Dentist refusing NHS patients
Dentist refusing NHS patients
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JapanRed

Original Poster:

1,591 posts

140 months

Wednesday 26th February 2020
quotequote all
My wife has seen the same (NHS) dentist for 20+ years. Last year he said he would only continue seeing her if she went private, as he was passing all his NHS patients to another dentist at the same practice. She didn’t want to pay so has remained in the same practice but with another dentist.

Our first child (now 2) saw my wife’s dentist (the new one) last year and again this year, again under the NHS.

My wife today tried to register our second child and the whole dental practice is refusing to take on NHS patients now. So we either have to find another dentist for my 6 month old, or pay privately for her to use the same dentist as my wife and eldest child.

Is it legal for the dentist to transfer his long-standing patients and then refuse to accept NHS patients even when 2 members of the same family already go there?

If all GP’s did this where would everyone go?

eybic

9,212 posts

203 months

Wednesday 26th February 2020
quotequote all
As I understand it, Dentist's are free to decide what patients they have. Private work will be better paid than NHS so that's what he's chosen. I don't think they have any legal obligation to accept patients.

C0ffin D0dger

3,440 posts

174 months

Wednesday 26th February 2020
quotequote all
Yep, that's the way it is unfortunately.

Personally if I was in that situation I'd be looking for another practice accepting NHS to take all of you and then move away from the current one. Loss of revenue for them but then they may or may not care depending as to how much private work they have coming in.

Deesee

8,509 posts

112 months

Wednesday 26th February 2020
quotequote all
Take out private dental care off-set against tax (if your self employed/ltd). There are literally no NHS dentist where we are, and I'm half tempted to sign up for one of these paid online doctors.

JapanRed

Original Poster:

1,591 posts

140 months

Wednesday 26th February 2020
quotequote all
Thanks all. I am tempted to find an NHS dentist that will take us all. Although the post about paying for a dental plan through my limited company is also worth me exploring further.

Could I use this dental plan for my wife and kids even if they have nothing to do with the business? Is it a legitimate expense?

Oakey

27,981 posts

245 months

Wednesday 26th February 2020
quotequote all
Deesee said:
Take out private dental care off-set against tax (if your self employed/ltd).
Tell me more

Deesee

8,509 posts

112 months

Wednesday 26th February 2020
quotequote all
Employee benefit (so a bit of BIK -benefit one kind-)

This is the old national dental plan company rebranded.

https://www.unum.co.uk/dental/rewarding-employers-...

Yep you can add the kids.

Sheepshanks

40,983 posts

148 months

Wednesday 26th February 2020
quotequote all
We had this with our dentist a few years ago - we felt blackmailed into going private. I have very iffy teeth and when our previous dentist retired he recommended her and I didn't want to switch dentists again.

Wife and I pay using Denplan, which works like a service plan for a car. The dentist sets the amount based on what they think you'll need, and it's paid monthly by my company, I pay tax on it.

Our adult kids still see her but they pay as they go. I don't know if this is common, but since she switched to private, checkups take literally a minute. Any cleaning etc you get directed to a hygienist. For wife and I that's included in our Denplan charge - our kids have to pay separately for it.

On a positive note, and there's no pun intended in this story, she did turn out on Christmas Eve (which was a Sunday) a couple of years ago, to stick my crown back in place - Christmas would have been a bit of a nightmare otherwise. Denplan pay her for that, although not in full, but she said she doesn't ask patients to pay the excess.

Countdown

49,367 posts

225 months

Wednesday 26th February 2020
quotequote all
Deesee said:
Employee benefit (so a bit of BIK -benefit one kind-)

This is the old national dental plan company rebranded.

https://www.unum.co.uk/dental/rewarding-employers-...

Yep you can add the kids.
Am I missing something?

The LtdCo may avoid Corp tax but it's still a taxable BIK for the Employee...so where's the saving?

Deesee

8,509 posts

112 months

Wednesday 26th February 2020
quotequote all
Countdown said:
Deesee said:
Employee benefit (so a bit of BIK -benefit one kind-)

This is the old national dental plan company rebranded.

https://www.unum.co.uk/dental/rewarding-employers-...

Yep you can add the kids.
Am I missing something?

The LtdCo may avoid Corp tax but it's still a taxable BIK for the Employee...so where's the saving?
My BIK is about 30£ a month, with minimal bills, get a quote see if it works for you, works for me.. as I pay myself under the NI threshold and under the tax free allowance (for the paye element) it cost less than using money that’s paid Corp Tax & Personal Tax (dividends in my case) as mine stretches to 32% divs.



Countdown

49,367 posts

225 months

Wednesday 26th February 2020
quotequote all
Deesee said:
My BIK is about 30£ a month, with minimal bills, get a quote see if it works for you, works for me.. as I pay myself under the NI threshold and under the tax free allowance (for the paye element) it cost less than using money that’s paid Corp Tax & Personal Tax (dividends in my case) as mine stretches to 32% divs.
Thanks, yes that would explain it. Your company paying it means that there's no CT to pay and as you're paying yourself below the NI threshold there would be no BIK to pay either.

Johnnytheboy

24,499 posts

215 months

Wednesday 26th February 2020
quotequote all
Our dentist is currently closed... due to the absence of a dentist. laugh

blueg33

46,409 posts

253 months

Wednesday 26th February 2020
quotequote all
My wife works as a reception manager in a large and busy dental practice that has private and NHS patients.

Generally the NHS lists are maxed out and they only open the lists for new patients once or twice a year. They have a finite number of surgeries and hence can only manage a finite number of patients.

They get paid the least for NHS work, but generally the patients are the ones that mess them about, miss appointments, are rude and abusive to staff. The admin around NHS patients is also onerous. Private patients typically (not always) are the opposite, less rude, turn up etc. There is not a single day when a patient hasn't been rude and abusive. Often because they are turned away for being late for appointments or expect to get an appointment at really short notice and are pissed off when they can't. May NHS patients lie claiming an emergency to try and get priority treatment, they don't like it when the lie is exposed.

If the practice took on more patients the waiting time for appointments would be even longer. Reception get grief either way. Its a surprisingly stressful job and the staff turnover is high. I can understand why dentists want to limit the number of NHS patients

The more senior dentists who are higher cost tend to see the private patients, junior and placement dentists see the NHS patients.

Saleen836

12,497 posts

238 months

Wednesday 26th February 2020
quotequote all
Oakey said:
Deesee said:
Take out private dental care off-set against tax (if your self employed/ltd).
Tell me more
Interested to hear more on this, I pay for private dental cover

Rollin

6,331 posts

274 months

Wednesday 26th February 2020
quotequote all
JapanRed said:
My wife has seen the same (NHS) dentist for 20+ years. Last year he said he would only continue seeing her if she went private, as he was passing all his NHS patients to another dentist at the same practice. She didn’t want to pay so has remained in the same practice but with another dentist.

Our first child (now 2) saw my wife’s dentist (the new one) last year and again this year, again under the NHS.

My wife today tried to register our second child and the whole dental practice is refusing to take on NHS patients now. So we either have to find another dentist for my 6 month old, or pay privately for her to use the same dentist as my wife and eldest child.

Is it legal for the dentist to transfer his long-standing patients and then refuse to accept NHS patients even when 2 members of the same family already go there?

If all GP’s did this where would everyone go?
The practice will have a fixed annual allocation of funding to provide NHS treatment. Once this runs out, the NHS refuses to give any extra funding despite practices having capacity to see more patients.

Funding should be available since the NHS takes back money from other practices who fail to use up their allocation. This amounts to over £100million per year. They generally refuse to spend this on other practices who could make up the shortfall.

The only options are for practices to charge privately for treatment or close the practice until the next financial year when the NHS funding will resume.

In my case neither of these options are possible and we will be providing NHS dental care, as usual, for the whole of March which will be funded by me.

JapanRed

Original Poster:

1,591 posts

140 months

Wednesday 26th February 2020
quotequote all
Rollin said:
JapanRed said:
My wife has seen the same (NHS) dentist for 20+ years. Last year he said he would only continue seeing her if she went private, as he was passing all his NHS patients to another dentist at the same practice. She didn’t want to pay so has remained in the same practice but with another dentist.

Our first child (now 2) saw my wife’s dentist (the new one) last year and again this year, again under the NHS.

My wife today tried to register our second child and the whole dental practice is refusing to take on NHS patients now. So we either have to find another dentist for my 6 month old, or pay privately for her to use the same dentist as my wife and eldest child.

Is it legal for the dentist to transfer his long-standing patients and then refuse to accept NHS patients even when 2 members of the same family already go there?

If all GP’s did this where would everyone go?
The practice will have a fixed annual allocation of funding to provide NHS treatment. Once this runs out, the NHS refuses to give any extra funding despite practices having capacity to see more patients.

Funding should be available since the NHS takes back money from other practices who fail to use up their allocation. This amounts to over £100million per year. They generally refuse to spend this on other practices who could make up the shortfall.

The only options are for practices to charge privately for treatment or close the practice until the next financial year when the NHS funding will resume.

In my case neither of these options are possible and we will be providing NHS dental care, as usual, for the whole of March which will be funded by me.
Thanks for explaining, I guess it makes sense.

JapanRed

Original Poster:

1,591 posts

140 months

Wednesday 26th February 2020
quotequote all
Rollin; is it the NHS that sets the allocation for number of NHS patients per practice, or does the practice have a say in it?

CrgT16

2,524 posts

137 months

Wednesday 26th February 2020
quotequote all
The NHS “offers” a contract value to the practice. I don’t think it’s a negotiation. I haven’t worked on the NHS for 14 years and I am glad I am out. Not sure if I am better financially but I am certainly better in mental health, self esteem and work-life balance. NHS dentists that provide decent care have my respect.

Rollin

6,331 posts

274 months

Wednesday 26th February 2020
quotequote all
JapanRed said:
Rollin; is it the NHS that sets the allocation for number of NHS patients per practice, or does the practice have a say in it?
The NHS gives practices funding for a certain amount of NHS treatment for the year, not a certain amount of patients.

I have asked for more funding for the past 2 years and been refused. Our funding only covers 10.5 months of the year now. Our options are close the practice or run the entire practice without NHS funding. Private treatment is generally not an option for patients in our area.

JapanRed

Original Poster:

1,591 posts

140 months

Thursday 27th February 2020
quotequote all
Rollin said:
JapanRed said:
Rollin; is it the NHS that sets the allocation for number of NHS patients per practice, or does the practice have a say in it?
The NHS gives practices funding for a certain amount of NHS treatment for the year, not a certain amount of patients.

I have asked for more funding for the past 2 years and been refused. Our funding only covers 10.5 months of the year now. Our options are close the practice or run the entire practice without NHS funding. Private treatment is generally not an option for patients in our area.
Thanks again for explaining. Rubbish situation to be in.