How to mix (up) NHS and private dentistry

If you want to know a short-cut to a guest appearance before the Fitness to Practise Committee of the GDC, why not start at the interface between NHS and private treatment. Here you will discover no end of opportunities to develop your skills as a dodgy dentist.

There is no reason why you shouldn’t mix NHS and private dentistry, but just remember that every time you do, you walk a tightrope. One false move and you could hurtle into oblivion. Staying on the tightrope is not difficult.

You simply need to tell the truth.The absolute truth. What’s difficult about that? So when you advise a patient that chrome dentures or bridges are not available under your NHS contract – is that the whole truth or were you thinking of the lab bill at the time? The list of tricks to help you fall off the tightrope is endless. In addition to misleading patients about the true benefits (to them) of the NHS contract, you can try charging them a private fee and claiming NHS UDAs as well, or you can tempt them into your practice with a promise of NHS treatment when your plan was to trick them into paying privately all along.

Another good ploy is to bamboozle your patients so much that they don’t know which bit of their treatment is NHS or private. Because of the massive unmet demand for NHS dentistry in some parts of the country, many patients feel at a considerable disadvantage.

Not only are they both desperate and grateful for an NHS dentist to take them on, but they must also rely on you to explain how your NHS contract affects them. After all, how can you expect patients to understand your NHS contract – regulations so obtuse that Mr Justice Collins recently described them as ‘rubbish’ and ‘like going through a marsh, trying to leap from tussock to tussock.’

Of course, the fact that the regulations may be rubbish doesn’t give you a right to skew them to your advantage and it doesn’t absolve you from telling the truth. It is the call of this insatiable demand for NHS dentistry that our unscrupulous brethren simply cannot resist – an opportunity too good to miss. So if you have used up your UDAs or have no NHS contract at all, why not offer private dentistry at NHS prices? The trouble with this wheeze is that the prices are not usually NHS prices and no one tells the patient about all the additional NHS benefits they have lost.

These include safeguards such as vocational training, clinical references, criminal record and English proficiency checks and friendly inspectors who check out the suitability and safety of your dental practice and the delivery and quality of your treatments.

To you, they may be an irritation rather than a benefit – but what do your patients think, I wonder?
Of course, you can mislead patients about NHS versus private treatment as much as you like and still avoid all the inconvenience of the GDC disciplinary process by not being registered in the first place.

This was the cunning plan adopted by three entrepreneurs from Peterborough, who in September 2006 set up their corporate body ‘Community First for Treatment Limited’ to launch three dental practices dedicated to providing – yes, you’ve guessed it – private dental treatment at NHS prices or less!

This was a company, featured on TV and radio, that was heralded as the solution to the local NHS dental access problems. But instead of delivering on their promises, the three directors, none of whom were registrants, employed dentists, collected patients’ fees up-front and then closed their practices and kept the money.

And if they thought they were untouchable, little did they account for the GDC’s own tenacious in-house legal team who on 15 February this year brought a successful prosecution which, whilst only resulting in a total of £1,000 in fines and £3,000 costs, achieved two significant criminal convictions under the Dentists Act. So what is the secret of mixing NHS and private dentistry: just tell your patients the truth.

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