With contract values changing, should we now start ending the era of the ‘Ten Quid Dentist’, Alun Rees questions.

In George Bernard Shaw’s play, You never can tell, the opening scene is set in a dental surgery.

We are introduced to Mr Valentine the dentist, who has just treated his first patient six weeks after renting the room in this seaside town.

The dentist has just removed a tooth from an 18-year-old patient.

His fee is five shillings; had the patient chosen to have a general anaesthetic there would have been a further fee of five shillings.

He explains his fee scale of five shillings for everything because, as he tells her: ‘I am what’s called a five shilling dentist.’

Associates

I was reminded of Mr Valentine and Dolly, his debut in private practice, a couple of weeks ago during a conversation with a dentist who had just bought a ‘mixed’ practice.

They had just taken on an associate to run the NHS contract agreeing to pay them £10 per UDA; the contract UDA value was £30.

I asked if the associate knew they would be earning 33% of gross (less after lab bills deduction) and was told that there was no intention of telling them.

Make your own mind up about the rights or wrongs of starting a working relationship that way.

It brought home how many adverts for associates I have seen since 2006 that offer ‘£10 per UDA’ and how that figure has stayed constant in spite of the rise of the contract values.

I know the arguments about increasing expenses better than most, but with rising profits for NHS principals and falling associate income (NASDAL figures), one can see a clear shift in the balance of power.

In 2002 when the BDA conference debated, ‘associates are parasites and bleed practices dry,’ nobody could have predicted the era of the ‘Ten Quid Dentist’.

You never can tell.