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Tuesday, April 09, 2013

Trying to find a dentist

Many working people in Britian will have some awareness of the recent changes to the way dentistry is provided to us, the public. Many will know that NHS treatment is still free to a certain section of the community: children and (encouragingly) pregnant women and new mothers.

But what about the rest of us? It seems that the vast majority of us are being forced to make a very difficult decision with regard to our oral health.

Few people will be unaware of the popular opinion that it is hard to find an NHS Dentist these days. So I was very suprised to go on to the NHS website and discover that my local Primary Care Trust (East and North Herts PCT) has no less than 25 dental surgeries local to me that offer NHS treatment ranging from a full list of general dental services to more specific treatment like orthodontics.

What I found slightly concerning however, was the fact that only 9 out of the 25 are "Taking on fee paying NHS patients at present".

As you may know, the way that NHS dental work is funded is by allocation of a certain funding quota to the dental practices via the PCT. Funding is assessed and agreed upon on the basis of the previous year's demand for NHS dentistry at that surgery. However, it has been well documented that these quotas often fall short of the actual demand experienced by some Dental surgeries.

What this ultimately means, is that once a surgery's allocation has been used up, any patient requiring extensive treatment is forced to make a stark choice between waiting for the next year's NHS funding allocation to be made available to their dental surgery or paying privately for the treatment there and then.

Given this, it is obvious that those on lower incomes are really faced with no choice at all. With private dental treatment running into the hundreds, sometimes thousands of pounds, an increasing number of people are being forced to wait many months for their treatment; often not only suffering extreme discomfort and pain in the interim, but also being faced with the possibility that by the time they are finally able to have the treatment, that even more extensive work than was previously needed may be required.

However, other reforms in dental treatment provision do appear to offer an alternative. Since 2006 the necessity to "register" with a particular dentist has been abolished. What this means is that, in theory at least, a patient whose regular dentist is unable to provide NHS funded treatment can "shop around" for another dentist who does have funding allocation left and be treated there.

The reason I say this "appears" to be an alternative is because when you look at those same low-income families and elderly people who can't afford to "go private", you see that really this is not much of an alternative at all.

Going to another dentist obviously can involve increased travel costs if the dentist is out of the area. While merely inconvenient for some it could mean the difference between having the treatment and not for others such as the very low-waged who do not have access to personal transport or the rurally housed elderly who rely on poor public transport coverage. When you add the psychological factor of forcing people to see a dentist they are unfamiliar with which, as we know can have a particular impact on older members of our community, you can see why so many people elect to wait for their own dentist to be able to do the work or forego the treatment altogether.

Added to this is the fact that even those who can travel relatively easily to a different surgery have to suffer the incredulity of dental receptionists who seem universally affronted that someone would expect to just phone up someone who is not "their" dentist and expect treatment. I have found this to be the case even when enquiring about private treatment let alone that provided under NHS subsidy. This is not to imply that dental staff object to non-regular patients but is indicative of the fact that the idea of using another dentist in order to get cost effective treatment is highly unusual, suggesting that this option is rarely seen as practical.

So must we continue to be forced in to a situation where, when we need treatment which is vital to our health and well-being, that we either pay extortionate private fees, are forced to seek out another dentist at our own cost or if none of the above are possible for us because of our financial situation, simply wait, with our condition worsening until the opening of the PCT purse once again gives us access to treatment which should be the inalienable right of every man, woman and child in this country.

Under real Socialism dental treatment would be provided freely to anyone who needed it. Unshackled from the financial pressures of the Capitalist system, freed from the necessity of ekeing out the inadequate funding budget the health services would be able to treat all those in a timely fashion to the best possible standard.

The fact is that no-one in this country or any other should be forced to make such dire choices when it comes to this or any other area of their health. The NHS was built originally upon a great and admirable principle: "Treatment free at the point of need". It seems that, at least where our dental treatment is concerned, that this principle has had a thread tied around it and the door handle and the door slammed shut.

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