OPEN WIDE AND SAY ARGH!
Teacher’s £1k dental bill highlights NHS shortage
ASUPPLY teacher has spent more than £1,000 on dental bills after his practice announced it was stopping NHS treatment and going private. Adam Faries said he reluctantly signed up for a private treatment plan after he was unable to find another dentist near where he lived that offered NHS treatment.
He claimed he tried “pretty much every dentist within 30 miles” of Bangor, and was told by nearly 20 different practices that he would be put on a waiting list for at least two years before he was seen.
Through his search, he discovered that there was currently only one NHS dentist in the city, which he argued was “incredibly unsustainable” for a city of its size.
“I signed up with a dental practice in 2019, having looked for a new dentist for over year after my previous practice in Bangor closed down,” Adam said.
“They offered NHS dental and it was going well but I was sent an email in August, 2020, when I was midway through a course of treatment, that the practice had decided to go private.
“I was offered a £10 per month limited offer of private treatment. It was quite a good offer, it allowed me to two consultations a year, discounts on core treatments, same-day emergency care, things like that. But even so, I was still unsure about it.”
Reluctant to commit to private treatment, Adam began to search for alternative options. But he was met with disappointment when he could find no other local practices that offered NHS treatment, while those further out that did had mammoth waiting lists.
“I looked around pretty much every dentist within about 30 miles of Bangor,” he said. “I phoned and emailed around 15, maybe 20 different practices in Menai Bridge, Llandudno, Colwyn Bay, Llangefni, Penmaenmawr and others.
“This was during the pandemic, so many of them weren’t taking anyone anyway, but what I was told by those that were was that the waiting lists would be at least two years, likely even longer. It was crazy, but even now, with things back open again, the waiting lists are still the same. It’s still two or three years and that’s after contacting every dentist between here and Rhyl, and every one on Anglesey too.”
Conscious that the limited time offer at his current practice was running out, and with no suitable alternative, Adam apprehensively joined the private treatment plan.
So far, he has received work on his root canal, which he was halfway through treatment for before the practice went private, while all other items have come at the full private price. Over the course of three treatments, which were all for fillings, he has been charged more than £980.
Including the monthly membership fee that he pays, this total is approaching £1,200, which Adam said was an unsustainable amount for him to pay given the nature of his job.
“It is a huge financial burden,” he said. “The treatment has meant I haven’t had pain and my teeth are being kept in some sort of order, but I’m having to pay a lot for it.
“I work as a supply teacher, which is unpredictable by nature, so having large amounts of money go out of my account, before I’ve even had the treatment, is a little bit scary. It’s money that I don’t know that I have.
“I think I’m right in saying that in Bangor there is one single NHS dentist at the moment. That is for a city of 10,000 when students aren’t here, and 25,000 when they are. It’s unsustainable.
“The idea of the NHS is that everybody has access to free or at least cheaper healthcare, and I think everyone should have the right to access an NHS dentist. It would be good to see the Welsh Government make that happen, firstly by attracting more dentists to the area to open a few more NHS practices.”
In a plenary session in the Senedd on March 22, Andrew RT Davies spoke of Adam’s situation to illustrate the “extremely concerning” lack of capacity within Welsh dental services.
He added that waits had become so long that people like Adam were paying thousands to ensure their dental health, while some were going further and extracting teeth themselves through desperation.
Addressing the First Minister, Mark Drakeford, he said: “We often talk about the consequences of shutting down parts of the NHS to deal with coronavirus, which has left 20% of the Welsh population on an NHS waiting list, and, of those 20%, one in four people are waiting over a year. But none of those lists contain the waiting times for dentistry.
“The waits have become so chronic that we are seeing people having to fork out hundreds of pounds, if not thousands of pounds, or taking more drastic measures into their own hands to extract teeth.
“Now, when we see dental treatments falling by 70% over the last 12 months, do you agree with me that there is a genuine problem with capacity within the Welsh dental services and people’s ability to register with NHS provision?”
But while Mr Drakeford accepted that NHS dentistry was “undoubtedly very challenged” currently, he insisted there had been a recovery, with patient volumes nearly at three-quarters of pre-Covid levels. He also denied the problem was due to a capacity issue, saying instead that it was down to the “circumstances under which dental treatment is carried out”.
He added: “We still have significant numbers of dentists in Wales carrying out NHS dental treatment, but they are simply not able to provide the volumes of treatment that they were in pre-Covid conditions, because, of all the things that the NHS does, the aerosol-generating procedures that dentistry relies upon are the most likely to spread Covid.
“Therefore, conditions continue to be that dentists have to reduce the number of patients they can see over a day, they have to have longer periods between appointments in order to carry out necessary cleaning, and that is resulting in the very difficult circumstances to which the Member referred.
“There is recovery in dentistry. We’re back up to about 70% of the volumes that were possible prior to Covid. There are new ways of providing advice to people.
“I think there are over 2,000 people a week getting over-the-phone advice from their dental practitioner. And there are plans particularly to diversify the dental workforce, which will mean that the capacity we need in future can be brought on stream.
“In the meantime, the position will continue to be challenging. Despite there being more money in the system, the system isn’t able to absorb the money that the health minister made available to it in this calendar year.
“Because the money isn’t the answer here. There just isn’t the time in the day or the hands on deck to be able to do everything that we’d like to see done.”
Mr Davies told the session there were now 83 fewer dentists working across Welsh health boards than there were in 2020, adding this was “probably not helped” by the Government’s new NHS dental contract, which was driving dentists out of the service and into private practice.
The British Dental Association said the new contract reduced focus on regular check-ups, made dentists choose between old and new patients and paid dentists based on out-ofdate performance data.
He added: “In a letter from the chairman of the Dyfed Powys local dental committee sent to the health minister, the committee has confirmed that all practices in their area are unable to sign the proposed contract, which would result in a cut in capacity of 75% on agreed existing levels. The chairman said that every member is unprepared to compromise on quality of care of their patients.
“That, as a group, is extremely concerning – that NHS dental services in west Wales are at risk of collapse as soon as next month.
“If you accept that there are challenges on this particular issue, why are you introducing a contract that would make the situation worse and potentially create dental deserts in certain parts of Wales?”
Mr Drakeford said he was “puzzled” at the letter adding that, from next month, dentists in Wales will have a choice whether or not to take the new contract, with nobody forced to take it. “Many, many dentists believe it is far preferable to the existing contract because it allows them to carry out quality dentistry rather than the treadmill of units of dental activity that drive the existing contract and push dentists into doing routine check-ups, small procedures, rather than practising at the top end of their professional competence,” he added.
Asked what action the Welsh Government would be taking to boost access to dental services across Wales, Mr Drakeford said that there were plans to “press ahead with the liberalisation of the profession,” while a further £2m would be provided for dentistry next year. He added that a “major new dental centre” would soon be opening in Bangor, which would “provide a new level of NHS dental provision to people in the north-west of Wales.
However, despite the First Minister’s promises, Adam was apprehensive about the future. “I heard the First Minister talking about a new dental academy,” he said. “But it’s the first I’ve heard about it. It might solve some of the issues, but it would be good to have a bit more detail on what it will provide. Are people who sign up there going to be seen by trained professionals or by dentists in training?
“If you’re going in for something as important as dental surgery, you ideally want to be seen by trained professionals, although of course students have to learn. I don’t know if it will solve anything for people like me, but we’ll wait and see – something needs to be done.”