The media reported recently that 130,000 people with toothache went to
Hospital A & E Departments rather than a dentist. See
https://bdaconnect.bda.org/toothache-piling-the-pressure-on-ae/ . They
didn't mention the obvious reason: that A & E treatment is free while
most people have to pay for dental care.
Many working people in Britain will have some awareness of 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
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
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
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 eking 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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