The new Statement of Dental Remuneration (SDR) – is it worth the paper it’s written on?
A new streamlined SDR was unveiled at the end of the summer to mixed reviews. Practice Plan regional support manager Joanne Phoenix spoke to dentist and chair of the Scottish Dental Association Douglas Thain to hear his views.
I have spoken to a number of dentists and their views on the new SDR seem to vary a lot. Those who actively want to remain within the NHS see it as a reason to stay, while those wanting to leave feel it bolsters their case. How do you view it?
In normal times this might have been looked upon as something quite positive and I think a lot of people are seeing it as a positive move. They see the extraction fees are better as are the denture fees, although clearly the labs are likely to increase their fees in line with that. So, we may not be that much better off.
From an associate’s perspective, I think it works better than it does for a practice owner because the restorative treatments aren’t paid much better overall and restoratives account for the bulk of our costs in terms of materials.
However, it doesn’t come anywhere near to covering just how much our costs have risen and the amount of money we’ve lost over the past year or so. The real question is, will it attract dentists who’ve either left NHS dentistry or taken a much bigger private split to change back? And I don’t see that being the case.
I have never heard of a dentist who gave up NHS dentistry going back to it.
I’m sure that’s the case.
I feel the big problem is the obsession with items of service being done. Even Jason Leitch, the national clinical director spoke up saying the trouble is we need a system that pays for widgets but also pays for background care.
But this kind of bizarre obsession with the balance between paying for ‘widgets’ as he calls them, is the whole root of the problem. The government is basing things on a business model that hasn’t worked for 20 years or so. Dentists from 20 years ago who opened the equivalent of NHS factories turning out items of service have now turned their backs on them.
The driven, ambitious types don’t see the NHS as their future so the whole model of high volume work just isn’t there anymore and that’s where the fees were originally based.
So, without going back to that volume of work, the model just isn’t going to work.
I get the impression there’s hope amongst the powers that be that these new measures will tempt some dentists back. Is that likely given what we said earlier about dentists leaving for private dentistry and never looking back?
In some ways I think the damage has been done. I know of practices that, through a combination of being unable to recruit and dentists retiring, seem to be existing on just part-time locum cover at the moment.
If we had the continuing care payments and just looked after emergencies, we’d probably be making more money than we are by doing the right thing and trying to treat our regular patients. In the meantime, our costs have skyrocketed. Our lab bills are through the roof and we’re paying two or three times the amount for stock that we were a few years ago.
This is a hastily put together response to the wrong question. A simplified SDR is welcome but we have all been able to use the existing document for decades. The real problem is how to address the long-term dental health needs of our patients. This new SDR does not address that. Patients need preventive care and support and we, as dental teams, need a stable platform from which to provide that.
Dentists don’t want to have to focus on selling big ticket items of private treatment to survive but that’s what’s happening. Equally I’m sure patients would be just as happy not to need these things.
For those who can afford it, a plan is the ideal solution but for those who cannot, nothing but the sense of obligation we feel to our patients stands between them and a real crisis.
By not addressing the issue of prevention, the Scottish government is neglecting its people and ill-conceived stunts like the new SDR are a shameful alternative to genuine reform.
Thank you for sharing your thoughts, Douglas.
If you’re considering your options away from the NHS and are looking for a plan provider who will hold your hand through the process at a pace that’s right for you, why not start the conversation with Practice Plan on 01691 684165 or book your one-to-one NHS to private call today: practiceplan.co.uk/nhsvirtual.
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