Finding a dentist is like pulling teeth

FASTER, cheaper and more accessible treatment for all - that's the aim of a new government contract for dentists being introduced this year.Try telling that to those of us trying to find a dentist in Suffolk, where many practices are taking private patients only.

FASTER, cheaper and more accessible treatment for all - that's the aim of a new government contract for dentists being introduced this year.

Try telling that to those of us trying to find a dentist in Suffolk, where many practices are taking private patients only. SARAH GILLETT reveals there is only ONE emergency dentist in Suffolk - and asks are things really going to get better?

CASTING an eye over the list of dentists registered with NHS Direct, it soon becomes clear that if you want to register with an NHS practice it is not going to happen in a hurry.

There are 585,000 people in Suffolk and 90 dental practices. Only 14 are currently open to all NHS patients, while 26 will only take those on benefits or under 18.

Even some of those which take new patients on are simply placing their names on waiting lists - an appointment for a check-up could be as far as seven months down the line.

If you are not registered with a dentist at the moment, access in an emergency is even more tricky. Only one of the practices - in Leiston - operates a system where non-registered patients can ring up and make an emergency appointment.

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If you cannot get there, or there are no available appointments, you will have to rely on the emergency dental services provided through NHS Direct.

There are only five practices on that rota and these are based in Ipswich, Lowestoft and Bury St Edmunds - so you may have to be prepared to travel some distance for your treatment.

Access to dentists is one of the most common complaints raised at patient forums in the county.

Jan Rowsell, spokesman for the Suffolk East Primary Care Trust, admits the service is not ideal.

She said: “You have to accept sometimes that you can't be seen when and where you want to be seen.

“We will always try to find a dentist within a reasonable travelling distance from the patient though.”

Malcolm Briggs, chairman of the Suffolk Coastal Primary Care Trust's (PCT) patient and public involvement forum, said: “It does concern me. It's a sad reflection of the times.

“It needs sorting out but it's hard to know whether it is dentists being stubborn or the PCTs and the government putting impossible obstacles in their way.”

The government says the introduction of a new national dental contract in April will help improve access to dentists, and 13 new dentists have started work in east Suffolk in the last 12 months. The new contract aims to stop a 'drill-and-fill' culture, by getting dentists to look focus on preventative measures and spend more time with patients.

However there are fears it could have the opposite effect, forcing even more dentists to turn to the private sector in order to make a living, and hiking up prices for patients.

The British Dental Association (BDA) believes hundreds of dentists may leave the NHS because they are disappointed with what is on offer. Jo Tanner, spokesman for the BDA, said: “We really don't know how it will affect NHS dentistry at the moment, but what we are already seeing in a lot of areas is dentists turning away from the NHS because they just can't continue.

“There is absolutely no evidence that the reforms will improve access to dentists.”

At the moment, each type of dental treatment has a fixed price. There are around 400 different types.

Under the new contract, dentists would be given a lump sum of money each year - from which they are expected to pay all their costs, from laboratory costs to overheads like heating and lighting.

Health Minister Rosie Winterton said: “The new patient charges are simpler, fairer and easier for patients to understand, and for dentists to administer. Patients often complained that they didn't understand what they were paying, and dentists didn't like the time taken to administer over 400 separate charges, so the new simpler banded system helps both."

Have you had problems accessing dental treatment? Are you a dentist who has concerns about the new contract? Write to Your Letters, Evening Star, 30 Lower Brook Street, Ipswich, IP4 1AN or send us an e-mail to eveningstarletters@eveningstar.co.uk

One Ipswich dentist talked frankly to The Evening Star about his fears for the future of NHS dentistry.

The new system means that, rather than being paid for the number of treatments they carry out, dentists will be expected to do a set number of 'units' of work in return for a fixed monthly income.

If they do not achieve this number of units they do not receive the full amount of money. If they do more than the set number of units they are not paid any more money.

The dentist, who did not wish to be named, said: “Until now, if dentists worked harder they would earn a bit more money but the new unit system has changed that.

“Something that takes hours of work like a root filling is still only the same amount of units as an ordinary extraction which takes much less time. It is going to force people in to a primitive form of dentistry where you almost have to take the tooth out to make your target number of units.

“This system is completely extraordinary. The government said they wanted to get dentists 'off the treadmill', but at least it was a treadmill of our own making. If we wanted to work harder we did.

“Our current contract ends in April. Unless we sign up to this new contract we are no longer an NHS dentist. You could argue it's not us leaving the health service but the health service leaving us.”

It is not just dentists who are fearful for the future. Those working in laboratories are also feeling the impacts.

Derek Richardson owns the Adept dental laboratory in Bury St Edmunds which provides services like crowns and dentures to NHS dentists across East Anglia. He said: “People can't afford to pay private prices anymore so they are just not getting things done. “They put it off, or just have teeth extracted, because that's the cheapest option.

“I really fear for what's going to happen to NHS patients in the next year or two and for staff.

“I have a team of 19 staff and I don't know how many of them will still be employed by the end of the year.”

The new contract is designed to make the payment system easier for dental patients. Instead of a fixed price for each individual treatment, there will be three price bands:

1) Preventative work like scaling and polishing - £15.

2) Simple treatment like fillings and extractions - £41.

3) Complex treatment like bridgework or dentures - £183.

Consumer group Which? say the new charges will be fairer for all, particularly those who need complex work. At the moment people can be charged as much as £384 for this kind of work.

A Department of Health spokesman admitted: “The charges may benefit some more than others.”

SUFFOLK WEST PCT: (total number of NHS dentists - 36)

Number of dentists taking all kinds of NHS patients (eg. All age groups, charge-paying and non charge-paying): 8

Number taking some NHS patients with restrictions (eg. Those on benefits, under 18s, for orthodontic work): 20

(of these, seven are only available for orthodontic work)

Number offering emergency NHS appointments to patients who are not registered with their practice: 0

SUFFOLK COASTAL PCT: (14)

Number of dentists taking all kinds of NHS patients (eg. All age groups, charge-paying and non charge-paying): 2

Number taking some NHS patients with restrictions (eg. Those on benefits, under 18s, for orthodontic work): 7

(of these, two are only available for orthodontic work)

Number offering emergency NHS appointments to patients who are not registered with their practice: 1

CENTRAL SUFFOLK PCT: (9)

Number of dentists taking all kinds of NHS patients (eg. All age groups, charge-paying and non charge-paying): 0

Number taking some NHS patients with restrictions (eg. Those on benefits, under 18s, for orthodontic work): 5

(of these, four are only available for orthodontic work)

Number offering emergency NHS appointments to patients who are not registered with their practice: 0

IPSWICH PCT: (31)

Number of dentists taking all kinds of NHS patients (eg. All age groups, charge-paying and non charge-paying): 4

Number taking some NHS patients with restrictions (eg. Those on benefits, under 18s, for orthodontic work): 16

(of these, nine are only available for orthodontic work)

Number offering emergency NHS appointments to patients who are not registered with their practice: 0

If you need to access an emergency dentist call NHS Direct on 0845 46 47.

Like thousands of others, Paul Todd recently received the news his NHS dental practice was planning to turn private.

Mr Todd, currently a patient of the Rushmere Dental Practice, said: “I am infuriated because when it comes to dental health there should be no distinction based on whether or not people can afford to pay.

“This is turning us into a more American-style system where money, and not people's health, it coming first.”

Mr Todd, 42, from Dorchester Road, Ipswich, plans to write to the health secretary Patricia Hewitt, to express his fear that if more practices become private it will be detrimental to the dental health of people in Ipswich.

Dr Chris Taylor, dental surgeon at the Rushmere Dental Practice, said he had been left with no option but to turn the practice private. He said: “I was upset about making the decision and I am concerned about the impact it will have on poorer patients.

“I have been an NHS practitioner for 13 years but the NHS dental system is restrictive and underfunded.

“The final straw has been the new dentist contract which changes the way we are paid, making it very inconsistent.”

Dr Taylor said he was dismayed the NHS had failed to listen to the concerns or guidance of dentists.

Jan Rowsell, spokeswoman for the Suffolk East Primary Care Trusts, said: “13 new NHS dentists have been introduced to this area in the last 12 months.

“Encouraging new dentists to come and work throughout east Suffolk has been a major priority.”

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