DENTISTS 3

GOING PRIVATE
Hume-Spry and Barr dental practice, based in Market Street, Swadlincote, is going private after taking Ł50,000 of taxpayers' money three years ago to set up as an NHS practice. Only patients on benefits, children or OAPs will now be served on the NHS due to a loophole in the old NHS dental contract.

South Derbyshire MP Mark Todd said, "Is it not worrying that, where the NHS has provided capital funds, three years later the practice should choose to go private and retain only its core NHS commitment, despite substantial public funding?" Health Minister Rosie Winterton said a new NHS dental contract, due to be implemented for all dentists in April 2006, would lead to "tightening of the arrangements" which would "prevent the same thing from happening in future".

Hume-Spry and Barr was able to go private because of a loophole in the old NHS dental contract. That contract compelled all dentists set up by Government grants to serve at least 2,000 patients on the NHS. But because Hume-Spry and Barr has 9,000 customers, it can get around this rule and still go private because the number of children, OAPs or benefit recipients on its books, who will continue as NHS patients, now total up to 3,000.

EMERGENCY
Peter Owen, of Colwyn Bay, North Wales, needed major surgery after an abscess grew so big that it blocked his windpipe. He developed toothache but was told an emergency dentist would not be available for six days.

Unemployed Peter travelled to a private practice where a nurse diagnosed a broken tooth, but he was too hard-up to pay the Ł121 to get it removed. Three days later his mouth was badly swollen so he went to his local GP, but was again refused help.

He eventually saw an emergency dentist at the Royal Alexandra Hospital in Rhyl who immediately booked him in for an extraction four days later.

The following day Peter, who was not registered with a dental practice, could barely breathe and was rushed to Glan Clwyd Hospital in Bangor for an emergency operation. Doctors performed the tracheotomy and he was placed on a life support machine for 48 hours.

DENTISTS

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Hundreds of NHS patients have been left without a dentist following the closure of a city centre practice. Dentist Roger Blackham has retired and as a result his surgery has shut, leaving 1,800 patients to seek treatment elsewhere. Derby City Primary Care Trust, which is responsible for community health services, said it would be looking at all the options, including another practice taking on the patients or bringing in a new dentist at Roger Blackham's.

The trust also said that patients in the middle of treatment were being referred to its Cathedral Road dental practice, which provides urgent appointments. Other patients are asked to get in touch with the Patient Advice and Liaison Service but only five dentists in the city were accepting new patients. Two of these were accepting children only and only one was offering treatment to adults.

Anyone looking for a dentist can contact the Patient Advice and Liaison Service by calling into the their offices at Derwent Court, Stuart Street, Derby, between 9am and 5pm, Monday to Thursday, and 9am to 4.30pm on Fridays. (Source: Derby Evening Telegraph, Nov/06)

Millions of pounds is to be invested in NHS dentistry in England to fund major reforms of the service promising an extra Ł368m for dental services, and to recruit an extra 1,000 by October 2005. The government plans to attract dentists who have left the NHS back and to recruit abroad. A 25% increase in training places is also promised.

The British Dental Association welcomed the announcement of extra funds. Announcing the plans, Health Secretary John Reid said, "I want more people to be able to see an NHS dentist. So we are investing an extra Ł368 million in NHS dentistry, recruiting 1,000 more NHS dentists in little over a year and reforming the dental system to improve the long term oral health of the nation."

The government hopes to meet its target to increase the number of dentists working in the NHS by encouraging those already working in the health service to increase their commitment to it and attract back those who have taken career breaks. Dentists will also be recruited from across the EU, including new member countries such as Poland, and it will be made easier for dentists from overseas to register to work in the NHS.

Longer-term plans include funding another 170 dental school training places from October 2005, a 25% increase. By 2005/06, spending on NHS dentistry will increase by 19% a year compared to 2003/04. Some of the funding will be devolved down to primary care groups. They will take over the funding and commissioning of local NHS dental services in England in 2005.

The change will mean PCTs will either have contracts with dentists to provide dental care or will provide the services themselves. Under the plans, dentists will receive funding depending on the number of patients in the local population instead of receiving a fee per treatment carried out as happens now.

The government has also promised to introduce a new contract for dentists which will be less bureaucratic and complex. There will also be new roles for dental hygienists and nurses. In 1999, Prime Minister Tony Blair pledged everyone who wanted it should have access to NHS dental care.

Health Minister Rosie Winterton said the government was awaiting guidance from the National Institute for Clinical Excellence on how often people should go for a check-up. She said the government would then look at revising the existing system. Currently, patients have to register with a dental practice and attend every six months, even if their teeth and gums are healthy, in order for dentists to be paid for their care.

The government is to crack down on dentists who fail to be upfront with patients about their treatment options. It follows a report in 2003 from the Office of Fair Trading suggesting that some patients were being "ripped off" by private dentists. In future, dentists will have to give patients full information on their treatment options, the cost and whether or not it can be done on the NHS. Those who fail to do so could face disciplinary action.

The OFT report followed a year-long inquiry into private dentistry. It found evidence that some patients were paying for private treatment when they could have been treated on the NHS. The report said some dentists were failing to tell patients about NHS alternatives. It also found that some patients were only told how much their treatment would cost after it had started.

Under proposals drawn up by the Department of Health, private dentists will have to be more upfront with patients. Ministers will also make it easier for patients to complain about private dentists. At present, there is no formal complaints system for non-NHS dentists. The General Dental Council, which regulates the profession, can only investigate serious complaints.

It will be given new powers to investigate less serious charges, such as failure to be upfront with patients about the cost of treatment. The GDC has the power to discipline dentists and ultimately to ban them from practising in the UK. Under the proposals which are out for public consultation, dentists will also be required to have indemnity insurance before they are allowed to practise.

The move will ensure patients are able to seek compensation if they have poor treatment. "We are determined to make sure that patients get a fair deal and clear information when they receive dental treatment, whether in the NHS or in the private sector," said Health Minister Rosie Winterton. "Our proposals are about assuring the quality of care that patients receive and will provide a more robust and effective complaints system to take early action when things go wrong."

The General Dental Council, which helped draw up the proposals, backed the changes. "It is excellent news for patients and dental professionals. This new scheme should fill that gap, by enabling patients and dental professionals to resolve complaints fairly, efficiently, transparently and quickly," said Hew Mathewson, its president.

Liberal Democrat health spoksman Paul Burstow welcomed the proposals but added, "For those patients finding it impossible to even register with an NHS dentist, these changes will not be greeted with hearty cheers." Frances Blunden of the Consumers' Association, said, "It has taken government far too long to act on the OFT's report, and we are still some time away from implementation of real changes that will benefit consumers."

New regulations threaten to put thousands of denture-makers out of business creating a shortage of false teeth. An estimated 5,000 dental technicians, known as denturists, make more than half of the false teeth used by Britain's estimated 13 million denture wearers. Under rules introduced by the General Dental Council, denturists will be banned from working in the UK unless they have passed an approved course and have registered with the GDC.

However, the nearest course is 3,500 miles away in Toronto, and costs Ł14,000. To date, only six British denturists have enrolled. From August 2006, those who continue to work without having registered will face fines of up to Ł5,000 and a prison sentence of up to six months. A spokeswoman for the GDC denied that the rules would lead to a shortage and said that denturists would still be able to manufacture false teeth if they registered and performed their work under dentists' supervision. (Source: Sunday Telegraph, Jul/06)

Patrick Schelts, a 14-year-old schoolboy, has been told he must wait four years for a brace on his teeth, by which time he will be too old for free treatment. Private treatment would cost at least Ł5,000. Patrick's teeth are crooked because there are too many in some parts of his jaw and he will need some removed or realigned and then wear a large brace.

His dentist referred him to a consultant in May 2004 but the NHS lost the paperwork. He was referred again in February 2005 but has been told at the current rate he will reach the top of the list when he is 18. The family live in Leicester Forest East, part of Health Secretary Patricia Hewitt's constituency. Patrick's mum said, "She says the NHS has never had it so good but it is a complete shambles."

Patrick is on the waiting list at Glenfield Hospital, part of University Hospitals of Leicester NHS Trust. A spokesman said, "He is 93 of 167 on a specific consultant orthodontist's list. The current waiting time is three to four years. "We are sorry we are not able to speed this up but patients are seen in chronological order unless they have more urgent clinical need." (Source: Daily Mirror, Oct/06)

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