And now for the OFT...

01 November 2011
Volume 27 · Issue 10

Will the report take into account the costs of running a practice, asks Nilesh Patel.

Another month passes us by in UK dental practice and for what feels like the umpteenth time we are under the spotlight and scrutiny of another organisation/regulatory body. This time it is the Office of Fair Trading. For those of you with a sense of déjà vu, you would be correct. The OFT previously investigated UK dentistry in 2003, as a result of a super-complaint by the Consumers' Association.

Some of their recommendations then included the following: ensuring the clarity of private dental pricing, the introduction of practice complaints procedures, and facilitating direct access to dental hygienists, therapists and technicians for patients.

Fast forward to 2011 and the OFT is again interested in dentistry. This time their concerns include: the amount of choice patients have in selecting dental practices, the types of treatments on offer and an investigation into why private dentistry in the UK is among the highest levels in Europe.

They state that: 'Given the current strains on people's finances, we think it is a good time to examine whether competition is working effectively to drive up the quality of private and NHS dental services and deliver better value for money for consumers.'

When the OFT starts its investigation of the rates charged by private dentists, I hope they look deeper and obtain a thorough insight into all the hurdles and costs we dentists face before we even get to the stage where we start to greet our patients. In my view the Government has made doing business in this country more and more difficult and dentistry even harder to provide as a service whilst still being able to pay the bills.

Practice owners have faced rising National Insurance costs when they employ staff, rising utility bills to heat and power their surgeries, higher material costs from generally imported dental materials (due to the weakened pound) and higher costs associated with the increase in unrecoverable VAT when dental businesses have to pay for goods and services although they are generally VAT exempt.

As well as the higher costs associated with running our business, dental practice owners also have to bear the costs of increasing regulatory burdens foisted upon us by the Government. First there was the introduction of HTM 01-05 which appeared to be based on very little sound scientific evidence but the net effect is most of us have no choice but to build extra decontamination rooms, buy and use generally costly equipment and bag instruments for use up to 21 days and then re-autoclave if not used. The costs appeared to keep mounting with no real justifiable benefit in return.

This was followed up by the regulation of dental practices by the Care Quality Commission in a manner which treated us all like 'mini hospitals' instead of being tailored to our niche profession. The Health Select Committee was astounded by what we had to go through, but whilst they made sympathetic noises we dentists still had to pay the price, with increased staff time being engaged to tick all the boxes required to pass the CQC standards, and the dubious 'honour' of paying £800 for the privilege of being regulated by yet another organisation.

Is it any wonder that the cost of private dental treatment in the UK is amongst the highest in Europe when we have to jump through the hurdles we do? I hope that when the OFT carry out their investigation they look closely at both sides of the equation and not just the end user price of the service. I am aware it would be too much to expect the OFT to actually conclude how it is almost a miracle that NHS dentistry is performed in the UK whilst facing these same struggles but still managing to survive.