Tuesday, 26 August 2008

Dentists' Bills

Yesterday, the leader of Wales' dentists, Stuart Geddes, called for dentistry to be free in Wales. He was right to draw attention to this issue, and I welcome the fact that it is dentists themselves who are saying this.

There can be little doubt that charging for dentistry acts as a disincentive to people to seek treatment for problems, and encourages them to seek the lowest cost treatment rather than the best treatment. It is also a regressive form of charging, in that those on lower incomes find it harder to find the money for necessary treatment than do those on higher incomes.

It is an anomaly in the NHS that treatment for other forms of ill health is free, whilst dental treatment has to be paid for. Above all, a proportion of dental work - and thus cost - is preventable, but charging for a check-up deters people from visiting their dentists regularly and thus identifying problems early. The decision of the Assembly Government earlier this year to freeze charges in Wales, even though they were being increased in England is, of course, welcome, as are the initiatives which are being taken to improve provision of dentistry across Wales. But we need to go further; we should be planning for free dentistry.

What really disappointed me in the report was the response of the government spokesman. There are all sorts of answers that he could have given. I understand that governments have to make choices and set priorities, and that the government cannot afford to do everything it would like. An answer which said something like "this is a long-term aspiration, but we are concentrating our resources on other initiatives at present" would at least have been something that I could have understood. It would demonstrate that the idea was receiving a degree of consideration at least.

But to justify charges by saying "…since 1951, successive governments have considered that those who can afford to make a contribution to the cost of their dental treatment should do so" must surely rank as one of the most inadequate responses ever to issue forth from a government spokesman. So there has been a cosy little LabourTory consensus to charge for dentistry for 57 years – that's no basis for justifying anything. It tells us only that the anomaly is a long-standing one; but the fact that something has been done in this way for a long time is absolutely no basis for arguing that it should continue.


Anonymous said...

Free Dentistry?? great idea, but even An NHS dentist would be a good start instead of being forced to go private, with Labour's shambles of a working contract, where I live in Cardiff, My Dentist, just told me that he's going Private because this Government would be effectively forcing him to take a pay cut if he stayed in the NHS.

While Wales can't keep Dentists from going Private, FREE dentistry will be a pipe dream.

ardibeltza said...

How much money do dentists earn in the NHS? If it's anything like GPs, it's a disgrace that they're opting for lucrative private practice when about 40% of people in Wales haven't got access to an NHS dentist.

Was it always the case we paid for dentistry under the NHS? Or is it one of those creeping payments that like prescription charges have crept in over the years?

Cibwr said...

Well the cost seems so low - less than £30 million a year, it seem crazy not to go for it. The costs for treatment are a disincentive for a large part of the population, the cost of a few filling is quite prohibitive for people on low incomes who are in work. Many of whom then go years without treatment and when they go they find a large amount of work has to be done - which of course they can't afford, so they go for the lowest cost option - extraction.

The cost/benefit analysis surely suggests that re introducing free dentistry (and opticians)would be something well worth doing.

John Dixon said...


I agree that making sure that we all have access to an NHS dentist is a major issue - and it's a particular problem here in Carmarthenshire and Pembrokeshire. I don't see, however, why that aim conflicts in any way with the idea of planning for free dentistry.


Dentists opt to work in the private sector only partly because of the money. The NHS contracts, and the associated bureaucracy are another issue. But neither need be insurmountable obstacles if the political will is there - and currently, it simply isn't.

"Was it always the case we paid for dentistry under the NHS?"

The WAG spokesman said that we have been paying for an element of NHS dentistry since 1951. My own personal memory doesn't go back that far, but I'm prepared to take his word for it. It's another long-standing compromise to the principle of free health (like prescription charges) which needs to be challenged.


Typically, prevention is better than cure, so I wouldn't be at all surprised to find that it would be cheaper overall to have free dentistry. But I'm not aware of specific figures proving that.