The financial situation within the NHS is rarely out of the news; there’s hardly a day goes by without some talk of cut backs, deficits or job losses. In June 2006 it was estimated that the deficit across the service was some £512 million and job losses of 15,000 were expected. Clearly this is worrying for all concerned. But perhaps more concerning is a trend in the number of dentists, opticians and other health related professionals who are facing financial difficulties.
You might be somewhat surprised to hear this – given the impression of heaving dental surgeries, refusals to take on more NHS patients and the vision of the high living, Porsche driving professional. However, when you consider the business model for dentist practices, it’s not hard to see how dentists could encounter financial problems.
Dentists are similar to other professionals who trade in partnership. They suffer the same succession issues and are reliant on their professional abilities and skills to bring in work and carry it out. They have the added pressure of needing to renew and revamp their surgeries with modern technology and the latest equipment. As a consequence equipment is frequently renewed much more frequently than in any other business, with the associated costs that this incurs.
Dentists are also victims of their own success, in that financiers generally see them as a ‘safe bet’ and are therefore willing to extend credit to them, perhaps more readily than they might to businesses in other sectors. Dentists are not immune to other pressures too – such as competition, pricing and general economic impacts. But perhaps the most significant limiting factor is time. Dentists cannot easily delegate their work to more junior members of staff, so sales are often limited by time constraints – ie the number of patients a dentist can see in any one day.
And the cuts in NHS funding are affecting dentists directly too. Nectarios Katsikas is a dentist who's been seeing NHS patients who find it difficult to get treatment elsewhere - but he's worried about the future.
With 1,000 families already on his list he can’t afford to accept new patients on the NHS - because he's calculated he will take home just £350 a month for what is currently 70% of his workload. "The sums are very low - disappointingly low. If the health authority does not renegotiate the contract I won't even be able to meet my mortgage and my car loan.” *
Of course most dentist practices in the UK today are healthy businesses – but many would benefit from a routine financial check up to make sure they don’t go the same way as other elements of the health service in getting into debt and having to lay off staff.
* quoted from BBC radio interview last year.