NCPA - National Center for Policy Analysis


October 16, 2007

The British government claims there are more dentists working in the government-run National Health Service (NHS) than ever before.  Yet people unable to find an NHS dentist have become so desperate that some are resorting to pulling their own teeth, says the Independent.

One of the main reasons for the shortage is that dentists are free to divide their time between NHS work and private work as they choose.  What is confusing for patients is that the same dentist may offer NHS and private treatment:

  • For example, if the payment for one filling is the same as the payment for six, then there is a big incentive for dentists to accept the easy patients with good dental health on the NHS and insist that the complex patients who require lots of fillings pay privately.
  • Although they are not allowed to discriminate, this is hard to police because a dentist can refuse a patient NHS treatment on a variety of grounds.
  • For example, they may say they are saving their NHS budget (fixed annually in advance) to treat children and people in pain.

Dentists will often choose private because the pay is better.  They also say the higher rates they can charge means that they can spend more time with patients and do better quality work, which is more satisfying.

The trend to go private accelerated in April 2006 with the introduction of a new NHS contract which irritated dentists, says the Independent.  What was once a sellers' market -- with private dentists chasing upmarket clients -- has now become a buyers' market as more dentists have switched more of their work out of the NHS, driving patients into the private sector.

Source: Jeremy Laurance, "The Big Question: What is so wrong with NHS dentistry that people are pulling their own teeth?" The Independent, October 16, 2007.


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