Clydebank dentist warns he'll have to scale back on NHS treatment

Stuart McGrow, principal dentist at DB Dental Care, said the whole dental care system in Scotland needs a rethink due to the “outdated” NHS contract between the Scottish Government and oral physicians.

Speaking exclusively to the Post, he warned that the contract limited the types of treatments they could do, but also the length of time spend on them.

Mr McGrow is down to just himself to serve 4,000 patients at his practice. He said he is still struggling financially to run off NHS treatments.

He said: “Going forward I’m in a situation where I am going to have to stop doing that and move to a more private base.

“At the end of the day, I have been forced into that from the government.”

Mr McGrow has been reduced from three dental surgeons to just himself

Last week the British Dental Association’s Scottish dental practice committee slammed the Scottish Government for rejecting a bid to extend financial support to dentists beyond March.

Morale in the procession is reported to be at an all-time low, with more than a third of dentists intending to leave in the next 12 months. And 80 per cent of professionals plan to reduce their NHS commitment.

Mr McGrow, who bought his Kilbowie Road practice a year after starting there in 2012, grew it to three dental care professionals before the pandemic hit. But he said the problems with dental care started long before Covid-19.

The system works on a code basis, with procedures listed by code, which is then used to claim reimbursement from an NHS health board.

Even though patients must pay for them, NHS treatments are far cheaper than private ones. A root canal would cost £65 on the NHS, but a private procedure would cost a lot more.

Most practices have NHS-registered patients, but dentists argue there isn’t enough funding for those patients to ensure the best care for mouths.

Mr McGrow said: “We can’t actually provide the dental treatment that is fit for purpose, that is the actual treatment of choice for these teeth. A hell of a lot of times we can’t actually properly fix the problem.

“The funding that we get from the government in terms of doing these treatments isn’t sufficient to take the time appropriate, and what’s actually available isn’t enough. So we are constantly working as a profession with our hands behind the back when we’ve got problems.

Although he will still be providing NHS treatments, he will have to reduce this and go to a more private base

“A patient put it quite rightly: they expect when patients go to the dentist, they think it’s like going to the doctor. If they go to the doctor with a problem, the doctor fixes it, the GP will refer them to a specialist department, whether it be for hearts or backs or whatever, then they’ll get that problem sorted with the best materials, the best equipment.

“In dentistry, that is not the case because we all run our own practices and own businesses, we’ve got to budget for the materials.

“If the health board give us £12 for doing a filling, we can’t use the best materials to do that filling. We’ve got to budget for these materials and do the job to actually make a profit – to keep our businesses afloat.

“There’s been a fundamental problem in dentistry for a hell of a long time.”

Mr McGrow explained that a number of coded procedures could be crammed into one 10-minute appointment, such as a check-up, a scale and polish, and an x-ray. But even when reimbursed together, NHS payments don’t cover the business outgoings.

He said his own practice mortgage is £3,000 a month, which he worked out is £11 an hour. If he gets £12 for a scaling, he has to include time to clean the room after each visit.

Dental practices also get money for each patient on their books, but Mr McGrow said he wasn’t comfortable with a “conveyor belt” approach requiring a maximum number of patients.

He said: “I don’t think it’s right that any healthcare professional has to work with those restrictions. It’s about patient care and that can’t be done with a conveyor belt approach and the government has known this for a long time.

“The actual contract that we’ve got started in the early 1990s so it’s 30 years old now. In that time material costs have gone up, laboratory charges have gone up, all the charges have gone up, but the fees that we get from the practice from the petitioner services hasn’t.”

The Scottish Government has been paying practices for 85 per cent of treatments they were doing pre-Covid. But they must keep 95 per cent of their registered patients and do at least 20 per cent of the work they did before the pandemic.

That funding approach ends this month.