Responding to our campaign, the Government has announced today that it will act to ensure dentistry charges and treatment plans are clearer and easier to understand. This announcement comes as part of the Government's plan to bring down bills for families called 'A better deal'.
Existing rules state that dentists must prominently display a price list in their surgery and set out treatment costs upfront. However, our research found that that 51% of people visiting their dentists didn’t see a price list and one in five weren’t clear about costs ahead of their treatment.
Cleaning up dental costs
So as part of our campaign to Clean Up Dental Costs we called on dentists and regulators to act to end the confusion for consumers.
Commenting on today’s announcement, our executive director, Richard Lloyd said:
‘We warmly welcome the Government's plan to help consumers get a better deal.
‘Hidden charges are still too common in markets we all rely on. By making it easier for consumers to save time and money, these reforms are good for people, businesses and growth in the economy.’
We're asking the Competition and Markets Authority to step in and ensure dentists comply with existing rules, as our new research reveals a third of dentists who say they’re accepting new patients actually don’t, and those that do often have lengthy waits.
Our researchers called 500 dental surgeries advertising on the Government’s official website, NHS Choices, as accepting new NHS patients to see if they could book an appointment. Three in ten practices turned down our researchers because they didn’t have availability. Of those that did offer us an appointment, 29% couldn’t see us within two weeks, with one surgery saying we could book but we’d be facing a wait of eight to nine months.
Dental patients need better information
We've already seen evidence of dentists failing to provide clear information on the cost of treatment, or what treatment patients are entitled to on the NHS. This could lead to people paying more than they need to.
Dental sector needs to change
The Office of Fair Trading identified problems with patient information in its dentistry report in 2012, but three years on we see few signs of improvement.
We want the Competition and Markets Authority to step in and ensure the dental sector follows the existing rules and improves the way treatment options, prices, and appointment availability are communicated to patients.
Our deadline for the bodies overseeing the dental market to formally respond to our campaign has arrived. When we launched we asked the Care Quality Commission, NHS England, the Department of Health, and the General Dental Council to respond with a written update to Which? on how they would change their practices to ensure the problems identified by our investigation would be dealt with. We offered each a space on Which? Conversation to do so.
So far, only the General Dental Council has formally responded to our campaign. Last Friday, the CQC announced changes they are putting in place for the new inspection regime for dental practices. However, these changes don't go far enough as they haven't included the need to assess dental practices on whether they are providing treatment plans to patients. The Department of Health and NHS England haven't made any public commitments to changes.
We're disappointed in the lack of progress made to ensure patients aren't misled. The lacklustre response in correcting the problems we've identified is worrying. We'll be stepping up the pressure on when the next Government is formed after the General Election.
Dentists have responded to our call for more clarity for patients on dental costs, acknowledging the importance of transparency and clear pricing.
Mick Armstrong, chair of the British Dental Association said, 'In the narrow window available in a time-pressed NHS, a dentist must explain not just the technical details of clinical treatment options, but also the workings of the payment system and where the NHS and private treatment cross-over. With such a muddled set of arrangements, the system almost sets up the dentists working in it to fail.'
He added: 'The BDA supports recommendations about clear published price lists as this helps to ensure both the patient and the dentist share a common understanding.'
Preventing hidden dental costs
Justin Ash, chief executive of Oasis Dental Care, the largest provider of private dental care responded, saying:
'Oasis Dental Care... champions transparent and easy to understand pricing. We publish all of our prices in highly visible positions in practice and on our website, the vast majority of our prices are an easy to understand fee per treatment, without the confusion of “from” prices, so that patients are in no doubt of what they will be charged. We therefore welcome the Which? dental costs campaign.'
Dr Steve Preddy, dental clinical director for private healthcare provider Bupa UK said: 'Our dentists regularly see the health problems caused by putting off dental treatment. In our recent dental survey, nearly a quarter of respondents said they would actually be more likely to go to the dentist if they knew that there wouldn't be any hidden costs.'
He added: 'We are committed to making sure our customers know the full cost of treatment before it goes ahead, so we welcome this campaign to improve transparency.'
The key regulators of the dental industry in England have responded to our calls for action, acknowledging that dentists need to make sure that dental costs are transparent and clearly communicated to patients.
Barry Cockcroft, the Government's chief dental officer said: 'Dentists have a duty to be open and honest about payment and treatment options, always considering the best interests of their patients.'
The General Dental Council (GDC), which regulates dentists in the UK, welcomed our call for clarity, saying, 'It is essential for patients to be given clear information about pricing and options for NHS or private treatment and the GDC expects that dentists will provide this.'
People could be paying more than they need to for dental treatment because some dentists aren't upfront about prices or clear about what treatment patients are entitled to on the NHS.
Existing rules state that dentists must have a price list prominently on display in their surgery and set out treatment costs upfront. Yet our new research finds that 51% of people who visited a dentist in the last six months didn’t see a price list and one in five weren’t clear about costs ahead of their treatment.
We also found evidence that some people could be being overcharged. One in five NHS patients who pay said they paid more than one charge for one course of NHS treatment over the last two years when they shouldn’t have.
Dental treatment and costs
Our campaign is calling on NHS England and regulators to make sure all dentists comply with existing rules and make information on prices clearly available, explain the treatment options properly, and make sure patients know whether or not their treatment is available on the NHS.
With a quarter of people unsure about how NHS and private treatments differ it’s important that dentists are clear with their patients about cost and treatment options.
Our executive director, Richard Lloyd, said:
'Most of us will need dental treatment throughout our lives and it’s important that when that happens people feel clear about the nature of the treatment and what it will cost upfront.'
We need your signatures to show the scale of the problem and get dentists to polish up on prices. You can also find out about our mystery shopping dental investigation here.
Following the announcement that the Office of Fair Trading is to investigate NHS and private dental markets, Which? called for improvements in dental patient information
While we welcomed the investigation, we said that the OFT work must deliver for patients, who continue to be left confused by the lack of cost information displayed in surgeries and from dental staff themselves.
Read more about this OFT investigation into private dental markets.
We fed into the Office of Fair Trading's healthcare market study with our research findings that patients lack a source of comparable information on private dental prices, indicative private prices are rarely on display in private dental surgeries and patients have mixed views of their dentist recommending cosmetic treatments.
Which? research reveals that private dental prices can vary by hundreds of pounds, and it's not always easy to know what's included in the consultation or to get the clear pricing information you need to shop around.
In May 2010, Which? mystery shoppers called 423 private dental practices and found prices varied wildly – from £45 to £124 for an initial check-up and £250 to £518 for a crown.
We also discovered that patients need to question what’s included in an initial check-up – only 56% of practices included the cost of an X-ray and just 19% a scale and polish.
Which? fed into the independent review of NHS dentistry in England led by Professor Jimmy Steele, reporting that access to NHS dentists was fairly good but there were still localised problems which needed to be fixed. Consumers were confused about the treatments they were entitled to and the price they should pay.
2009-03-14 Review of NHS dentistry - Which? submission pdf
We called on the Government to fix remaining access problems, provide clear and well-publicised routes to NHS dentists along flexible and patient-friendly care pathways, base guidelines on evidence, and ensure that quality was monitored and rewarded.
2009-07-14 Which? responds to review of NHS dentistry pdf