's no longer possible under the NHS.
Can't say more than that without getting into politics and that's not for the G&D.
Chatting to another one of our customers Friday R who’s also a dentist
He was telling me about the UDA’s and saying that he does a filling for example for 3 UDA’s that’s all he can claim despite the fact there were complications, extra time, other products used… it’s quite ridiculous
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Teaching students must be fun. I was up in Dundee a couple of years ago and was in so much pain I walked into the Dental Uni, I was seen in the morning by I think a 3rd year for an examination then a year 4 or 5 for an extraction. It was the first tooth she had pulled and it was interesting listening to how to do it, after a few goes and a few injections she was still to close and the lecturer said watch and it just came out to everyone’s relief. They have to start somewhere, but they broke a crown so I had to pay for that in the end when I got back home.
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I do really enjoy my teaching job one day a week. It’s so rewarding, not in monetary terms as I’d earn at least 3 times the salary if I did that extra day in my practice, but in the terms of me feeling that I am passing on the tips & tricks from my 40 years’ experience in general practice. It’s like passing on the baton.
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