I have worked in the NHS for many years and know first-hand the many deficiencies of the system. After becoming frustrated by the quality of work that I was doing, I left to join a private practice where I could deliver the high-quality dental work I have been trained to provide.
In 2006, the government made the mistake of introducing the UDA system into dentistry and capped the wages of dentists. They were expected to do more work for less pay. Dentists were given targets of the number of UDA’a (Unit of Dental Activity) they needed to achieve and if they did not achieve them, their salaries would be cut. If they overworked and provided more treatment, they would not get paid for their work.
What do you think happens in a situation like this?
Well first, you need to meet your target otherwise you are going to get a cut in your wage which means the system is encouraging dentists to do work they may not need to do.
Second, once you meet your targets you no longer get paid. This means you are going to want to avoid treating anyone else, which may lead to neglect.
In addition, the way the UDA system works is that your dentist will get paid the same for doing one simple filling or if they were doing 10 fillings. If you needed multiple fillings, the dentist would be better off if he or she just did one of them as for every additional filling they did, they would not get paid for it. Do you think this system works well for the patient?
The same applies to crowns, root fillings, and bridges. NHS dentistry focuses on single tooth problems and has no interest in looking over your mouth as a whole. The more work your dentist does (in one course of treatment), the more they get penalised.
A dentist who has been working on the NHS for many years often gets deskilled as a result of this system and therefore unable to offer you complex treatment plans as a result of this.
NHS dentistry is all about volume and speed.
The system is designed for 10-minute check-ups and 15-minute fillings. Even complex treatment such as crown preparation visits and root canal treatment are done at alarmingly quick pace, often at the detriment to your mouth.
So, why is private dentistry different?
Private dentistry is often performed by highly skilled dentists and is purely down to market forces. If his or her work is poor, they would fail to get patients and would soon close. This does not happen to NHS dentists, as they are always guaranteed patients because people will always want to sign up for NHS treatment.
In private practice the price is not fixed by the government so that you can choose a dental practice that is cost effective or you can choose a super-duper fancy dentist who charges a lot.
The average salary of an NHS and private dentist does not differ hugely. The difference is that the private dentist will offer better quality of work, more time, and less volume. On the NHS you get quick, poor quality work, but more volume. Who would you prefer to see?
As NHS dentists do not earn much (per patient they see) they will often send laboratory work to cheaper laboratories, which as a result, do not earn much themselves, so they employ cheaper people, use cheaper material, and do work quick with less quality.
Private dentists will earn more for each patient so they will use better materials, better quality laboratory work, and offer you a completely different service. In addition, as the NHS does not offer cosmetic dentistry, you will often have to fork out privately for white fillings, crowns, and root canals.
As there are no time constraints, a private dentist has more time to explain all the treatment options to you properly and there you are more in control of your oral health.
NHS dentists do not get paid for giving preventative advice or treatment, so they simply do not do it. For private dentists, this is in built into their exam fees, so you know you are getting the best preventative advice and treatment.
Who is better at treating nervous patients – NHS or a private dentist?
NHS dentists have a very limited time to see you and can rush treatment. If you are nervous, would you like to be seen by someone who takes their time and treats you with care? If yes, a private dentist is your ideal choice.
In addition, services such as sedation, which is ideal for nervous patients, is very difficult to get on the NHS so it is always better to see a private dentist.
If you are thinking about switching dentists or would like to see a private dentist for the first-time please contact us and we would be delighted to help.