Monday, 20 April 2020

Campaign reply: Private and Mixed Practice Dentistry and COVID-19


I have been contacted by a number of dentists locally regarding Dentistry and COVID-19, highlighting concerns for private and mixed (delivering both NHS and private care) practices. NHS England have offered a wide range of support measures for NHS dentists, which includes the NHS-funded work of mixed practices. NHS dentists are also able to be redeployed to other roles within the NHS using their clinical experience and expertise, such as working within the new urgent dental treatment centres, also known as dental hubs, the 111 service and in hospital sites across the county. All NHS dentists are expected to continue to provide telephone assistance for any dental concerns and are able to prescribe painkillers and antibiotics as appropriate, or refer patients for urgent treatment at a local dental hub if it is required to ensure anyone in urgent need of dental care is able to access it.

For those working in private practices on PAYE arrangements, they should be able to access the Coronavirus Job Retention Scheme and furlough staff, ensuring staff can received 80% of their salary, up to a maximum of £2500 per month. For mixed practices, those on PAYE arrangements and unable to work for example due to the nature of their role not being possible to continue from home, they can be furloughed via the Coronavirus Job Retention Scheme in proportion to their practice’s private activity, without endangering any NHS funding. For those self-employed, the Self Employed Income Support Scheme is available. One major advantage for the self-employed in the support offered to them is that they can continue to work and earn, where possible, whilst those on the employed scheme are not able to work if they are furloughed.

One of the issues highlighted in the campaign emails I have received is that many dentists are self-employed earning an average of £69,000 annually, which is above the £50,000 threshold for eligibility of the scheme. The concern highlighted is regarding their ability to pay bills such as mortgages through this crisis. I would highlight that there is a range of support from the banks for all individuals experiencing financial difficulty. For example, anyone concerned about paying their bills would be able to take advantage of the offer of mortgage holidays, a variety of different payment holidays on credit cards and loan repayments, transfers of credit card balances to 0% interest credit cards. Banks must also offer £500 fee-free overdrafts for anyone requesting them through this pandemic and many utility companies have payment options for anyone struggling to pay their bills through this challenging time. I would encourage them to discuss concerns with their bank as more support is being made available every day. There are also opportunities to move payment-free months of Council Tax, normally at the end of the financial year, to the beginning to ease cashflow for anyone struggling.

Additionally, many who are earning this amount are likely to have significant savings they can access. Where this is not the case, and they are experiencing severe financial hardship, they are able to claim Universal Credit (UC). For those whose who do have savings but these savings are set aside for their tax bill, this can be taken into account when determining eligibility for UC. It is also important to note that self-assessment tax payments have also been deferred until January 21.

In terms of the support available for practices, some practices will be eligible under insurance policies for interruption of business, although this will depend on the type of cover in place. There is also £10,000 extra cash grants which have been made available to some of the smallest businesses and I believe some dental practices with rate exemptions have already received these grants.

With regard to concerns about the Coronavirus Business Interruption Loan Scheme, I am aware there were some initial difficulties for businesses seeking to secure these loans however this has been considerably enhanced by the chancellor following feedback from myself and other MPs. If you have applied with your lender before without receiving a helpful response or acceptable terms, I would urge you to reapply following his recent intervention. Additionally, a rejection from one lender does not prohibit you from applying with a different lender, who may take a different view on your application.  

I have discussed these issues directly with the Minister, who has assured me the government are working closely with the Chief Dental Officer, patient groups and the British Dental Association to ensure appropriate services are in place for all who need them. The government are also discussing with corporate and private providers how they may be able to support the NHS effort in areas of the country where current emergency dental provision is more limited so patients do not have to travel far for treatment.

There are additional avenues of financial support for anyone experiencing severe financial hardship, such as the hardship fund via Cornwall Council, and specifically for dentists and dental professionals is the British Dental Association (BDA) benevolent fund (https://www.bdabenevolentfund.org.uk/). I have also produced blog posts with further details on the support available for:

The government is continuing to review the situation and if necessary, extend measures or implement further measures as underscored by the recent changes to the Coronavirus Job Retention Scheme.

I think it is also important to keep in mind that many of the schemes announced would normally take years to be drawn up are instead being produced in a matter of days and rolled out in just a few weeks in response to this crisis. They may of course be less than what we would perfectly want to see as a result and are the best compromise that can be found in the circumstances. The focus has of course been on the most vulnerable and those at high risk, and the government and civil servants have been working around the clock to design and implement all of these measures, whilst facing up to 30% reduction in staffing levels themselves.

I have fed back the experiences and concerns raised by dentists and dental professionals with me, both of mixed and private practices, when in discussions with colleagues in Westminster and would recommend following any further developments from the BDA, NHS England and the chancellor as well exhausting all available avenues currently available regarding financial assistance.



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