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Dentist pays price of NHS contract: Nicholas Timmins compares MPs' costs with the problems faced by a dentist who is in dispute over his contract

Nicholas Timmins
Wednesday 15 July 1992 23:02 BST
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'I WISH I could do that,' said Trevor Payne, 18 years a dentist in Barnet, north London, as he contemplated MPs voting down the Government yesterday to give themselves a 38 per cent increase in office expenses to pounds 40 short of pounds 40,000 a year.

His income - from which he has to meet treatment costs - is pounds 80,000. That is pounds 1,600 below what MPs will now get, made up of pounds 30,854 salary, pounds 39,960 office costs allowance and up to pounds 10,786 in London supplement and other allowances covering rent, hotel bills and subsistence for MPs outside inner London when on parliamentary business away from home.

Mr Payne, 44, is one of the 17,000 dentists currently in dispute with Virginia Bottomley, the Secretary of State for Health. The dentists' review body gave them an 8 per cent pay rise this year. But earnings from fees under the new dentists' contract have proved higher than expected. The average 8 per cent pay rise is thus being matched by a 7 per cent cut in fees. Given that the amount dentists earn is what they have left over after they have paid the bills connected with their work - unlike MPs, who get a salary - they are none too happy.

Mr Payne says his pounds 80,000 is made up of pounds 75,000 from the NHS and some pounds 5,000 from private practice. He has about 1,600 patients, 400 of them children. His biggest single expense, he says, is laboratory fees for the manufacture of dentures, crowns and the like, followed by staff salaries for a receptionist and nurse.

But the most irritating expense, he says, is the overdraft costs of pounds 1,500 a year. These are incurred because the NHS pays him, at best, a month in arrears; at worst, three months. It can be longer if there is a query on the bill. Added to this is the fact that dentists can charge the NHS only when a course of treatment is completed. 'Some of the bigger treatments can take three to four months to complete, and obviously I have to pay out the laboratory costs on those up-front,' he says.

A new expense he faces is pounds 8,500 to be paid over five years for a computer system and the cost of training staff to use it - an expense which he says the new contract has made essential. Although the new contract was supposed to involve dentists in less form-filling, he believes it has produced more. 'We've tried to keep up manually and it is literally impossible.'

After expenses that come to more than pounds 50,000, Mr Payne says he takes home less than pounds 30,000, gets nothing for paperwork he does at home, and has only an pounds 800-a-year allowance for his car which he uses for visiting patients at home.

MPs, on top of their office costs allowance, get free stationery, phone calls and postage at Westminster, free first-class travel by rail or air, and a mileage allowance worth up to pounds 15,345, without proof of mileage, if they drive a 2.3 litre car for 25,000 miles.

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