Hugh Reilly: Public cash helps numb dentists’ pain

Their wages have fallen 25 per cent in five years, but they still draw a good income, writes Hugh Reilly

Theres no chance of detists downing tools in dispute. Picture: Getty

WHEN I was a toddler, I had a somewhat distrustful relationship with all things dental. De-fanged friends told me that losing milk teeth was a pathway to temporary opulence, thanks to the overnight delivery of a sixpence discreetly placed under one’s pillow by a philanthropic Tooth Fairy.

Unfortunately – and completely unconnected to my dad’s overtime being cut – my Tooth Fairy regularly encountered something of a cash-flow problem. To be fair, I wasn’t alone. Nightly, my impoverished mum endeavoured to take cunning advantage of the dental pixie’s alleged generosity by leaving an entire set of teeth in a glass by the bedside table, but the Tooth Fairy wasn’t easily fooled.

By dint of a sugary west of Scotland diet, trips to the dentist became a regular trail of tears. Like most city toothsmiths, my dentist worked out of a two-bed flat up a tenement close. It was a foreboding experience to enter the B.D.S. den – in this place, everyone could hear you scream. The waiting room floor was covered in a careworn carpet that, had it been of the flying variety, would have been grounded by the Civil Aviation Authority. Cheap wooden dining chairs that appeared to have been salvaged from a bonfire pile lay against sepia-papered walls like condemned seats about to face a firing squad. The dentist operated as a lone wolf, save for one assistant and the occasional visit of an itinerant ‘gas man’ accomplice – the word anaesthetist had yet to enter Weegie parlance. It didn’t help calm my fears that my dentist bore a tad menacing visage that further fuelled rumours he was on Mossad’s hit-list.

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In the cinema classic, Marathon Man, Dr Szell (Laurence Olivier) tortures Babe (Dustin Hoffman) by pushing a dental probe into a cavity (for any American readers of a sensitive disposition, please replace “tortures” with “uses enhanced interrogation techniques on...”). Bravely, Babe refuses to squeal the gen. Of course, had he been a Scottish patient presented with a terrifying dental bill in 2014, Hoffman would have cracked and told everything. It’s a cold fact that the high whine of the drill is often drowned out by the kerching sound of the dentist’s cash register or the kindly words of a receptionist helpfully instructing someone how to empty their bank account using the practice’s pin and chip machine.

Recently, a Freedom of Information request extracted the fact that 17 dental practitioners in Scotland received more than £500,000 from the public purse. Two dentists were crowned millionaires, and another earned £948,869 – clearly, a seven-figure publicly funded payment package was a bridge too far.

Anyone gobsmacked by these sums should bear in mind that these are gross, not net, rewards. Running a dental practice doesn’t come cheap, with as many as two or three minimum wage front-desk staff on the labour force. The dental assistant giving suction and helping her boss to make mountains of cash out of molars is another payroll parasite, often earning downwards of £16,000 when fully trained. Stocking the waiting room tables with reading material for patients about to be fleeced, sorry, flossed, comes at a cost. Buying copies of the hugely interesting Hello! magazine chomps into the dentist’s retirement fund as does an annual subscription to The Readers Digest; to be fair, the fact that the cover price is in shillings and pence hints that the subscription lapsed some time ago. Were it not for the remuneration on offer from the taxpayer, the outlay on expensive glossy posters advertising the availability of private cosmetic dental surgery on the practice’s premises would not be possible.

Before anybody from the Taxpayers Alliance starts bumping their gums about the astronomical amounts disbursed to those living a mouth to cash-grabbing-hand existence, it should be stated loudly and clearly that the current figures represent a decline in earnings. In 2013-14, the top earner polished off £2.1 million. No doubt aware that his words would act as a catalyst for a tsunami of public sympathy, a spokesperson for the British Dental Association said: “Dentists in Scotland are feeling the squeeze. Average incomes are now £68,000, down 25 per cent since 2009. This leaves Scottish dentists the lowest earners in the UK.”

I’ll need to up my Tramadol to dampen the shared pain I feel.

Quite why there has been a marked fall in average earnings is difficult to fathom. One logical explanation is that the oral hygiene of the populace has improved dramatically but, sadly, observing the ubiquitous buckled smiles of my Scottish kinsmen sharply undermines that suggestion.

In a time of austerity, I’d have imagined that fewer people would be able to afford private dental care, hence I would have expected to see a surge in public health expenditure in the field of dentistry. Perhaps the reason for salary decline is more prosaic – the number of dentists has increased substantially since 2007 and therefore the individual share of the public sector pie has decreased.

Given that I’m due a check-up, I’d like to point out that my current dentist is a sincere, wonderful, human being who would not countenance the very notion of causing unnecessary suffering in a patient who had mildly criticised her chosen profession.

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