Face up to dental cover

PRIVATE HEALTH: SPECIAL REPORT

Private practice is making increasing inroads into dentistry following government cuts to the pay of National Health Service dentists. In London and other high cost parts of the country, dentists are increasingly treating only children and exempt adults on the NHS and all other adults privately.

The withdrawal of dentists from the NHS is due to frustration over pay, over the limited time they can allocate to each patient and over the inferior quality of materials they are able to use.

In April the government reaffirmed its commitment to the NHS, while unveiling plans for reform. It made clear that everyone who wanted dental treatment on the NHS was entitled to it, even though that might mean travelling to get it. The Department of Health maintains that despite large scale deregistration of patients by dentists in the past few years, there are more NHS dentists and more NHS patients now than three years ago. The figures are at odds with dentists' experience. Denplan, the market leader in private dental care, estimates that 850 patients are being deregistered from the NHS every day. It conducted a survey among dentists a year ago which found that 90 per cent treated patients on the NHS in 1989, by last year the figure had dropped to 60 per cent and by 1999 the proportion was expected to drop to 30 per cent.

The reforms of last April have not changed dentists' thinking, according to Denplan and other providers of private care plans. Although the government backed away from some ideas in its previous Green Paper, most notably the recommendation to make most non-exempt adults pay 100 per cent of their NHS treatment costs, it reiterated that it wanted better value for money for the pounds l billion spent annually on NHS dentistry.

Dentists are particularly concerned about plans to introduce more rigorous prior approval procedures which in the words of Gerald Malone, Minister for Health, "will ensure that general dental services provide only those treatments which are clinically essential and for which there is no clinically acceptable, less costly, alternative".

Dentists worry that this means standards will be cut and more red tape introduced. David Shapiro, of private dental plan Complete Direct Care (CDC), said, "The increase in paperwork will make it impossible for dentists to stay in the NHS." Crossing the divide from NHS to private practice is not as drastic a step for patients as it once was. Non-exempt adults are charged 80 per cent of their NHS costs, so the increase for private treatment is not usually punishing. The spread of capitation schemes helps ease the pain by smoothing payments to monthly amounts for long term preventative and continuing dental care.

Unlike insurance, which is taken out in the hope it will not be needed, capitation gives patients what they pay for. Most plans include supplementary insurance cover for emergency treatment and treatment resulting from injury. There are several plans available from dentists, which vary in detail in how they charge and what they cover.

Denplan, owned by medical insurer Private Patients Plan, has signed up 5,500 dentists - a quarter of UK dentists - and 630,000 patients. It has five fee categories with discounts for children and other groups. More than 90 per cent of patients pay between pounds 5-pounds 15 a month. Unlike some of its competitors, Denplan does not offer lower prices for less care, but puts patients in a fee band according to the state of their teeth and location of the practice.

CDC has more than 800 dentists and 60,000 patients. It stresses its low administration charge at 98 pence a month and lack of joining fee. Dentists set their own fees and and charge each patient a different amount or everyone the same. Average charges to patients outside London are pounds 8 and inside London are pounds 10.50.

BUPA Dental Cover entered the market at the start of last year, some eight years behind Denplan, but has signed up 2,650 dentists and 45,000 patients. There is nothing to stop dentists offering both Denplan and BUPA and many do.

BUPA has five fee bands, with dentists choosing what to charge according to the state of a patient's mouth and their own overheads. Patients can choose to exclude expensive treatment to reduce monthly payments. The average monthly subscription is pounds 11, says BUPA.

Norwich Union also launched a capitation scheme at the start of last year, but it determines fee levels rather than the dentist. It offers four levels of cover and three cost areas depending on location. Plan One, which covers check-ups, scale and polish, X-rays and emergency cover costs pounds 5.85 a month in cheaper locations. Plan Four, which includes bridgework and dentures, costs pounds 16.90 in ritzy areas.

Clindent levies no administration charge, but makes its money through the pounds 24 annual insurance fee for protection against accident, sickness, redundancy or trauma to teeth. Densure, with 70 dentists and 3,000 patients, like Norwich Union offers set price plans allowing the patient to choose the level of care required.

As well as an expanding individual market, corporate dental plans are growing in popularity. Employers see dental cover as a valuable perk to offer employees, mostly on an insurance basis. Alternatively, employers will offer to meet a proportion of employees' dental costs on a co-payment basis or negotiate a bulk discount with dental practices, but employees pay their own way.

Start your day with The Independent, sign up for daily news emails
ebooks
ebooksA celebration of British elections
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs Money & Business

Recruitment Genius: Claims Administrator

£16000 - £18500 per annum: Recruitment Genius: This is an excellent opportunit...

Recruitment Genius: Senior SEO Executive

£24000 - £28000 per annum: Recruitment Genius: A Senior SEO Executive is requi...

Recruitment Genius: Online Customer Service Administrator

£16000 - £18000 per annum: Recruitment Genius: An Online customer Service Admi...

Recruitment Genius: Digital Marketing Executive

£18000 - £22000 per annum: Recruitment Genius: This global, industry leading, ...

Day In a Page

Fishing for votes with Nigel Farage: The Ukip leader shows how he can work an audience as he casts his line to the disaffected of Grimsby

Fishing is on Nigel Farage's mind

Ukip leader casts a line to the disaffected
Who is bombing whom in the Middle East? It's amazing they don't all hit each other

Who is bombing whom in the Middle East?

Robert Fisk untangles the countries and factions
China's influence on fashion: At the top of the game both creatively and commercially

China's influence on fashion

At the top of the game both creatively and commercially
Lord O’Donnell: Former cabinet secretary on the election and life away from the levers of power

The man known as GOD has a reputation for getting the job done

Lord O'Donnell's three principles of rule
Rainbow shades: It's all bright on the night

Rainbow shades

It's all bright on the night
'It was first time I had ever tasted chocolate. I kept a piece, and when Amsterdam was liberated, I gave it to the first Allied soldier I saw'

Bread from heaven

Dutch survivors thank RAF for World War II drop that saved millions
Britain will be 'run for the wealthy and powerful' if Tories retain power - Labour

How 'the Axe' helped Labour

UK will be 'run for the wealthy and powerful' if Tories retain power
Rare and exclusive video shows the horrific price paid by activists for challenging the rule of jihadist extremists in Syria

The price to be paid for challenging the rule of extremists

A revolution now 'consuming its own children'
Welcome to the world of Megagames

Welcome to the world of Megagames

300 players take part in Watch the Skies! board game in London
'Nymphomaniac' actress reveals what it was really like to star in one of the most explicit films ever

Charlotte Gainsbourg on 'Nymphomaniac'

Starring in one of the most explicit films ever
Robert Fisk in Abu Dhabi: The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers

Robert Fisk in Abu Dhabi

The Emirates' out-of-sight migrant workers helping to build the dream projects of its rulers
Vince Cable interview: Charging fees for employment tribunals was 'a very bad move'

Vince Cable exclusive interview

Charging fees for employment tribunals was 'a very bad move'
Iwan Rheon interview: Game of Thrones star returns to his Welsh roots to record debut album

Iwan Rheon is returning to his Welsh roots

Rheon is best known for his role as the Bastard of Bolton. It's gruelling playing a sadistic torturer, he tells Craig McLean, but it hasn't stopped him recording an album of Welsh psychedelia
Russell Brand's interview with Ed Miliband has got everyone talking about The Trews

Everyone is talking about The Trews

Russell Brand's 'true news' videos attract millions of viewers. But today's 'Milibrand' interview introduced his resolutely amateurish style to a whole new crowd
Morne Hardenberg interview: Cameraman for BBC's upcoming show Shark on filming the ocean's most dangerous predator

It's time for my close-up

Meet the man who films great whites for a living