The article points out that
This is a deep-rooted problem that needs a drill taken to it. The Government should start by scrapping the new contract that it introduced for dentists in 2006. Dentists are now paid a fixed fee, in exchange for completing a certain number of units of NHS dental activity a year: the net result is that idle dentists never get round to seeing enough patients – and their funding is subsequently reduced – and energetic dentists are forced to look to the private sector for more work after they fill their quota. In 1990, only six per cent of dentists’ income came from private patients; now it’s 58 per cent. Worse, NHS dentists now receive the same amount of money for six fillings as for one, so there is no incentive to take on complex cases.
Our dentists are trained at a cost of £175,000 by the NHS, so they should be expected to work within the sector for a number of years. And we need more of them. America has twice as many per head as does Poland – half of whom are here. Britain only has 3.7 dentists per 10,000 people. Even if you find an NHS dentist, it’s not all smiles: the cost of a filling has gone up from £14 to £43 in the past few years. The NHS budget has doubled in the past decade while dentistry decayed. The Government has finally started filling the financial gap but, as usual it has gone on bureaucracy.
This appears to be a triple problem – Demand, supply and technology:
1. People have grown accustomed to expecting that all their healthcare needs will be met by the government. The government is not paying enough for NHS dentists to provide adequate care.
2. Dentists are trained at the expense of the public. There are not enough dentists being trained. Once dentists complete their training, they have no option but to work for the state monopoly for several years.
3. The dentists in private practice have no incentive to facilitate payment plans to their patients/customers; medical research companies have no market incentives to come up with new technologies.
Here in the USA most people do not have dental coverage, but manage to have the best dental care in the world. How is that?
Is it because students pondering future carreers have enough choices and economic incentives to enter the profession? Is it because there’s enough of a business opportunity for medical research to bring to market new drugs (painless dentistry) and new technologies (invisaligns, for instance) that provide better care? Is it because the patients have enough choice of dentists in their towns that there is a free market of sorts with enough competition that a patient can compare treatments – if you don’t like your dentist, you can check out the other dentist?
In addition to these factors, is it because the American patients themselves are more aware that dentistry is not simply cosmetic?