A patients’ group has defended a survey which sparked global headlines about do-it-yourself dentistry in the UK.
The Dentistry Watch survey, overseen by the Commission for Patient and Public Involvement in Health, asked more than 5,200 patients and 750 dentists in England for their views on today’s dental service.
It found six per cent of respondents (276 people) had resorted to self-medication – including pulling out their own teeth – because they were unable to access NHS services. The survey cited a handful of examples of people who spoke of extracting teeth or fixing broken crowns with glue. One person questioned in Lancashire spoke of carrying out 14 separate extractions with pliers.
It led to a flurry of damning newspaper headlines, including ‘Rise of the DIY Dentist’ and ‘Don’t Call That Dentist, Hand Me the Pliers’.
Shadow Health Minister Mike Penning said the report was proof of the ‘crisis’ the government had created and said: ‘It is shocking that patients are being forced to resort to Victorian practices like pulling out their own teeth.’
But following the release of the survey, on October 15, the government hit out at what it called the ‘sensationalist’ reporting of its findings.
Baroness Royall of Blaisdon, who speaks for the government on health issues, told the House of Lords the situation was ‘much brighter’ than the one portrayed by opposition politicians and the media. She said: ‘There is absolutely no reason for anyone to resort to self-treatment. The cases that were outlined by the media were absolutely sensationalist – there are very few such cases.’
The Baroness pointed out that the survey also found 93% of patients were ‘content’ with their dental treatment.
But Sharon Grant, chairwoman of the Commission for Patient and Public Involvement in Health, told Dentistry the government’s ‘defensive’ response to the survey was unhelpful. She warned that the difficulties patients were having in seeing an NHS dentist, as identified by the survey, might cause self-treatment to increase unless action was taken.
Mrs Grant said: ‘We have to report what we find. It was the case that a small but worrying number of people reported they have resorted to treating themselves. We reported that finding along with a number of others which show some trends that cause concern.
‘If you put those trends together I think one could reasonably deduce there might be a lot more people treating themselves in future. If we get more dentists exiting NHS dentistry it will become even harder for people to find dentists, certainly at the lower end of the income scale.’
Pointing out that the Dentistry Watch survey was carried out by patient volunteers, she added: ‘When patients themselves who are active on health issues go out and take the trouble to ask other patients how they are faring under the system, we think the government needs to look seriously at the responses.
‘If we are going to have a patient-focused and centred NHS, with which the public is engaged, then where there are serious concerns it is important the government takes them away and looks at them, then comes back with some serious proposals to address those concerns. A defensive response is less than helpful.’
The survey also found that 78% of private dental patients had left the NHS because either their dentist stopped treating NHS patients, or because they could not find an NHS dentist. Only 15% of respondents claimed they had switched to private because they believed they got better treatment.
Thirty-five per cent of those not currently using dental services said it was because there was no NHS dentist near where they lived and almost 20% of NHS patients had gone without treatment because of the cost. In addition, 84% of dentists questioned said the new contracts had failed to make it easier for patients to get an NHS appointment.
Susie Sanderson, chair of the British Dental Association’s Executive Board, said: ‘The picture it paints, of patients unable to access care, dentists struggling with the target-driven system and anxieties about the new charging system, is an all-too-familiar one.
‘The new contract has done nothing to improve access for patients and failed to allow dentists to deliver the kind of modern, preventive treatment they want to give.’
Quentin Skinner, chairman of DPAS, the payment collection agent, said: ‘Reduced access, perfunctory dental examinations, a new treadmill replacing the old one – this survey confirms high levels of dissatisfaction on all sides. However, the remarkable level of patient loyalty and satisfaction with their own NHS dentist is also clear. The survey indicates that patients will stay with their own dentist even if it means having to go private.
‘Interestingly, a minority of patients (40%) feel that NHS dentistry offers good value for money – however, the majority of respondents who paid for private dental plans (57%) felt this was good value for money. Patients consider private dental plans as “a good affordable flexible” option. Compounding this is the fact that the majority of dentists themselves (52%) believe that NHS patients get a worse quality of service than their private patients.’
By Andy Tate, parliamentary correspondent