Is it worth paying privately for a child's Orthodontics when they can "have it for free" under the NHS?
A decade ago, I can honestly say that my answer to this question would have been an emphatic ‘NO!’
In those days, the dentist –
- had access to unlimited funding (and could therefore offer treatment to any child whose parent or guardian requested it)
- was paid a reasonably high fee or (to allow the use of the most up to date materials, and dedicate sufficient time)
- was paid a fee for each appliance used (allowing absolute choice over the most appropriate kind of treatment)
Although complex treatments were usually referred to hospital orthodontic departments or specialist practices for treatment, the majority of cases could be treated ‘in house’ at their own or some other convenient local dental practice.
Furthermore there were, in theory, unlikely to be any significant waiting lists, as a busy practice could merely contract another assistant if the work-load became too much.
ALL THIS HAS NOW CHANGED!
Under current arrangements, orthodontic providers have to bid for a fixed amount of funding, which will only allow treatment of a certain number of patients per year.
Treatment is no longer ‘available to all’ and children must be assessed to see if they fall into a sufficiently severe category under the IOTN (Index of Treatment Needs) before they can be offered treatment. Those who do NOT meet these criteria CANNOT be offered NHS treatment anywhere.
Recently, orthodontic fees have not only all been set at the same level (for minor and severe cases alike) but, in many cases, the total fees have been driven downwards, as many large so-called ‘super‑practices’ compete for funding. Furthermore, there are no additional fees for more complex braces, such as functional appliances to help favourable jaw growth, or anchorage devices to reduce the need for extractions.
Because of this, waiting lists have become commonplace, sometimes with waiting periods of many months just for an assessment under the NHS and, even if they qualify, it can be years before the treatment itself can commence.
There are huge variations between different practices, and only your local PCT can provide accurate data.
Whilst the availability of conveniently located, prompt and efficient high quality NHS orthodontics in any given area may not be a problem, it is no longer something that can be taken for granted. Likewise, it cannot necessarily be assumed that the treatment offered (either NHS or privately) is either of the highest quality or the most suitable for each case.
If all cases are funded to exactly the same level, you have to ask yourselves whether all orthodontists are really going to consider offering a longer, more complex – and hence more expensive – treatment if there is a quicker and easier choice available. There is very little official pressure on ANY practices to provide detailed and credible audit statistics for their treatment outcomes, although many better practices are independently seeking to provide and volunteer their own data.
We cannot comment on what treatments are or are not available in practices other than our own. We CAN, however, clearly set out what WE offer and this, hopefully, will allow parents at the very least to make an informed choice which is ultimately in the best interests of their children.
Author: Dr John Davey
Brixworth Village Dental Practice