Random Irritations

[Crazyface]

Received an email this morning saying that my dentist is now going private and no longer taking nhs patients

Ouch! I'm surprised there is any dentists still wanting to do NHS work. The cost of private is eyewatering ( I know someone who goes private. Lord does she know how to waste money!)

 

[Swinglowandslow]

Dentists should all do more NHS work!

Except......

The NHS total dental budget is capped by the government both at the total level and for every individual surgery. A dentist cannot just choose to do more NHS work even if they want to (which, to be fair, most don't want, as the terms are so bad) - every single NHS dentist's budget is capped at a maximum. Do more NHS work than your allocation and you still pay all the costs of building, equipping and running the practice yourself but receive no payment at all. So you go bankrupt.

The government can choose to increase that budget and commision more dentistry if they wish of course. Have they?

If anyone wants to put this into numbers:

In 2000 the whole NHS budget was about £55bn and within that the spend on dentistry in was £3bn.
In 2025 the whole NHS budget had increased to £205bn.
If dentistry had simply retained its share of the overall NHS budget then the NHS would now be spending £11bn on it.
The NHS spend on dentistry in 2025 was .............. £3bn.

So 0% increase in 25 years before inflation. Remember what inflation has done in that time (with inflation, costs have gone up roughly 116% in that time)
Imagine what hospital services, GPs or any other area would be like if they had only 40% of the budget (in real terms) that they had in 2000.....

The government (of all political parties) wants to remove high street dentistry from the NHS in order to save money but doesn't want to be honest about that fact as it is a massive vote loser. So they are slowly starving it to death instead.

I take this on board, and clearly, if figures are correct ( no reason to think they aren’t), then N H S dentistry is underfunded.
However, the charges that private patients are paying are eye watering . And I find it difficult to believe they have be that high.

 

[Lucifer MorningStar]

Ouch! I'm surprised there is any dentists still wanting to do NHS work. The cost of private is eyewatering ( I know someone who goes private. Lord does she know how to waste money!)

It’s keeps her mouth healthy and she sees the value in that then it’s not a waste of money it’ll be worth every penny.

 

[The Squirrel]

I take this on board, and clearly, if figures are correct ( no reason to think they aren’t), then N H S dentistry is underfunded.
However, the charges that private patients are paying are eye watering . And I find it difficult to believe they have be that high.

I can 100% see how people think that. They're so used to NHS dental prices as their frame of reference. Remember that these are (a) subsidised, (b) ultra-high-speed and (c) even with subsidy they often don't cover costs (that's exactly why NHS dentistry is gradually disappearing). I also get that nobody likes to pay more for anything, especially something like dentistry that's not exactly in the category of "fun and enjoyment", so in no world will paying anything towards dentistry, never mind the full cost, ever be anything other than very unpopular. People especially don't like paying for healthcare in the UK as there's a collective belief that this is wrong or that they've paid already through taxes - we've been sold the lie that the NHS is "free at the point of delivery" for so many decades.
(this oft-repeated-by-politicians phrase quietly ignores the fact that it's completely untrue; the 3 most frequent recurring NHS interactions for most people are: prescriptions, dentists and opticians - and there have been charges on all of these for 75 YEARS now!)

It costs between £150 and 250 per hour to run each dental chair and the surgery/staff around it, something you can confirm via google. That's without making any profit - just covering costs, and those costs still mount even when patients no-show or cancel at short notice, so actual hourly pricing rates have to be higher just to break even and stay open. Have a look at the pricing you believe to be unjustified through that lens. You can also benchmark against comparable cost-base countries and see that UK dental charges are about the same (Ireland, Singapore) lower (Australia, Canada) or much lower (USA) than those.

Sorry, I fully accept that's probably not what you wanted to hear