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Medical Forum / General / Dentistry / October 2005Is NHS Dentistry Near Collapse?
Is this story true? http://flapsblog.com/?p=1078 George, what is going on over the pond? Flap http://flapsblog.com It's getting there slowly Flap. The new contract that has been delayed for 2 years now will come in effect in April '06. As always, the government made so many modifications it barely resembles the contract promised to the profession 2 years ago. It is now so ridiculous that many practices will go fully private, stopping NHS provision even for children and patients on benefits. A few key points of the new contract: 1) Your income is capped; you will be paid an amount of money yearly equal to previous years. The underfunding is therefore not addressed. For people thinking of that as a salary, you will still have to carry out expenses and the risk of a business. 2) The treadmill is still there, as you will have to perform 95% of what you performed before to get the money. Of course, if you perform 105% there is no additional money. 3) You will not be able to provide NHS services only to children or benefit patients. It's a "all NHS or no NHS" kind of thing. 4) Under the new system, molar endo or reimplantation of a tooth carries the same value as an occlusal amalgam filling. 5) You will not be able to refuse NHS treatment to anyone asking for it. The only reasons you can refruse a patient are direct physical violence or refusal to pay. Abusive language or a breakdown in the dentist-patient relationship is not a good reason. 6) You will not be able to charge for failed appointments. 7) In general, intrusion by the government in the everyday affairs of your practice will be so great, you essentially give the keys of your practice and your goodwill to them. 8) Patient charges will go up; it has been estimated that most patients will pay between 50%-100% more for dental treatment. Your regular, low-need patients will be financially penalised to pay for irregular, high-need patients, in a true social fashion (which is OK, but let's not forget that people are already supposed to pay huge taxes for this sort of thing). All of this money will go to the government, so you will be acting as a dental tax collector. Not one week goes by in which there is not a piece in the tv or the rags about some practice going private. As we come closer to April, conversion into private practice will accelerate. The media and the public have begun to wake up from their deep slumber and realise the lies put forth but Bliar and his cronies. To see their tactics, last week there was a practice going private near Scotland and a quueu of people formed outside the practice to register as private patients. Two MPs (parliament members) were outside giving leaflets to people saying that they didn't need to go private and soon they would have NHS dentists for everyone (same promise they made 7 years ago). The patients basically told them "you failed us, now get lost". George George's Post: t's getting there slowly Flap. The new contract that has been delayed for 2 years now will come in effect in April '06. As always, the government made so many modifications it barely resembles the contract promised to the profession 2 years ago. It is now so ridiculous that many practices will go fully private, stopping NHS provision even for children and patients on benefits. A few key points of the new contract: 1) Your income is capped; you will be paid an amount of money yearly equal to previous years. The underfunding is therefore not addressed. For people thinking of that as a salary, you will still have to carry out expenses and the risk of a business. 2) The treadmill is still there, as you will have to perform 95% of what you performed before to get the money. Of course, if you perform 105% there is no additional money. 3) You will not be able to provide NHS services only to children or benefit patients. It's a "all NHS or no NHS" kind of thing. 4) Under the new system, molar endo or reimplantation of a tooth carries the same value as an occlusal amalgam filling. 5) You will not be able to refuse NHS treatment to anyone asking for it. The only reasons you can refruse a patient are direct physical violence or refusal to pay. Abusive language or a breakdown in the dentist-patient relationship is not a good reason. 6) You will not be able to charge for failed appointments. 7) In general, intrusion by the government in the everyday affairs of your practice will be so great, you essentially give the keys of your practice and your goodwill to them. 8) Patient charges will go up; it has been estimated that most patients will pay between 50%-100% more for dental treatment. Your regular, low-need patients will be financially penalised to pay for irregular, high-need patients, in a true social fashion (which is OK, but let's not forget that people are already supposed to pay huge taxes for this sort of thing). All of this money will go to the government, so you will be acting as a dental tax collector. Not one week goes by in which there is not a piece in the tv or the rags about some practice going private. As we come closer to April, conversion into private practice will accelerate. The media and the public have begun to wake up from their deep slumber and realise the lies put forth but Bliar and his cronies. To see their tactics, last week there was a practice going private near Scotland and a quueu of people formed outside the practice to register as private patients. Two MPs (parliament members) were outside giving leaflets to people saying that they didn't need to go private and soon they would have NHS dentists for everyone (same promise they made 7 years ago). The patients basically told them "you failed us, now get lost". George Flap's Reply: It looks like private dentistry is coming to the UK whether the Labour government likes it or not. I suppose they could try to outlaw private insurance like they did in the Canadian medical system (recently overturned by the Canadian Supreme Court). Are there enough dentists currently in practice to handle all of the people? If there is a private system the market forces of demand should be a windfall for you guys. Flap http://flapsblog.com Flap, they can't outlaw private medical insurance. Private insurance in the UK has been around since before the NHS. Anyone who would try to outlaw private insurance would commit political suicide, ran afoul of several EU directives and have their decision overturned by the courts and Brussels. As to whether they are enough dentists to provide a service: There is a severe manpower shortage nationally. There is a shortage based on the calculations that each NHS dentist can cater for 3,000 patients. Now if all dentists went private and reduced their lists to more manageable size, say 1,500-2,000 patients each.... well you do the maths. Mark my words... UK dentistry is an apocalypse waiting to happen. The public, the politicians and the profession will find out in a really painful way what 57 years of eroding standards and depressed fees can do to a basic hea;th service like dentistry. If you can buy shares in a UK manufacturer/distributor of penicillin, do it now! George George, Sounds to me that it may be time to invest in some private dental clinics and offices in the UK. There are opportunities awaiting to happen. How is your blogging coming along? Flap http://flaspblog.com Not bad at all Flap, but I don't update more than once a week now, since clinical subjects are hard to come by and analyse, plus I have to work like a slave during the week! George >It looks like private dentistry is coming to the UK whether the Labour >government likes it or not. Private dentistry is already here. There is not one dentist in the city where I live which takes NHS patients. We are well used to private dentistry here. And most people don't have insurance. We just pay. >I suppose they could try to outlaw private insurance like they did in >the Canadian medical system (recently overturned by the Canadian [quoted text clipped - 9 lines] > >http://flapsblog.com What percentage of the population in the UK do you suppose continues to use NHS dentists? And in what area of the UK do you pracrtice? Flap http://flapsblog.com Considering that 40% of the population is not visiting a dentist regularly, I'd say a 25% of the population uses NHS dentistry as regular attenders. I'm an associate working in a working class area. George George: Considering that 40% of the population is not visiting a dentist regularly, I'd say a 25% of the population uses NHS dentistry as regular attenders. I'm an associate working in a working class area. George Flap's Reply: What about private dental insurance in the U.K.? Will the employers pay for it like in the USA? Flap http://flapsblog.com I would say no chance. People would have to fund it out of their own pockets. Which is quite bad, since they are already paying 8% national insurance contributions on their income, effectively paying for a service they're not getting. According to my calculations, someone on average income (18000-20000 pounds a year) is paying enough in health tax to buy private medical + dental insurance (giving a much better service than the NHS) and have some change to fund his private pension. Right now, there are two kinds of dental insurance in the UK. The first and most popular are capitation "maintainance" plans like Denplan, Isoplan or in-surgery plans. They cost a monthly amount depending on a patient's current oral health status. There are several options to take, from free checkups and scalings, to discounts over more serious work, to full coverage for most routine procedures. They are the route mostly followed by practices converting from NHS to private, as they provide a steady income. They are not terribly brilliant, but they are not as bad as HMOs are. The second is generic insurance that reimburses up to a yearly limit. Limits are usually between 300-500 pounds. George, Your dental insurance plan marketplace must be busy with sales. BTW do you have any links to these plans? Will the folks there put enough pressure on the government to reduce your taxes then? Flap http://flapsblog.com > George, > > Your dental insurance plan marketplace must be busy with sales. BTW do > you have any links to these plans? The biggest is DenPlan, with a 87% market share: http://www.denplan.co.uk/ >> George, >> [quoted text clipped - 3 lines] >The biggest is DenPlan, with a 87% market share: >http://www.denplan.co.uk/ I don't know anyone who has dental insurance. It just isn't worth it. The cost of the plan is much higher than the cost of private treatment. Of course we don't know what's down the line but if I look at my own case over the last 5 years. Insurance would have cost me something like £1,000 but I haven't spent anywhere near that on treatment. Of course the whole point of insurance and the way it is funded is that some win and some lose but with such large amounts of money I'd be silly to go that route. Ann Ann: On 9 Oct 2005 16:12:26 -0700, "letsconnect" <letsconn...@myway.com> wrote: >Flap wrote: >> George, >> Your dental insurance plan marketplace must be busy with sales. BTW do >> you have any links to these plans? >The biggest is DenPlan, with a 87% market share: >http://www.denplan.co.uk/ I don't know anyone who has dental insurance. It just isn't worth it. The cost of the plan is much higher than the cost of private treatment. Of course we don't know what's down the line but if I look at my own case over the last 5 years. Insurance would have cost me something like £1,000 but I haven't spent anywhere near that on treatment. Of course the whole point of insurance and the way it is funded is that some win and some lose but with such large amounts of money I'd be silly to go that route. Ann Flap's Reply: The DenPlan's site is interesting. Thanks L/C The plans are capitation which means the individual dentists are at risk to provide all of the care necessary within a set fee determined at initial examination. The bean counters must be especially busy to keep track of finances and to extract their administrative percentage before funds go to the dentist. Here in California a group PPO dental insurance plan provided by Delta Dental will cost an employer around $800-900 annually for $2,000.00 annual coverage per family. However, USA marginal tax rates and VAT (there is none) are lower than the UK. Ann, what do you see the outcome of this NHS mess? More Denplans or folks just paying out of pocket? George, what do you think? Flap http://flapsblog.com >Your regular, >low-need patients will be financially penalised to pay for irregular, >high-need patients, in a true social fashion (which is OK, but let's >not forget that people are already supposed to pay huge taxes for this >sort of thing). Socialism is not OK. It simply doesn't work. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com I'm talking about a safety net WB here, not all-out socialism, which is an utopic ideal that doiesn't work in the real world. George >I'm talking about a safety net WB here, not all-out socialism, which is >an utopic ideal that doiesn't work in the real world. > >George Good ! Then we agree. However, these 'safety nets' just grow out of control and end up defeating the very purpose that they were designed for. For instance, currently in the US the food stamp program has an excess of about $2,000,000,000. The liberal answer is of course to sign more people up ! I say the program is over funded. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Hi WB, If these 2,000,000,000 went to people in real need, I wouldn't have any real problem. The problem I have is with freeloaders. Providing benefits around without any kind of limits or checks is simply against human nature; the people who receive the benefits soon lose any incentive to better their lives and are converted into apathetic zombies without any aspirations (one could argue that this is exactly what politicians want). I don't have any problem providing a denture for the old state pensioner on a discount, but I have a great problem doing the same for the yob who has never tried to worked in his life and busted his teeth after geting drunk in a fight. And lastly: isn't it too early on the other side of the pond to be replying to my posts? Get some sleep man! George >Hi WB, If these 2,000,000,000 went to people in real need, I wouldn't >have any real problem. The problem I have is with freeloaders. [quoted text clipped - 11 lines] > >George Early ? No way man, it was mid morning. This one is after lunch. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com After lunch you are supposed to start doing your crown preps so you can earn money and fund the food coupons. That's the way it goes. :) Take care, George >After lunch you are supposed to start doing your crown preps so you can >earn money and fund the food coupons. That's the way it goes. :) > >Take care, >George Silly me, I have been doing endo in the afternoon to fund welfare. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > >After lunch you are supposed to start doing your crown preps so you can > >earn money and fund the food coupons. That's the way it goes. :) [quoted text clipped - 3 lines] > > Silly me, I have been doing endo in the afternoon to fund welfare. I'll do my part tomorrow afternoon. carabelli >>Silly me, I have been doing endo in the afternoon to fund welfare. > > I'll do my part tomorrow afternoon. > > carabelli Endo? I hope not. <VBG> Dartos > >>Silly me, I have been doing endo in the afternoon to fund welfare. > > [quoted text clipped - 6 lines] > <VBG> > Dartos 18 carabelli > Is this story true? http://flapsblog.com/?p=1078 > > George, what is going on over the pond? Some people are finding it hard to find an NHS dentist.... https://secure.securewhich.co.uk/www_dentistry/stories.php?offSet=40 CWatters Post: "Flap" <fullosseousf...@gmail.com> wrote in message news:1128746683.055728.221100@g14g2000cwa.googlegroups.com... > Is this story true? http://flapsblog.com/?p=1078 > George, what is going on over the pond? Some people are finding it hard to find an NHS dentist.... https://secure.securewhich.co.uk/www_dentistry/stories.php?offSet=40 Flap's Reply: The stories are so sad. What is the U.K government doing to address the immediate need? Flap http://flapsblog.com Well, considering the UK goverment created this need by alienating dentists... they keep on doing the same thing. Which is alienating dentists even more. George > Well, considering the UK government created this need by alienating > dentists... they keep on doing the same thing. Which is alienating > dentists even more. I bet the politicians have no idea why all the dentists hate the program ! Most politicians are so far out of touch with the real world.  Signature/ Amatus / > Well, considering the UK goverment created this need by alienating > dentists... they keep on doing the same thing. Which is alienating > dentists even more. > > George |
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