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Originally Posted by homealone
Hi Simon -  to Cable Forum
One thing you may want to think about, is stating a few of your thoughts on how you feel you an offer a better service as a private, rather than NHS, practice? |
One has to be careful because of our terms of service. The latter end of
This article (hope that works) identifies some of the problems. We cannot say that private is better than NHS.
All treatment that is neccessary is available on the NHS. Did you know that? If you can make a case that the treatment is neccessary then the dentist (if the treatment is within his capability) is obliged to provide that treatment on the NHS, nowhere does it say all NHS dental treatment must be profitable.
Indeed, when I do root canal treatments, single crowns, metal dentures, plastic dentures, large fillings and fillings on children on the NHS I know I am making a loss. I got over this years ago and now, because I see my adults privately, private fees subsidise these losses. Only because of private subsidy can I continue to privide NHS care.
The ethical dilemma's in dentistry are horrible, most dentists have managed to continue providing some NHS care by charging fee paying adults privately and continuing to see exempt patients and children on the NHS. This is now the norm and private fees subsidise NHS fees. Its not fair, but it allows children and those who have low income to continue receiving free dental treatment.
The new contract is designed to allow access for all, (fullfilling TB's 1999 pledge that everyone would have "access" to NHS dentistry within 2 years) and this (above) way of working will be a breach of our terms of service on the grounds of discrimination.
This article refers to the BDA's attempts to get the discimination claws scrapped.
Dentists will likely have to choose entirely NHS or entirely private in April 2006. I will choose entirely private because I dont think the new way of working is good for my regular patients and I dont believe appropriate state funding will be available. This means my exempt patients and children will have to either pay privately or rely upon NHS direct. I really really really dont want to have to do that. I am effectively dividing my regular patients into those who can pay and those who cant and denying care to those who cant. Someone who doesn't know the detailed background to this situation will say "the dentist is going private because he is greedy" and thats how the politicians want it to appear, but the alternative is to force 'the new way of being treated' on all my patients, and 'the new way of working' upon myself, which is worse?
On the up side though there should be "access" for non private patients somewhere because those dentists who choose entirely NHS will be contracted to provide them with "access to NHS dentistry" It is likely that this "access" will be more like an emergency service, and will be provided by the NHS dentist at the expense of routine care for their regular patients, which will likely be waiting listed (the new way of being treated)
Caveat: it is possible that the current form of the new contract to be imposed on April 2006 is merely the governments first bargaining position and there may be amendments, if that occurs then the above position would change.
simon
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) with the current situation that is helping nobody.