Letter: A disaster for dentists and a pain for their patients

Sir: As both a member of the general public and a manangement consultant for a number of dental practices, it was with great interest and amazement that I read about dentists' reaction to the Government's 7 per cent cut in fees. I am absolutely convinced that if NHS dentists really understood the method by which they were paid, they would not even consider jumping into private practice. For most practices that I have come into contact with, this move would be an unmitigated disaster.

Statistics suggest that for a dentist to achieve, from private practice, the average pounds 41,000 target earnings that the Government is proposing to pay next year, he or she would need approximately to double fees to the general public. What dentists fail to recognise is that a substantial amount of their net income is derived not from treating patients but from the registration of patients. They have also made the mistake of assuming that the majority of patients will be prepared to pay the additional money for a service that offers few perceivable benefits. Public sympathy will take a nosedive when the Government points out that, instead of paying dentists the pounds 35,000 which an independent review body recommended, they have agreed to pay them pounds 41,000.

There is, however, no doubt that practice owners (principals) have suffered financially in the past few years. This, for the most part, has had little to do with their NHS remuneration but more with a lack of commercial understanding. Many practices employ associates who, although they take no financial risk, will take home exactly the same as a principal for carrying out the same amount of work. This gives the risk taker no return on his or her investment. Other professions have realised that this is totally unacceptable and pay non-risk takers substantially less accordingly.

Dentists (like opticians and vets have already done) must become more commercially aware if they are to survive, especially if they are to operate outside of the NHS.

Yours sincerely

JOHN SKELLERN

Talke, Staffordshire

6 July