Andrew Martin

We will continue sounding the alarm (Buckle in, it’s long, but long past due) If patients are informed then they can plan accordingly. Governments pretending it’s all going to be “fixed” keeps patients hanging on, hoping the access and fully comprehensive care for all is just over the hill. Dental problems don’t get better over time without treatment, they get worse If patients are told honestly what the government is willing and able to provide then they can make choices about their care, saving up, finance options, dental insurance etc Good healthcare costs a LOT to provide in the UK. We are highly regulated (that costs the practice a lot of money), we are very highly trained (very high ongoing training costs every year for the dentist and their teams), expensive equipment (paid for by the dental practice, no grants or separate funding for this), expensive materials (even more expensive since Brexit, and fewer choices), expensive lab costs (which, again, we pay for, the labs are struggling too), clinical waste contracts and general waste contracts (all up in price due to new rules in Wales), phone lines, internet, energy prices (rising just as fast, if not faster than domestic), struggling to pay our teams what they are worth (even more so with the impending NI hikes that are a direct and inescapable attack on NHS primary care settings) means that we struggle to recruit or retain staff. None of these costs are “paid for by the government” there aren’t “NHS dental practices” your high street dental practice is a small private business, usually run and managed by the dentist providing the care (try running a business AND being a highly skilled clinician with patients to look after). If the practice provides NHS services then they are given a chunk of money, paid in instalments by the NHS, to provide care over a financial year. Either by “Unit of Dental Activity” or by unique patient a fixed fee, paid only once, regardless of how many times that patient comes in that year, and whatever the patient pays over the till is deducted from the money the practice is paid. So if you see a patient for 2 courses of treatment in a year the NHS will probably deduct more money from your contract payment (stating that you’ve had it from the patient) than you would have been paid for seeing that patient; and the amount you would have been paid to see that patient was unlikely to come anywhere near what it actually costs to treat them. To top it off, we never even see the full amount of our contract payment because WE have to pay the banking fees to process those patient charges (tax collection) which are taken off us. So we pay for the privilege of collecting their taxes for them! Make it make sense… We are losing these highly skilled team members, not just dentists, hygienists, therapists, nurses, lab technicians. This limbo is hurting the NHS and private sides of the profession alike. Ultimately it will be patients who suffer. As we lose these skilled professionals the stress in the system will be even higher. This pressure cooker needs a release as soon as possible before more damage is done and nobody will be able to find a dentist, NHS or private. Only dentists (and their teams) can do what we do. We do it very well within the constraints that we are under. NHS dentists have had their take home pay cut almost in half over the lifespan of this contract. The erosion has gone on too long and we can’t afford to pay out of our own pockets anymore. For many of us the well is now completely dry and we will never recover financially. After long careers of dedicated care and service, some of my colleagues will be left with nothing to show for it & no time to start over. We won’t stand by and watch colleagues and the patients we care for, to whom we have dedicated our lives, suffer needlessly. The government can’t continue to run the GDS by breaking our backs and raiding our pockets @TheBDA #NHSReform #StealthCuts

NHS dentists have had even more real term reductions to their pay. Why is it acceptable to pay our most qualified healthcare professionals (doctors and dentists) so poorly in comparison with our colleagues from similar nations or even in comparison to the way we were paid 10 years ago?” Two years ago at LDC conference we heard that NHS associates (dentists who work for a practice) have seen a 34% reduction in pay compared to 10 years before NHS practice owners (dentists who own the practice, see the patients, manage the staff, take all the risk of owning a small business etc) saw a 49% reduction in pay in the same period and the trend continues downwards. Now ask yourself if you would continue in a very stressful, responsible, all consuming profession. One where you are told at least 10 times a day by patients “I hate the dentist”, under immensely heavy regulation (best part is that you have to pay a LOT to be regulated!), under constant threat or being sued &/or struck off. Coming home every day with your back, neck, fingers, wrists and shoulder aching and burning, eyesight strained and hearing ruined. Many of us are forced to retire early due to these health issues. Would you continue in these circumstances for HALF of what you were earning 10 years ago? Why should the rest of our teams (dental nurses, receptionists etc) work twice as hard for minimum wage or just above? Their job is very responsible too, dental nurses have a couple of years of training and a bunch of tricky exams and coursework to gain their qualifications. Practice owners want to be able to pay their teams what they are worth but often simply can’t make the figures work. When we work outside of the NHS we can charge what we need to be able to pay the bills and remain solvent. When performing NHS work we are on a fixed budget with an ever growing workload and the price of wages, utilities and materials going up sharply. “The math isn’t mathing” When the “math doesn’t math” for a small business then something either has to change rapidly or it is forced to shut down. For example; a typical 3 surgery dental practice will cost £25-45K, per month to run, without paying for a dentist/therapist/hygienist. Our equipment costs a lot, it costs huge amounts to maintain and service (that chair you lie in while we do your teeth costs anywhere from £15-40k to buy and that’s the very tip of the iceberg!). We don’t get any extra to maintain the building or equipment or purchase materials. Often a practice HAS to offer private work to make ends meet, subsidise the NHS contract. Strangulation of funding and pressure to make ridiculous targets means a downward spiral for those doing NHS dentistry. We await a “recovery plan” for NHS dentistry. I’ve stopped holding my breath, we were promised it last year and still not a peep! Meanwhile practices are under threat of financial ruin, dentists leave the country or leave the profession, and patients are becoming sicker because no government has the balls to admit what we all know….. @TheBDA @TheBMA