Dentists forcing 500,000 NHS patients to pay privately: report

Dentists are forcing 500,000 patients a year to pay for expensive private treatments by failing to tell them they are available on the NHS, according to an investigation by the Office of Fair Trading.

Dentists are wrongly telling NHS patients they must pay privately for some treatments which are actually available on the NHS, the OFT has found. Photo: ALAMY

By Rebecca Smith, Medical Editor

12:01AM BST 29 May 2012

UK Daily Mail:

The 18-month long inquiry, published today, finds patients are being “deliberately misled” and made to pay up to four times more for basic treatments such as fillings and crowns than they would on the NHS.

The Office of Fair Trading, which enforces competition law, warns that in some cases the high cost of going private is discouraging patients from having necessary treatments, putting their health at risk.

Lord Howe, the health minister, described the practice as “a very serious matter” and urged the NHS to take action against dentists who breach the terms of their contracts by misleading patients.

Under NHS regulations, dentists must offer basic treatment on the health service and can only charge extra for cosmetics such as veneers and white fillings.

A survey by the OFT, however, finds patients are routinely being told to pay for bridges, crowns, root canal treatment, silver fillings, dentures, extractions, check-ups and X-rays despite this work being covered by the NHS.

A root canal treatment costs £48 per tooth on the NHS but up to £475 for private treatment, while a small filling costs £48 on the NHS but £80 for private treatment.

The report says: “As a result, such patients are likely to incur financial detriment, where they choose to have private dental treatment instead of NHS dental treatment, or may suffer harm to their oral health where they choose to forgo the dental treatment altogether or to opt for a less beneficial course of dental treatment.”

Despite the routine breaches of NHS regulations, the OFT says regulators such as the General Dental Council and Primary Care Trust have taken little action.

The report says: “Despite OFT’s estimate that there are as many as 500,000 instances of patients being given inaccurate information by their dentists regarding their entitlement to receive a particular course of dental treatment on the NHS, the GDC appears to have a notable and concerning low enforcement track record of pursuing instances of breaches, and so deterring future misconduct.”

John Fingleton, chief executive of the Office of Fair Trading said: “All too often patients lack access to the information they need, for example when choosing a dentist or when getting dental treatment.

“We also unearthed evidence that some patients may be receiving deliberately inaccurate information about their entitlement to NHS dental treatment, and we expect to see robust action taken against such potential misconduct by dentists.”

The wide-ranging report also criticises dentists for:

- The lack of information available on the potential cost of treatment, despite rules saying NHS charges should be displayed.

- Pressuring patients into buying expensive dental payment plans.

- Stopping patients from seeing hygeinists or technicians without referrals from dentists.

- Poor NHS contracts that mean it is difficult for new dentists to set up and successful ones to expand, meaning there is little competition.

- A complicated and time consuming complaints procedure.

Dentistry in Britain is worth £5.73 billion a year, with around 29,500 dentists practising. Most of them offer NHS treatment or a combination of NHS and private dental treatment.

A spokesman for Which? welcomed the OFT’s report. He said that it echoed the consumer group’s own research, which found confusion among patients and a lack of clarity about prices.

“Regardless of whether dental treatment is NHS or private, patients need clear and transparent information up front about the proposed treatment and the costs. So we support calls from the OFT for more rigorous enforcement of the rules to ensure patients are given clear and timely information,” said the spokesman.

He said that patients also need to know how to complain and get redress when something goes wrong.

Katherine Murphy, chief executive of the Patients Association, said: “It is an outrage that, because the focus has been on other aspects of the health and social care system, dentists have been able to get away with unacceptable practice. This must change, and the needs of patients must be put first.”

“The impression we have is that, because the focus has been on other aspects of the health and social care system, dentists have been able to get away with unacceptable practice.

“This must change, and the needs of patients must be put first.”

Health Minister Lord Howe said: “We welcome this study, which has found that the vast majority of patients are happy with their dental treatment – and that the vast majority of dentists behave ethically.

“However, denying patients care on the basis of misinformation is a very serious matter – any dentist that does this risks breaching their contract and we would expect the local NHS to take action.”

Dr Susie Sanderson, chairman of the British Dental Association’s Executive Board, which represents dentists, said the majority of patients are happy with their dentist and accused the OFT of ‘headline grabbing’.

She said: “The delivery of effective dental care is all about good communication between dentists and patients. That communication will not be enhanced by the OFT’s headline-grabbing approach to publicising this report.

"That it has chosen to ignore what it knows about patient satisfaction and instead focus on a very small number of cases where it believes it has identified problems is disappointing.”