Fife dental practice 'forced to privatise for survival' as NHS lists cut

A Fife dental practice has opened up about the challenges facing NHS dentistry after it was forced to privatise for survival.

The Dalgety Bay Dental Practice announced on social media this week that it is turning towards private care and reducing its NHS lists after much consideration.

“Due to the current crisis within the NHS and no foreseeable solution, it is with regret that we are no longer registering new NHS patients and to ensure the survival of our practice we are also reducing our NHS lists. All children under the age of 18 years will still be seen under the NHS,” the practice announced on Facebook.

Following the announcement, dentist and practice co-owner Sergey Grihanov opened up about the decision.

He described being overworked and underpaid as an NHS dentist.

Mr Grihanov and his wife have owned and operated the practice for the past ten years. They currently serve approximately 5,000 NHS patients between two dentists and are struggling to survive financially.

“We’ve always been NHS,” he said. “I believed in NHS but every year for the last five years has become worse and worse, and every year we were getting promises from health boards about improvements but nothing happens.

“Now we’re in the position of working almost for free after paying all the laboratory bills and expenses. We only just managed to survive the last couple of years by doing our private work.”

The costs of NHS dentistry treatments are set by the Scottish Government which has announced a 6% cost increase for treatments from November.

However, NHS dentists are currently paid £150 to provide dentures and just £12 for scaling and polishing services.

“From the NHS we get £150 dentures. I have to pay about £90-100 for the laboratory so that means for us as a dentist we get £50 for four or five, for materials, for reception, for nurses, and what’s left over for the dentist? Obviously nothing,” he said.

“And for £12 you can’t sit for 30 minutes and do cleaning and oral hygiene. Plus if you just do scale and polish for three minutes, what kind of quality are we talking about?”

Mr Grihanov continued: “I’d rather see eight to 10 patients per day and do quality treatment than see 40 people per day where I don’t even have the time to go to the toilet while working with the NHS.”

The Scottish Government announced the 6% increases for NHS treatments last week. Jenni Minto, Minister for Public Health, said it represented “the biggest change to NHS dental services in many years.”

The reforms include an extra £10m to support the delivery of lab-based treatment items, such as dentures. It also streamlined ‘item of service payments, reducing the number of fees from over 700 to 45.

However, Mr Grihanov highlighted that under the reforms, most patients will only be able to visit the dentist once every 12 months instead of once every six months for check ups.

He said it has not been easy to make this decision: “I’ve seen my patients for ten years and I know them so well. Now every time they come for a check up we explain the problem and after we have to say ‘I’m sorry, goodbye, that was your last visit’ and it’s quite sad,” he said.

“Of course people are upset and sad. Older people, especially, feel really frustrated – especially when you tell them they have to go around and find another practice to accept them as an NHS patient. We know nobody accepts new NHS patients anymore. It’s very sad and frustrating for them and they don’t know what to do.”

He continued: “Obviously more and more patients will struggle to find a dentis, and then more and more go to an emergency dentist. There are so many unregistered patients that need help but nobody can give them it. The emergency dentist just gives them antibiotics over the weekend and tells them ‘OK go find a dentist who will do a root canal,’ but nobody will accept new patients so it’s a vicious circle.”

NHS Fife clarified that Dalgety Bay Dental Practice is an independent dental practice and operates as a private business.

“NHS Fife does not have responsibility for delivering routine care for dental patients, and remuneration for NHS dentistry is set by the Scottish Government,” a spokesperson said. “Nationally and in Fife, there are challenges for patients who wish to register with an NHS dentist and we are aware of the situation with regards to the Dalgety Bay Dental Practice.”