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Letters: Dental care

Dentists are too eager to push patients into private treatment

Friday 11 January 2008 01:00 GMT
Comments

Sir: "British dental care the most expensive in Europe" (10 January): no surprise there. I qualified as a dental surgeon in 1962 and spent most of my practising life working in the NHS as a general practitioner and in the hospital service. I made a comfortable living, could sleep at night and had no desire to join the "yacht in the marina" brigade.

Quite early on I was astonished at the greed of some of my colleagues. One I knew quite well as a competent and respected professional decided that he was worth more than could be legitimately earned on the fee per item system operated by the NHS at that time, so he would often drill and fill a few extra cavities (totally clinically unnecessary) to make up the deficiency. An extreme example perhaps, but undoubtedly "over prescription" was common practice at that time. The alternative for those with an inflated sense of their own worth was to go private, but the demand for private treatment was not so great back then.

The Government changed the rules in an attempt to redress the situation, but it is manifestly not working. The rot set in when "marketing" of skills became the fashion, rather than providing a competent service where clinically indicated. Even the British Dental Association climbed on this bandwagon and promoted courses on the marketing of dental skills.

The new contract for NHS dental practitioners has proved unpopular with the profession. It is quite common for patients to be accepted on the NHS, only to be told that this or that item of treatment is either not available on the NHS, or can be done much better privately, neither of which is usually true. I am pleased that our European colleagues are breaking this inflated-fee stranglehold. As a retired dentist, I am not proud of the direction my profession has taken.

John St Pierre

Lewes, East Sussex

Sir: I found your article on dentistry misleading. The majority of patients in this country receive their dental care from the NHS, where charges are much lower and cover entire courses of treatment. The old system had around 400 separate individual fees. Now we have just three fees and we have cut the maximum possible charge by 50 per cent (down from £384 to the current £194).

We are determined to increase access to NHS dentistry. Under the new system we have introduced, if a dentist retires, leaves the area or stops providing NHS services, the local NHS keeps the funding and can use it to bring in other services. This has resulted in an increase in the number of dental services available in areas where access was previously poor. A survey by the Greater London Assembly concluded in November that London is well served for NHS dentistry.

We have also increased by 25 per cent the number of dental undergraduates who will begin to graduate from 2009 and next year the NHS will be receiving an 11 per cent increase in funding for dentistry.

Ann Keen

Parliamentary Under-Secretary of State, Department of Health, London SW1

Give 'scroungers' a chance to work

Sir: Peter Stanford is spot on in puncturing the populist belief currently espoused by our leading political parties that disabled people fake their impairment in order to avoid work (Opinion, 9 January).

This stereotype is not only offensive, but untrue, and completely overlooks the root causes of why many disabled people are not in employment. This is not just about flexible working arrangements or physical adjustments; many employers are still reluctant to take on disabled employees, and there is a serious lack of specialist support for those who have been out of work the longest.

Scope has worked hard to increase the number of disabled people it employs and we are sharing our experiences with many leading companies. However, until the "lazy scrounger" stereotypes are replaced with an understanding of the real reasons disabled people find it hard to enter employment, there will be no progress at all.

Andy Rickell

Executive Director, Scope, London N7

Sir: Thank you to Peter Stanford for so eloquently articulating the arguments that have been tumbling around my own head over the past few days.

At the weekend, we were treated to David Cameron's prescription for sorting out "welfare scroungers". Then on Tuesday your paper reported on an Israeli billionaire, the latest in a long line of such people who have chosen to live tax free in London because by doing so they can escape paying tax in their own countries. Let's not mention the British people who manage to avoid our tax system by living abroad in their second, third, fourth homes for much of the year. Or the CEOs of large corporations who oversee spectacular losses yet still seem to "earn" obscene bonuses. Or the MPs who have taken us all for a ride with their expenses and legitimised shady practices. I await Mr Cameron's equitable application of his moral code to these parasitic scroungers also.

At Age Concern Halton, we conducted a survey a few years ago among the elderly people and their carers on our patch to discover what the take-up of benefits, particularly disablement benefit, actually was. Most people are simply too proud to claim. We found that 90 per cent of those we were able to help were successful in claiming their entitlements, which has made a considerable difference to their quality of life.

Josephine Fenton

Vice-chair, Age Concern Halton, Frodsham, Cheshire

Sir: I was disappointed to read Peter Stanford's opinion piece regarding the Conservative Party's announcement on welfare reform. He clearly wrote his comment before he had the opportunity to read our full proposals on welfare reform and out-of-work benefits.

We have been clear that disabled people with impairments that prevent them from working will not be expected to undergo repeated assessments, take on work, or lose their welfare support. They will continue to receive the proper support that they require and deserve.

There are, as Mr Stanford points out, many disabled people who do want to get into work. Our plans will provide considerable support for people who want to get back into work, providing training and ongoing support.

We can and will do more to tackle prejudice in the workplace and encourage companies and organisations to take on disabled employees more widely.

I have sent a copy of our Green Paper to Mr Stanford and I hope that he will take the opportunity to study it in detail.

Mark Harper MP

Shadow Minister for Disabled People, London SW1

Sir: With Labour and the Tories competing as to who can look tougher on the unemployed, it seems likely that some form of compulsory community service will be introduced before very long. Meanwhile, the Sentencing Guidelines Council now apparently considers that community service is a more appropriate sentence than prison for drivers who kill. So there you have it: being unemployed is now officially regarded as morally equivalent to manslaughter.

Mike Wright

Nuneaton, Warwickshire

Reasons behind our challenge to bequest

Sir: Your leading article "Where there's a will..." (3 January) mentions the recent legal battle fought over the will left by our late aunt, Golda Bechal, and wrongly implies that we, her relatives, challenged the will because we believed her money was "rightfully" ours, and that we should inherit her estate.

As was made clear in the family statement after the judgment, we did not go to the High Court as "jealous" relatives; we did so in order to try to ensure that charities, not family, or indeed friends, would inherit millions of pounds. After the tragic death of her husband in 1971 and her only son in 1974, our aunt had made clear to us, and to her solicitor and accountant, that she intended to perpetuate her family name by leaving at least 80 per cent of her multimillion pound estate to various charities.

Our intention from the outset, as made clear to the Treasury Solicitor representing the charities, was to reinstate a will to this effect made by our aunt in 1988.

Marian Lebor (on behalf of Golda Bechal's family) Raanana, Israel

The plot to get rid of telephone boxes

Sir: BT has started a new tactic in its campaign to get rid of payphones. It has removed the coin boxes from all our local payphones. The only way to make calls is to use a phone card or a credit card or to reverse the charges.

Reversing the charge is not really a useful option. A phone box is typically used where reverse charges are not accepted, such as phoning for a taxi, train information, or a hotel. The £3.48 minimum charge will also be a serious deterrent. There will be a £1.20 minimum charge for using a credit card – another deterrent.

It has been obvious all along that BT wants to get rid of phone boxes completely. Removing the coin boxes will lead to a big reduction in usage, and it will use this to justify removing them altogether.

Paul Adkins

Tetbury, Gloucestershire

The Pope is a serious astronomer

Sir: Your Rome correspondent, Peter Popham, is indulging in some conspiracy theory. He interprets the Vatican observatory's move, from the Pope's residence at Castel Gandolfo to a larger building nearby, as Benedict XVI's being cool on science and astronomy (4 January).

What he fails to mention is that the principal Vatican Observatory Research Group has for many years been operating much further from Castel Gandolfo – at the Vatican's Mount Graham international observatory in southern Arizona. Light pollution and air pollution are much less there than near Rome.

Pope Benedict is a leading advocate of the role of reason in theology . One of his main points is the rationality, as opposed to arbitrariness, of the Creator. Recent astronomical discoveries invite us to contemplate this rationality and design in the heavens more deeply than our ancestors ever could.

Rev Dr Francis Marsden

St Mary's Chorley, Lancashire

Imagine Route 443 in your own garden

Sir: Dr Tom Weinberger urges your readers "to consider their own response" to attacks on Israelis on Route 443 (letter, 7 January). This got me thinking: what would Dr Weinberger's response be if he found that his neighbour had built a shed in his yard and that a new path had appeared connecting the shed to his neighbour's house?

This hypothetical path is protected on both sides by barbed-wire fences with a gateway, manned by soldiers, for Dr Weinberger to leave his property. I trust the doctor would be willing to wait at the checkpoint until a soldier deigned to examine his papers and allow him to go to work. I suspect his neighbour will be grateful that they will not have to use "self-defence" to ensure Dr Weinberger's cooperation.

Jack Downey

Caherdavin, Co Limerick, Ireland

Sparrows crossing Atlantic on the 'QE2'

Sir: A group of North American sparrows, living on the QE2 and fed by soft-hearted seamen and passengers, accompanied us from Canada to Southampton last year ("No privacy for white-crowned sparrow on rare visit to Britain", 10 January). A falcon swooped magnificently over them for the first part of the voyage, but enough sparrows survived the entire journey to the UK.

I had the impression that this was not the first time that a group of sparrows had made a similar journey on a ship. Might there be a colony of transatlantic sparrows in Hampshire?

Professor Richard Wilson

Oxford

Briefly...

Bar counsel

Sir: Perhaps Dr Helen Lomax is not one of the many parents who take children to pubs and ignore them so much that they become a nuisance to all concerned (Letters, 9 January). Staff are helpless in curbing the activities of these little terrors, and rather than teaching their children discipline the parents merely smile at their antics. Are they really responsible adults?

Paul Gilbert

Solihull, West Midlands

Poll position

Sir: Your correspondents comment on how the voters of New Hampshire "confounded the pollsters" (letters, 10 January). Living in New Hampshire during the presidential primary season, we are continuously pestered by politicians and pollsters. For the month before the primary, I stopped viewing commercial TV stations and did not answer my telephone unless I knew the caller. In the past, however, before I had caller ID, my approach to pollsters was to lie. I am not the only liar in New Hampshire.

Donald H Eckhardt

Canterbury, New Hampshire, USa

Different daffodils

Sir: At last, a correspondent on early-blooming daffodils has the perspicacity to mention "varieties" (Letters, 9 January). The Royal Horticultural Society's A-Z Encyclopaedia of Garden Plants lists numerous varieties of daffodil, and their flowering times include "autumn to spring" and ""mid- to late spring and early summer". Furthermore, purchased bulbs may have been treated to alter flowering time. Anyone who wants to contribute useful observations on climate change or seasonal variation should record the flowering time of the same groups of naturalised plants for many decades.

Dr John Etherington

Llanhowell, Pembrokeshire

Another alternative

Sir: Frank Lawton unfortunately falls foul of the pedantry trap himself (Letters, 9 January). He claims that alternative means "either one way or the other"; the correct definition is "either one way or another". Fowler's Modern English Usage says: "The notion that because it is derived from Latin 'alter' (one or the other of two) 'alternative' cannot be used of a choice between more than two possibilities is a fetish." I do, however, agree with his identification of Guy Keleny's "two alternative meanings" tautology.

Tim Strouts

London SW19

Liberal sentiments

Sir: As a neo-liberal, I am pleased that Kelvin Hopkins, the Labour MP for Luton North, holds us responsible for the disillusionment of millions of voters (Letters, 9 January). I think I know the sort of illusions he feels nostalgic for, and I wish him no luck at all in his attempts to foist them all on us again.

Godfrey Marriott

Ware, Hertfordshire

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