Private dentists charge up to six times NHS rate

The office of fair trading is expected to launch a formal inquiry this week into overcharging by private dentists who are cashing in on the lack of available treatment on the NHS.

According to evidence from the Consumers' Association, private dentists are charging up to six times the NHS rate without giving patients advance notice of their tariffs to let them shop around.

The association has made the first use of a new procedure allowing leading pressure groups to make a "super-complaint" to the OFT requesting an investigation into lack of effective competition in particular sectors of business or the professions.

The OFT has given itself until the end of this week to respond and is likely to decide in favour of a formal inquiry, although officials would not confirm it yesterday.

In a survey of 200 dental surgeries last year, the association found huge variations in prices that could not be explained by differences in costs of treatment.

The highest average prices were in Edinburgh where private patients usually paid £35-£50 for a simple check-up, scale and polish, compared with £24-£35 in Yorkshire. The prices charged for this treatment by individual dentists in Edinburgh were as high as £88.50, compared with £13.20 for those accepted as patients on the NHS.

The cost of a replacement gold crown varied from £150-£220 in south Wales to £200-£300 in Edinburgh. The association found charges as high as £500, compared with £70.72 on the NHS.

It said: "The prices charged for private dental treatment differ enormously within specific towns and between these towns. The charges... do not appear to be governed by the prices charged by other dentists, nor by the costs of doing business. This suggests a failure of competition."

The association found a lack of openness about prices. There was no national rate card to help patients judge whether their dentist was charging fairly, and many dentists refused to quote prices before examination.

Allan Asher, the association's campaigns director, said: "Private dentists' charges seem arbitrary.

"If there is limited access to NHS dentistry in an area, providers of private dentistry enjoy even less competition."

Companies such as Boots Dentalcare had set up chains to provide private dentistry, but these schemes were not using their scale of operation to bring down charges.

"For some treatments charges by chains are somewhat higher than average," the association said. The NHS should be providing a bench mark against which private patients could judge whether they were getting value for money.

"The NHS can only act as a means of disciplining pricing by private dentistry if the private dentists identify a sufficient threat from an NHS dentist taking their clients. The lack of access to NHS dentistry removes any pricing discipline," the association added.

An OFT spokesman said it would announce this week whether a formal inquiry would go ahead. The "super-complaint" procedure is to be included in an enterprise bill from the Department of Trade and Industry this year, but the OFT said it already had the powers to press ahead.

The British Dental Association said price differences were to be expected. Treatment was likely to be more expensive in metropolitan areas such as London and Edinburgh, where the cost of premises and salaries was higher.

But it acknowledged that pricing structures were confusing in some areas. "We advise patients to get a full breakdown of costs, and even to shop around, before undertaking a course of treatment," a spokesman said.

About 40% of dentists' income comes from private work, and in some parts of the country surgeries are not accepting new patients.

Tony Blair promised in 1999 that everyone would have access to an NHS dentist within two years. The association said the government had fulfilled this by opening emergency access centres to treat patients at short notice, but said this was a "sticking plaster" solution to a more deep-seated problem.

"The general feeling among dentists is that the government has underestimated the profession's disaffection with the NHS," the association said.