Dentists warn of fee hike to fill gap in income SCOTTISH patients could see their dental bills rocket as dentists face growing pressure on their own finances, experts have warned. A drop in people having treatment because of the economic climate and a loss of incentives for providing some NHS services could lead to more dentists focusing on private work, according to a business adviser. Leading dentists also warned that practitioners faced rising expenses for providing services while the fees they receive for doing NHS work had remained static for three years. And they expressed concern over a legal battle they are fighting to stop dentists having to pay back £3.5 million they say was overpaid due to administrative errors which were not their fault. The Scottish Government said it was in discussions with dental leaders on the issue of pay. The average income for a principal dentist in a practice in Scotland dropped 11 per cent from £113,800 in 2009-10 to £101,100 in 2010-11, according to the most recent figures. Jayne Clifford, a partner of business advisers Martin Aitken & Co and leader of their specialist dental team, warned that patients could face a sharp rise in their annual dental bills because of the financial pressures dentists were experiencing. "In today's business climate, dental practices need to adopt innovative ways to manage and grow their businesses because there have been many NHS cutbacks that are putting a financial strain on dental practices who offer NHS work," she said. Clifford claimed the effects of the economic downturn meant that even NHS patients could not afford to have treatment, perhaps leading dentists to turn to private practice instead. This would, in turn, leave patients with the choice of paying to see the same dentist privately, at considerably increased cost, or finding another NHS practice. Clifford said there had also been cutbacks to some of the incentives previously in place for NHS practitioners, such as grants to set up in areas with a shortage of dentists. As access has improved, these grants have been reduced. "The problem that the NHS dentists are facing just now and have done for the past year is that they are finding that patients are not coming or they can't even afford to pay an NHS dentist," she said. The fact that now the NHS dentist is beginning to potentially lose some of the benefits that they currently have means their income could go down. Pat Kilpatrick, Scotland director for the British Dental Association (BDA), said Scottish dentists faced a number of concerns which they wanted addressed. While she denied there had been a fall in NHS patients, she said there were many factors putting a strain on dental finances. "One of our biggest concerns is the lack of uplift in fees for practices," she said. The biggest problem for dentists at the moment is increasing lab, materials and radiology costs, staffing and decontamination costs and the cost of regulation. And the problem with the fees is that the government has not uplifted the fees for three years now. That means that more of the income that dentists get is spent on these expenses and they pay themselves less. Charges for NHS dental treatment are set by the Scottish Government, but practices can set their own fees for private work. This could potentially mean some could increase their charges to counteract other financial pressures. But Kilpatrick said practices should be aware that if they increase charges too much they may lose patients. "It is a very competitive market," she said. The Scottish Government is trying to claw back overpayments of £3.5m made to dentists as a result of some NHS patients being registered at more than one practice. This meant NHS registration payments were made to some dentists for patients who no longer used their practice. The BDA believes the mistake was due to the Scottish Government's decision to introduce lifelong NHS registration for patients, meaning they may remain on one dentist's list even if they have moved to another area. A legal challenge by the BDA has led to the postponement of the clawback exercise in an effort to stop dentists having to pay back the fees. Kilpatrick said: "This is no fault of dentists. It is a computer-generated error in a system that was set up for continuous registration, which we don't agree with anyway. A Scottish Government spokeswoman said: "Our most recent figures highlight the continued success of NHS dentistry in Scotland, with the dental workforce and patients registered with an NHS dentist at record levels. We are continuing to build on that success by investing significantly in dentistry, including £2m in the Child-smile Practice and a further £2m to help practices to upgrade their decontamination facilities. The government is currently in discussions with British Dental Association Scotland regarding dental pay and an announcement will be made in due course. Twitter: @LyndsayBuckland