Healthy teeth, happy smile

Interesting one in the Impartial Reporter (incidentally surely the best name for a newspaper ever) about the lack of dentists in Fermanagh. Of course this problem is not confined to Fermanagh and there are difficulties seeing dentists throughout the UK.The gradual collapse of NHS dentistry has been an ongoing crisis in slow motion. To begin to understand it one must remember that dentists are not employed by the NHS. They are private professionals who traditionally did most of their work for the NHS. The old NHS dentists’ contract was based on payment for work performed. This led to the so called “Drill and fill” culture which dentists had become highly dissatisfied with. There had been warnings about this problem for many years and it is interesting that Blair having promised that everyone would have an NHS dentist within two years, had by 2005 recognised that he could not achieve this.

A new contract for dentists was introduced which was supposed to allow them to take more time on education. This was, however, unpopular with dentists and many voted with their feet opting to do partly or wholly private work; a situation which has continued up to the present.

The essential problem is that there are too few dentists, the government contract was not attractive enough and people are willing to pay privately to attend the dentist. As such if the dentists leave the NHS there is absolutely nothing the government can do. Recruitment of overseas dentists can have some effect but obviously these new dentists can then simply set up privately. The government is trying to train more dentists but each one takes five years at university and usually a year or two before becoming an independent practitioner. Also of course unless there is a vast over supply of dentists, these new dentists can simply enter the private sector.

The only solution would be to offer the dentists much more favourable terms to completely re enter the NHS. However, since the population has become somewhat used to having to pay for dentistry one could argue that this suits the government as within a few more years for relatively little political damage the government could abandon NHS dentistry and essentially wash its hands of the problem. Such a strategy whilst somewhat Machiavellian would save them money and just might prepare the population for the possibility of having to pay for other services which the NHS currently provides for free. Remember that GPs are also privately employed persons who contract to the NHS.

  • Pearly White

    The lack of dentists in Fermanagh has more to do with them also serving the southern border counties and in many cases even further afield down the west coast.

  • joeCanuck

    I once complained to my dentist about, what seemed to me to be, an extravagant cost to pull a tooth, the whole job only taking 10 minutes.
    He agreed and said that the next time he would pull it slowly.

  • Eddie

    I have been with the same dental practice for as long as I can remember, certainly 30 years. About five or six years ago, the practice went private. The news was conveyed in a sort of “take it or leave it” letter. No tariff of charges was provided – even when one was requested.

    Nevertheless, I continued with them, though I found it difficult to meet their charges – for instance, around £40 for less than 10 minutes with the dental hygienist, not the dentist himself. Recently I was told it would costs around £250 for two fillings. I was charged around £40 for the inspection necessary to tell me this.

    I told the dentist I could no longer afford his charges and asked if he could tell me of a dentist in the area who still did NHS work (Being in the trade – they do talk – I thought he would know) The response was unco-operative. He did not even bother to sign the three-line letter acknowledging my resignation from his practice.

    I then phoned a number of dentists in my area, but none did NHS work.

    In desperation, because one of my teeth is now ehurting, I today phoned the Central Services Agency,(90-324431) with whom we are all registered for NHS services. I was put through to the dental section, and asked them for a list of NHS dentists in my area.

    The advice that I was given was that if I wanted to find an NHS dentist I should look in the Yellow Pages. I said that I had already phoned a number without success. I also protested that I did not think that this was an appropriate response. The person taking my call said: “Well, that is what we have been told to say” Further conversation revealed that my call was far from the first that had been received looking for a list of NHS dentists.

    The person I spoke to was perfectly polite and agreed to my suggestion that my complaint about the lack of a list should be passed upwards. It was also suggested that I try the Eastern Health Board. I will report back when I have done this.

    After 44 years of National Insurance contributions, where the state has been little troubled by me, one would have thought that there existed some sort of contract if not to supply some sort of dental service, at least to let me know where I could obtain one.

    Or am I just expecting too much? Should I talk to an MLA? Or is that a daft idea?

  • Dewi

    Have a look at this queue in Carmarthen – I pay £25 a month which is ridiculous but typical here.

  • Eddie

    Dewi
    But does that include all the work you might need in any give year? I doubt it.

  • joeCanuck

    Here in Ontario, no dental care is included under the government health plan.
    If you have an employer funded plan you’re ok (with limits), otherwise, don’t smile.
    Same for eyecare except for an exam every 2nd year.

  • Dewi

    But does that include all the work you might need in any give year?

    It does actually – should I be pleased ? – In the old days I paid nothing.

  • Dewi

    Eddie – if you are in real pain, however , go to the A&E;in your local hospital – they will contact an emergency dentist to see you.

  • Harry Flashman

    I agree it is very hard on people who have paid NI contributions all their lives but the whole NHS is one big pyramid scheme and the wheels are coming off.

    We have to realise that taking control of our own health needs, instead of expecting the gub’mint to do it all for us, is the only realistic future.

    It’s time to start allowing opt outs, give people who are willing to fund their own health care tax relief so that they can get out of this idiotic shambles and leave the government to do what is the government’s job; looking after the needy and genuinely poor.

    The rest of us are responsible adults, we manage to feed, clothe and house ourselves perfectly adequately, we aren’t idiots we can finance our own health care too if the state would leave a bit more cash in our pockets and allow us to get on with it ourselves.

  • heck

    to quote Mike Myers (austin powers) trying to find a good dentist in Britain is like trying to find WMD in Iraq

  • George

    In the Republic if you work then all you do is give your PPS number and the visit is free. At least it is at my dentist.

    I have never had to pay for a checkup and the filling I once needed set me back 40 euros.

    Dewi,
    In the Republic to stop people turning up at A&E;for such matters there’s an automatic 85 euro charge just for walking in the door.

    Harry,
    compulsory health insurance is the only way to go for a quality system. In Germany, you’d be shelling out around 280 euros a month and a lot more if you were a big earner. If you were on the dole, they’d be required to pay it for you.

  • When I moved to Belfast for university I switched doctors’ surgeries to the university one. I didn’t even try changing dentists since all the news stories were reporting how difficult it was to find one.

    If nothing else the fact that dentists are so hard to find is enough to keep me going to my dentist once a year or so for a check-up just to make sure I don’t get taken off their list by the health board!

  • It was Sammy Mc Nally what done it

    What is non iron citizen entitled to in ROI and vice versa?

    If there is excess capacity/availability in ROI or Non Iron then there should be reciprocal arrangments not just for dental work but in all medical/health areas.

  • Gréagóir O’ Frainclín

    Sure no need for pearly whites when folk don’t smile much.