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Highlighting the scandal of dental patient fines

Blog Author Charlotte Waite

Blog Date 14/05/2019



​I was delighted to see the BBC covering our story highlighting the National Audit Office's investigation in to dental patient fines, and their evidence showing that 1.7million people have had their fines overturned, due to a heavy-handed approach by the Business Services Authority (BSA).

As a community dentist, I see so many barriers to care for our patients, and the barriers caused by bureaucracy and misunderstandings, are among the most frustrating. There’s nothing inevitable about them, and it’s why we’ve put pressure on the NHS BSA and NHS England to act. Over 400,000 fines are issued each year., but too many are clearly hitting innocent patients fully entitled to claim.

Us making a noise about this issue and providing evidence helped to kick-start this NAO investigation.

To help highlight the issue from a personal perspective, I asked on Twitter if any patients had wrongly received a fine and if they'd be willing to share it publicly, to support our lobbying work.


Rachel-dental-patient-650px.jpgTrisha, mum of Rachel, aged 19, who has severe learning disabilities, got in touch with me and wanted her story heard.


They'd received a fine after ticking the wrong box on the form for dental treatment, and were shocked at the BSA's response: being accused of 'fraudulent behaviour', and being told to 'get out your credit card' to pay the fine immediately – and, only after a carers' organisation stepped in to help, did they manage to get the fine overturned.


As Trisha pointed out to me, '…it's not just about the money, it's about justice'.

It feels like parents of children with special needs are being forced to jump through ever-more hoops.


There are many vulnerable people who need dental care, for example, residents in care homes, older people, people with long-term conditions, such as dementia, who may find it difficult to access treatment. We don't want to make it even harder for these people, or for those caring for them.

Those caring for a family member often have a difficult and tough enough time as it is, without the added stress of being accused of 'fraud' or being seen as a criminal. The BSA has built a system on presumption of guilt, taking no account of the patients' vulnerabilities.

So, we're pleased to see the NAO report identifying that patients are confused by the myriad of benefits and types of exemptions and eligibilities out there.

But we are very concerned to hear that £1.6m was spent by the BSA on a campaign called 'Don't Run the Risk', their answer to 'help' patients to not mis-claim, which we believe has actually made the situation for vulnerable patients worse and has put many more people off seeking treatment.

And yet, this is one barrier to care that could be so easily fixed.

Rather than take a 'fraud first' approach with patients, how about following the lead of Scotland and Northern Ireland, who take the less draconian approach, of sending a letter to patients if there is a query about their status for getting free care and asking them to clarify it?

If the NHS is truly serious about being 'efficient', then we think this is a much more sensible, and cost-effective way to ensure eligible patients can receive the dental treatment they need, without being made to feel like a criminal. 

Charlotte Waite, Chair,

England Community Dental Services Committee


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