Another Reason to Celebrate

Apparently my husband has now been a dentist for 20 years. He thinks yesterday was his first day working, which is remarkable for him as he is generally useless with dates.

His first year of working life ended up rather fraught as within three months of being qualified he was accused by a nutty patient (and he was truly truly bonkers) of having crowned the wrong tooth. Said patient bombarded the local healthcare trust with letters talking about Spouse's "rouged lips" and the way he "comes at me from behind wearing a buff coloured mask". He also roundly abused the good constabulary of the Weybridge area where Spouse was working at the time, all of whom were apparently gay. Despite the obvious timewasting crap of his letters, the healthcare were obliged to investigate and Spouse ended up going to a tribunal where Loony Tunes discovered that yes, in fact, he had had the right tooth crowned. It was a total waste of time for all concerned, and caused Spouse a considerable degree of stress at the time.

I was of course a loving supportive wife, etc, etc (oh actually we weren't quite married then,but you know what I mean). But the writing bit of me never goes to sleep apparently, and the genesis of Strictly Love was formed then. I really loathe the litigation culture we have here now, which Spouse had a first dismal taster of twenty years ago, and so I wanted to write about it. While undoubtedly, there are people who do things wrong in all areas of the medical profession, it is my belief that the majority of them are trying to do the right thing, and the threat of being sued does no one (least of all the patient) much good.

So my hero dentist, Mark, gets sued by one of his zedlebrity patients for breach of trust, and I hope I've shown the devastation that an action which she takes relatively lightly can cause. As this is romantic fiction, I hope it's not too heavy and message laden - you do get lots of dancing thrown in, I promise - but I also don't see why you can't mix serious stuff into popular culture too.

And as Spouse has spent twenty years at the coalface (how the fuck did that happen anyway? Yesterday we were twenty), I'd just like to raise a metaphorical glass to him and all the teeth he has drilled, filled, cleaned and extracted over the last two decades. Someone's got to do it...

A Word on NHS Dentists....

As no doubt you all know, getting an NHS dentist is as easy as pulling hen's teeth, or whatever the expression is.

Apart from, if like me, you are married to one of the rarest of breeds.

I am not going to talk about this issue at length, because Spouse doesn't like me too, but I will just say this to Rosie Winterton who I heard pontificating ad nauseam yesterday on the Jeremy Vine show...

MOST NHS dentists don't choose to become private (if anything the bureacracy and form filling is even more scary when you don't have the NHS behind you) but have been forced into it by successive government policies. And Tony Blair's promise of NHS dentistry for all is sounding increasingly hollow. But hey, what does he care? He's out of here, soon and I doubt Gordy cares too much about NHS dentistry...

Many years ago under the Tories, NHS dentists were set targets to improve patient care. If you bring x number of patients in they were told you will get y amount of money. Being a hardworking and dutiful bunch, they did as they were told, only for the government to turn round and say, Oh shit, we didn't expect you to actually achieve that target, what we really meant is for you to bring in z number of patients. That was in 1991, and as a result of this constant shifting of goal posts loads of NHS dentists decamped and went private.

Scroll forward to now and we are just about to celebrate the anniversary of the new contract between dentists and the NHS, imposed on them from above, it is a contract that the majority of dentists didn't want. In theory the contract is supposed to take them off the treadmill of the NHS. Now instead of being paid per item of treatment, they get paid depending on how many units of dental activity they have achieved. No problem, you might say until you realise that we are not measuring like with like here.

For example, this time last year if you came in with a bog standard filling, you would have paid, say fifteen pounds, half of which went to the dentist, the other half of which went to cover the running costs of the practice. If you came in needing two bog standard fillings, plus several big fillings in your back teeth, you would have paid individually for each of them, paying more for the more difficult ones.

Not anymore you don't. The powers that be decree that if you come in in need of fillings, how ever many you need, that counts as one unit of dental activity. So now if you come in with a bog standard filling it costs more for you, and you lose out, but if you come in needing loads of fillings, you pay less, but the dentist loses out because he does all that work but gets paid the same as if he had done one filling.

I should also add here, that this is not about dentists feeling badly treated in terms of their pay (though without a doubt they are going to see it reduced over the next few years), but about them feeling they cannot provide the sort of service they want to under the new system. Most of the dentists I know (Spouse included) are highly professional, ethical and have a strong sense of wanting to do the very best for their patients. A system which allows benign neglect (as a patient you now only have to see a dentist once a year), and doesn't pay enough for dentists to spend the necessary time/use the best quality materials is always going to be one that lets the patients down. And that is where we're at, folks.

And far from being taken off the treadmill, the sense of being a rat in a run has increased a hundredfold, as twinkling away in the corner of the computer screen are numbers assessing how close to your target no of UDAs you are. At the beginning of this year Spouse was 13% behind -with the threat that if he didn't make it up, he would have not got paid for March.

They really now how to motivate people in Rosie Winterton's department...

Luckily, he has done it, but it has been a hell of a stressful ride.

Is it any wonder NHS dentists are deserting the sinking ship in droves? Or that the ones we have are mainly Polish?

Next week Spouse gets set a new target, and the whole rigmarole will start again.

I can't wait for this time next year...


PS Two days to go and counting...