Scottish dentists warn of crisis in industry with patients struggling to get appointments
“Firms that can, will go entirely private, and firms that can’t, will go bankrupt.”
That’s the warning from a Scottish dentist who sees a ‘perfect storm’ for the health service.
From Friday, the way the NHS pays dentists for treatment reverts to its pre-pandemic system – something industry players have said is no longer fit for purpose.
The Scottish Dental Association said a significant number of its members are forced to turn to private patients to balance the books and it is one of the main reasons why so many people find it difficult to see a dentist .
Dentists in Scotland say that in addition to a faulty payment system, the NHS service is facing a staff shortage as it recovers from Covid-19. They warned that this could cause irrevocable damage to the industry.
For the past 30 years, the Dental Compensation Statement or SDR has defined the treatments available under NHS contracts, the terms of their provision and the amount the health service will pay.
“This is an outdated document which our own chief dental officer, Tom Ferris, has publicly stated is no longer fit for purpose,” Dr Robbie Parr, a Fife-based dentist, told STV News .
“In order to earn a decent living and maintain the practice based on NHS income alone, dentists have traditionally had to do a lot of work very quickly: many examinations with scales and polishing, and many fillings piled up back to back. back. .
“SDR rewards drilling and filling, not modern, evidence-based preventative dentistry. By working within the confines of the SDR, it is often impossible to provide treatment that meets modern standards, and where possible, it involves financial loss.
The head of the Scottish Dental Association agrees.
Dr. Douglas Thain has been a dentist since 1999 and believes it’s harder than ever to attract new recruits to the profession
“The number of graduates who have no intention of entering general medicine in the NHS is astonishing,” said Dr Thain.
“The number of associate positions on offer right now is unprecedented. Practice owners will suffer because they cannot find dentists, so patients will suffer because there is a shortage of dentists.
“I keep coming back to this, the government doesn’t seem to have realized yet that they have to make an offer to dentists to make this an attractive career again.”
Dr. Parr also thinks there are misconceptions about dentists’ salaries.
“We use the term NHS dentist – but we are not directly employed, we are independent contractors, we are paid on a fee-for-service basis.
“There’s an old stereotype of greedy dentists bleeding the NHS dry, but oddly enough it’s actually the other way around.”
This is because the SDR document is incredibly complicated for professionals to follow literally, which means that something as minor as a spelling mistake can result in the resumption of any payment associated with the treatment.
There may also be a request that the clinician refund any money paid to them for the same treatment over a period of time, whether or not there was an error on those occasions.
Dr Parr said: ‘Imagine if your employer blocked you potentially tens of thousands of pounds because of a minor clerical error when you were doing an absolutely perfect job?
Industry players believe the combination of a lack of new hires, an outdated payment system and the Covid takeover will ultimately impact the availability of NHS dentistry and ultimately will result in deterioration of patient care.
“Many simply leave the NHS, with those who stay gradually reducing their commitment,” Dr Parr said.
“This is why NHS dental appointments are so rare and unless something is done it will only get worse.
“It is most likely a dilution of NHS high street services, you will see less and less NHS appointments and then you will be at a point where practices which can become private will do the business and those who may be in a more disadvantaged area, will potentially go bankrupt.
The Scottish Government has been asked to comment.