Published: 22/07/2004, Volume II4, No. 5915 Page 21
When my excellent Irish dentist in salubrious Twickenham retired with back trouble a few years ago his successor took the list private and we left to find an NHS dentist closer to home. At least, I thought we did.
Imagine my surprise last month when I said to my current dentist: 'Gosh, Ron,£500 is a lot of money for an NHS crown, is not it?' and Ron replied: 'You're not one of my NHS patients, Michael.'
We developed this informality with dentists when we lived in America ('Hi guys, I am Wayne.
My, what a good job your Twickenham dentist made of that filling'). It is almost as intimate as gynaecology, dentistry, is not it? But That is not my point.
Ron and I decided that the chap who had run the practice before him, the one who always asked what classical CD I would like to hear, must have taken me private in a moment of inattention, probably mine, not his.
I thought of this when reading last week's report by the chief dental officer, Professor Raman Bedi, published alongside a John Reid statement ('Reform With a Bite') about the latest shake-up.
John Prescott, no less, recently found he'd had trouble finding a new NHS dentist, too. Two points emerge.
One is that, as one of my New Labour chums observes:
'Dentistry was one of the Tories' most successful privatisations.'
In other words, the 1990 NHS contracts, plus the introduction of patient registration (on top of two dental school closures in 1987) had made it all so complicated (and fees were then cut by 7 per cent in 1992) that hordes of dentists thought: 'Sod this for a game of root canal work' and went private.
Second, my tale of a hunt for a dentist and my confusion about status and charges is a common one.When Rosie Winterton, the minister in charge of dentistry (she has a lovely white smile, too) was doing one of those Blairite 'Big Conversations' recently, a man complained that he had had to pay£1,500 for NHS dentistry.
'That is impossible, the maximum NHS charge is£378, 'Ms Winterton insisted. He took some persuading. No wonder she feels that things should be explained more clearly and the new proposals will ensure that prices are properly displayed.
I am no longer sure I picked the right material for my new tooth (they yellowed it to match my set). The minister tells me that NHS amalgam is both cheaper and better.
Where does this leave us? Well, It is important to stress that, despite shortages of dentists, especially NHS ones, dentistry is basically a success story, except among the very poor. Thanks to fluoride and better diet, most kids have far better teeth than they did when I got a fourshilling (20p) fortune from mum to take to the fair after having eight teeth removed. I think I was seven.
Second, let's be generous. A glance at Professor Bedi's data suggests the Tories had started to rectify past errors by 1997 when the number of dentists had begun to rise from 17,200 to last year's 19,300.Mr Reid promises us another 1,000 over the coming year: a mixture of returnees, a 25 per cent hike in places (170 more) at dentistry school, and overseas recruitment.
So there will be more and newcomers will be processed faster.
Ms Winterton tells me there are 460 applicants in the pipeline and that EU-stipulated exams take too long. In future some will take those exams before they arrive here.
That is not all, of course. There is the£368m filling Mr Reid promises the services, plus the new contract (when It is done) and the impending National Institute for Clinical Excellence guidelines (now out to consultation), not to mention the integration of dentistry into primary care trust structures by late 2005:
local control in practice.We hope. Tony Blair promised big changes five years ago, didn't he?
Well, yes, though that was only that you would soon be able to visit an NHS dentist, not register with one, hence the 47 emergency access centres that have sprung up. In any case, the new rules say, we do not need to get six-monthly checks because our teeth are so much better and dentists will not be paid just for doing things inside our mouths.
Ron says it was like groping in the dark before they had those micro-cameras. Now he shows me what he's up to on a TV screen where my new-polished fangs shine like a toothpaste ad. Is that NHS or private, I wonder?