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| Version 3 | Version 4 |
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| 'Go to the dentist and get fined £100' | 'Go to the dentist and get fined £100' |
| (35 minutes later) | |
| Going to the dentist is something that many would want to avoid - but how about if you also faced a penalty fine? | Going to the dentist is something that many would want to avoid - but how about if you also faced a penalty fine? |
| More than 40,000 people a year in England are getting fines of £100 - from an automated system that dentists say is hitting the most vulnerable. | More than 40,000 people a year in England are getting fines of £100 - from an automated system that dentists say is hitting the most vulnerable. |
| They warn that people such as dementia sufferers are unfairly getting caught up in a system meant to stop fraudsters from getting free treatment. | They warn that people such as dementia sufferers are unfairly getting caught up in a system meant to stop fraudsters from getting free treatment. |
| The NHS accepts there is a problem with errors and is promising changes. | The NHS accepts there is a problem with errors and is promising changes. |
| The fines, about £4m per year, are being applied by a random screening process that checks on whether people going to the dentist are really eligible for free treatment. | The fines, about £4m per year, are being applied by a random screening process that checks on whether people going to the dentist are really eligible for free treatment. |
| But dentists say rising numbers of people with dementia, or those with learning difficulties, are being unfairly fined for something as simple as ticking a wrong box in confusing paperwork. | But dentists say rising numbers of people with dementia, or those with learning difficulties, are being unfairly fined for something as simple as ticking a wrong box in confusing paperwork. |
| When these have been challenged, about 90% have been overturned as having been incorrectly applied. | When these have been challenged, about 90% have been overturned as having been incorrectly applied. |
| The British Dental Association says the problem seems to be increasing and with an ageing population is only likely to get worse. | The British Dental Association says the problem seems to be increasing and with an ageing population is only likely to get worse. |
| Why dentists are complaining | Why dentists are complaining |
| Charlotte Waite, a senior dentist working in Loughborough, Leicestershire, says this is a problem appearing on a "daily basis". | Charlotte Waite, a senior dentist working in Loughborough, Leicestershire, says this is a problem appearing on a "daily basis". |
| "This has become a significant barrier to care. It can cause a lot of distress if people feel they are seen as fraudulent," she says. | "This has become a significant barrier to care. It can cause a lot of distress if people feel they are seen as fraudulent," she says. |
| Mrs Waite, vice-chair of the British Dental Association's England community dental services committee, is leading a campaign to stop a wave of fines for elderly and frail people, those with dementia or learning difficulties, who have made honest mistakes when filling in forms about free care. | Mrs Waite, vice-chair of the British Dental Association's England community dental services committee, is leading a campaign to stop a wave of fines for elderly and frail people, those with dementia or learning difficulties, who have made honest mistakes when filling in forms about free care. |
| She says even when patients are eligible for free treatment, an incorrect description of specific benefits or failure to renew documents can trigger a penalty fine, which rises to £150 if there is a delay in payment. | She says even when patients are eligible for free treatment, an incorrect description of specific benefits or failure to renew documents can trigger a penalty fine, which rises to £150 if there is a delay in payment. |
| And she says because it typically affects vulnerable and often low-income families, there has been a lack of a "powerful advocate" to raise the issue. | And she says because it typically affects vulnerable and often low-income families, there has been a lack of a "powerful advocate" to raise the issue. |
| Many such patients will be brought to the dentist by a carer, and Mrs Waite says they might not have the detailed information about types of benefit and exemption certificates. | Many such patients will be brought to the dentist by a carer, and Mrs Waite says they might not have the detailed information about types of benefit and exemption certificates. |
| She says this becomes a dilemma for dentists, whether to turn away patients or to treat them and then risk that patients could face a fine. | She says this becomes a dilemma for dentists, whether to turn away patients or to treat them and then risk that patients could face a fine. |
| Patients might turn up for the dentist and go away again without treatment because of confusion over benefits and entitlements and worries about being fined. | Patients might turn up for the dentist and go away again without treatment because of confusion over benefits and entitlements and worries about being fined. |
| "I feel very strongly that clinical time should be spent on clinical work," she says, rather then trying to navigate the benefits system. | "I feel very strongly that clinical time should be spent on clinical work," she says, rather then trying to navigate the benefits system. |
| "It's an extreme waste of clinical time. | "It's an extreme waste of clinical time. |
| "We really need to sort this out now." | "We really need to sort this out now." |
| What dentists say they've seen | What dentists say they've seen |
| "They were fined twice over an 18-month period, due to the change in exemption and Mum accidently putting the wrong thing on the form. | "They were fined twice over an 18-month period, due to the change in exemption and Mum accidently putting the wrong thing on the form. |
| "Mum was having a bad year and the patient had suffered a few health problems, and these fines were very upsetting and caused lots of anxiety. | "Mum was having a bad year and the patient had suffered a few health problems, and these fines were very upsetting and caused lots of anxiety. |
| "We did manage to get the fines turned around, but this took long periods of time and many phone calls and a letter. We were constantly up against a brick wall." | "We did manage to get the fines turned around, but this took long periods of time and many phone calls and a letter. We were constantly up against a brick wall." |
| "He contacted me in quite a panic and I had to reassure him and request that he brought in the paperwork to me to see, I completed the appeal form for him as he was entitled to claim free dental care. | "He contacted me in quite a panic and I had to reassure him and request that he brought in the paperwork to me to see, I completed the appeal form for him as he was entitled to claim free dental care. |
| "The appeal form that needed sending back was quite a complex letter, and I think our patient would have struggled to respond to it without help. | "The appeal form that needed sending back was quite a complex letter, and I think our patient would have struggled to respond to it without help. |
| "I felt it was most unfair for him to have to go through that." | "I felt it was most unfair for him to have to go through that." |
| "I phoned on her behalf, but they would not accept my word regarding the patient's special needs and wanted a letter from the patient's doctor. | "I phoned on her behalf, but they would not accept my word regarding the patient's special needs and wanted a letter from the patient's doctor. |
| "It took three weeks for the patient to get in to see the doctor as it wasn't urgent. All I could get was a deferral in increasing the fine [for non-payment] while the patient waited for a letter from her doctor." | "It took three weeks for the patient to get in to see the doctor as it wasn't urgent. All I could get was a deferral in increasing the fine [for non-payment] while the patient waited for a letter from her doctor." |
| What the NHS wants to do in response | What the NHS wants to do in response |
| The NHS Business Services Authority, which oversees the fining system, accepts there is a problem and is looking for a way to make improvements. | The NHS Business Services Authority, which oversees the fining system, accepts there is a problem and is looking for a way to make improvements. |
| A spokeswoman says no-one wants vulnerable people to be unfairly fined or for dentists to waste valuable clinical time. | A spokeswoman says no-one wants vulnerable people to be unfairly fined or for dentists to waste valuable clinical time. |
| The checks have an important role in making sure free treatment isn't being unfairly accessed by those who should pay. | The checks have an important role in making sure free treatment isn't being unfairly accessed by those who should pay. |
| The screening system compares what people have put on forms at the dentist against two databases of information about benefits and entitlements - and if these do not match, the fining system generates a penalty notice. | The screening system compares what people have put on forms at the dentist against two databases of information about benefits and entitlements - and if these do not match, the fining system generates a penalty notice. |
| The most recent figures suggest almost 120,000 fines have been issued over the past three years. | The most recent figures suggest almost 120,000 fines have been issued over the past three years. |
| But the British Dental Authority says when 30,000 of these fines were checked, almost 90% were overturned, suggesting the scale of the error in the system. | But the British Dental Authority says when 30,000 of these fines were checked, almost 90% were overturned, suggesting the scale of the error in the system. |
| "We want to make sure that patients, particularly those who struggle with literacy, understand if they are entitled to receive free dental treatment or if they should pay," says a NHS Business Services Authority spokeswoman. | "We want to make sure that patients, particularly those who struggle with literacy, understand if they are entitled to receive free dental treatment or if they should pay," says a NHS Business Services Authority spokeswoman. |
| "We recognise the importance of information and access to it for everyone." | "We recognise the importance of information and access to it for everyone." |
| Have you or your family or friends been affected by any similar issues about penalty fines after a visit to the dentist? Email haveyoursay@bbc.co.uk with your stories. | |
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