[Help] Advice - NHS penalty charges

[Arthritic Toe]

Just an aside which demonstrates how broken the system is - she is now seriously considering quitting her job as a teaching assistant (she’s an excellent one) because she can’t afford to work. She’ll be considerably better off in on benefits and will get free prescriptions and dentistry.

 

[Arthritic Toe]

My area of expertise was NHS dental penalty charges so I can't really comment on prescriptions. Additionally, the whole benefits landscape has changed with so many benefits being absorbed into Universal Credit.

That scenario you mention never happens. Additionally, think about how practically your suggestion would work? The NHS does not have the resources to blanket check X million exemption claims of which millions might be legitimate and then simply warn all those that are incorrect.

But what is unreasonable is that she effectively made one honest mistake, but the amount of the ‘fine’ (I.e the accumulated penalty charges) is higher due to the length of time it took for the nhs to inform her of it, coupled with the number of prescriptions (the sicker you are, the bigger the fine).

 

[METALMICKY]

But what is unreasonable is that she effectively made one honest mistake, but the amount of the ‘fine’ (I.e the accumulated penalty charges) is higher due to the length of time it took for the nhs to inform her of it, coupled with the number of prescriptions (the sicker you are, the bigger the fine).

Please look at my previous posts. The honesty of the mistake is irrelevant. Look closely at the dental penalty letter and it will clearly state that there did not need to be any fraudulent intent.

The time of incorrect claim at the dental surgery to the point she received the penalty letter has no bearing on the amount of the charge. You have to pay the original dental treatment charges plus the penalty charge which is 5 times the original amount owed, up to a maximum of £100.

 

[trueblue]

Just an aside which demonstrates how broken the system is - she is now seriously considering quitting her job as a teaching assistant (she’s an excellent one) because she can’t afford to work. She’ll be considerably better off in on benefits and will get free prescriptions and dentistry.

Genuine question. If she quits her job and is physically able to work, how long will she get those benefits for? Not that long I'd imagine and not worth making yourself unemployed for.

 

[Harry Wilson's tackle]

Well I don't feel guilty regardless. Dentistry should be free under the NHS - it stands for National HEALTH Service - and your teeth are part of your health.

I gp private (because there were no NHS dentists in town when I moved her in 89, and I like the work my dentist does).

I pay three times the typical NHS charges:

I have taken note of the dental advice I have been given. Brush twice a day. Use an electric. Use a few other (cheap) tools. Use the right toothpaste. Don't have sweets sloshing in my gob 24/7. No 'fizzy drinks'.

I have one filling. I'm 66. The most I pay is around £80 for a (largely) vanity polish and clean.

Bad teeth starts with parental neglect. I remember kids at primary school who never brushed their teeth (and Portslade is hardly a ghetto). Bad habits can then kick in with adulthood.

I don't see any clamour to change the system which suggests that people sort of 'get it'.

More formal assistance to people with mental health issues would be good if it doesn't currently exist. The self neglect that may follow should not be disregarded.

 

[METALMICKY]

I gp private (because there were no NHS dentists in town when I moved her in 89, and I like the work my dentist does).

I pay three times the typical NHS charges:

View attachment 189819

I have taken note of the dental advice I have been given. Brush twice a day. Use an electric. Use a few other (cheap) tools. Use the right toothpaste. Don't have sweets sloshing in my gob 24/7. No 'fizzy drinks'.

I have one filling. I'm 66. The most I pay is around £80 for a (largely) vanity polish and clean.

Bad teeth starts with parental neglect. I remember kids at primary school who never brushed their teeth (and Portslade is hardly a ghetto). Bad habits can then kick in with adulthood.

I don't see any clamour to change the system which suggests that people sort of 'get it'.

More formal assistance to people with mental health issues would be good if it doesn't currently exist. The self neglect that may follow should not be disregarded.

Where have you got those figures from? Based on the current bands you are telling us that you pay £80 for a Band 1 treatment?

Unless I've totally misunderstood how can you say there's no clamour to change the system? The nations dental health is going to pot because of the shortage of dentists willing to supply NHS treatment. A large proportion of the population and arguable those who might need more dental care simply can't afford private prices.

The reason why so many dentists have gone private has some complex nuances but essentially it's root cause is the new UDA based contract introduced in 2006. In essence most dentists can't afford to provide NHS treatment and many would run at a loss. The government proposals to supposedly address the issue are a bit half baked.

 

[swindonseagull]

Very sorry to hear about the OP's friend. Had me scurrying to double check my circumstances. First checked regarding type 2 diabetes and saw that this needs to be certified, which I've never done. Fortunately I haven't been moved over to UC and am still on ESA (thankfully income related).

Don't know how far back it goes but if it was 5 years I would be looking at a fine of over £80,000 for prescriptions and a grand or so for dentistry. It's entirely possible that I wouldn't have realised this as I haven't signed an exemption at the pharmacy I use for years.

If you use insulin or medicine to manage your diabetes, you're entitled to free prescriptions, but if you’re under 60 and living in England, you must have a medical exemption certificate before you can claim them.​

My GP told more than 10 years ago if I took Metformin prescriptions would be free, they also provided me with an exemption card that needs renewing I think 5 yearly.

Free prescriptions (England)

If you use insulin or medicine to manage your diabetes, you're entitled to free prescriptions, but if you’re under 60 and living in England, you must have a medical exemption certificate before you can claim them. Free prescriptions mean you don't pay for any item you're prescribed, even if...

www.diabetes.org.uk

 

[Harry Wilson's tackle]

Where have you got those figures from? Based on the current bands you are telling us that you pay £80 for a Band 1 treatment?

Unless I've totally misunderstood how can you say there's no clamour to change the system? The nations dental health is going to pot because of the shortage of dentists willing to supply NHS treatment. A large proportion of the population and arguable those who might need more dental care simply can't afford private prices.

The reason why so many dentists have gone private has some complex nuances but essentially it's root cause is the new UDA based contract introduced in 2006. In essence most dentists can't afford to provide NHS treatment and many would run at a loss. The government proposals to supposedly address the issue are a bit half baked.

I agree. All complex and nuanced.

 

[Arthritic Toe]

Please look at my previous posts. The honesty of the mistake is irrelevant. Look closely at the dental penalty letter and it will clearly state that there did not need to be any fraudulent intent.

The time of incorrect claim at the dental surgery to the point she received the penalty letter has no bearing on the amount of the charge. You have to pay the original dental treatment charges plus the penalty charge which is 5 times the original amount owed, up to a maximum of £100.

Yes I understand that’s what it says. I am saying these charges are not reasonable for what is essentially a single mistake.

It’s similar to private parking penalty charges. If you were to overstay your parking by 5 minutes because your watch stopped, and get charged a £1000 penalty charge, I think you could reasonably say that was unreasonable for a minor mistake. Just repeating the wording on the sign at you doesn’t make the penalty charge reasonable.

 

[METALMICKY]

Yes I understand that’s what it says. I am saying these charges are not reasonable for what is essentially a single mistake.

It’s similar to private parking penalty charges. If you were to overstay your parking by 5 minutes because your watch stopped, and get charged a £1000 penalty charge, I think you could reasonably say that was unreasonable for a minor mistake. Just repeating the wording on the sign at you doesn’t make the penalty charge reasonable.

And now I remember why I much preferred chasing dodgy dentists as opposed to people giving me grief about the dental penalty charge!

The sheer volume of incorrect claims runs into millions of which only a small proportion can be checked. It's arguable that the amount of the the penalty charge is there to offset that. Admittedly unlucky if you are one of those checked.

In addition, in many cases it transpires that the patient has also been incorrectly claiming for many years thereby costing a tidy sum. Despite this the NHSBA never routinely issued multiple penalty charges for multiple incorrect claims. The most I ever saw was two and these were where there was strong evidence that the patient had deliberately evaded the charge.

It's debatable that the eligibility rules are complicated and difficult to understand, and that the NHS needs to improve public awareness of the rules. It's also fair to say that the current system doesn't efficiently deter fraud and that the NHS needs to reappraise its approach.

When I did the job I felt that the powers to be should have put a little more pressure on dentists. Dentists were totally correct in asserting that it was not the job of their practice staff to manage peoples benefits. However, simple steps such as clear warning and advisory signs in the surgery would have helped. Only after a few years into the system were they obliged to have such signs.

The simplest piece of advice to anyone is that if you are in any way unsure as to whether you are entitled to free dental treatment pay the NHS charges first. Keep the receipt safe and then check with the two relevant agencies. If it's established that you didn't need to pay the NHS charges there is a simple system in place to get your money refunded. If you want take your chance based on an assumption and a failure to read a form that you have signed don't get the hump when you get a penalty charge.

As an aside I actually used to represent the NHSBSA in civil court cases that reached the stage of the issue of a CCJ where a patient was disputing the charges. I only ever lost about 6 cases on legal technicalities over a 3 year period. That tells you that the civil judiciary doesn't entertain incorrect claiming. Lots of people fancied their day in court and went away distraught when they lost in 10 minutes and the judge also instructed them to pay my travel and hotel costs.

 

[dsr-burnley]

Where have you got those figures from? Based on the current bands you are telling us that you pay £80 for a Band 1 treatment?

Unless I've totally misunderstood how can you say there's no clamour to change the system? The nations dental health is going to pot because of the shortage of dentists willing to supply NHS treatment. A large proportion of the population and arguable those who might need more dental care simply can't afford private prices.

The reason why so many dentists have gone private has some complex nuances but essentially it's root cause is the new UDA based contract introduced in 2006. In essence most dentists can't afford to provide NHS treatment and many would run at a loss. The government proposals to supposedly address the issue are a bit half baked.

That attitude is just one of the problems with "the official mind" nowadays. If a private company, eg. a parking company, were to charge a woman on benefits several hundred or thousand pounds because she hadn't read the small print on the sign, and saved the penalty up for a year so as to charge a bigger penalty, there would be outrage. But because it's petty government bureaucracy, the attitude of the officials is that it's her own fault, making a mistake is just as bad as fraud, so pay up even if it costs you your house and your job.

 

[The Wookiee]

I gp private (because there were no NHS dentists in town when I moved her in 89, and I like the work my dentist does).

I pay three times the typical NHS charges:

View attachment 189819

I have taken note of the dental advice I have been given. Brush twice a day. Use an electric. Use a few other (cheap) tools. Use the right toothpaste. Don't have sweets sloshing in my gob 24/7. No 'fizzy drinks'.

I have one filling. I'm 66. The most I pay is around £80 for a (largely) vanity polish and clean.

Bad teeth starts with parental neglect. I remember kids at primary school who never brushed their teeth (and Portslade is hardly a ghetto). Bad habits can then kick in with adulthood.

I don't see any clamour to change the system which suggests that people sort of 'get it'.

More formal assistance to people with mental health issues would be good if it doesn't currently exist. The self neglect that may follow should not be disregarded.

The current charges

 

[Harry Wilson's tackle]

The current charges

View attachment 189871

Indeed. Gone up a little from when the web site I looked at was last curated.

What are the NHS dental charges?

In the UK, dentistry is one of the few National Health Service (NHS) services where you have to pay a contribution towards the cost of your care. This means that there are now three standard charges for the NHS for dental treatment. This will help to make the NHS system easier and more...

www.dentalhealth.org

This is still hugely subsidized versus private. I had a band 1 intervention last week and was charged £60.

This is interesting:

NHS dentistry - Wikipedia

en.wikipedia.org

It seems that dentistry was free when the NHS was created by Labour in 1948 but there was a massive demand due to the shocking state of the nation's teeth. It seems that the money necessary to fund it was never forthcoming. Charging was brought in in 1952. That was one year into Churchill's last government. Good old Tories.

The surcharging of people whose benefits were restructured under the Tories over the last few years is addressed in the article above.

Labour is unlikely to extend the free dental franchise because this would require increasing taxes, and it is not something about which there is a national clamour. In contrast, say, to The Boats.

 

[METALMICKY]

That attitude is just one of the problems with "the official mind" nowadays. If a private company, eg. a parking company, were to charge a woman on benefits several hundred or thousand pounds because she hadn't read the small print on the sign, and saved the penalty up for a year so as to charge a bigger penalty, there would be outrage. But because it's petty government bureaucracy, the attitude of the officials is that it's her own fault, making a mistake is just as bad as fraud, so pay up even if it costs you your house and your job.

Dear God please read my previous posts carefully. The ' penalty charge has not been " saved " up to make it bigger. And to trivialise it down to simply not reading the small print is ridiculous. People need to take some responsibility for their lives. And putting your signature on an official document without at least giving it a cursory glance is foolhardy. People's tendency to assume in their financial favour costs the NHS pot millions each year and we all suffer.

 

[Harry Wilson's tackle]

Dear God please read my previous posts carefully. The ' penalty charge has not been " saved " up to make it bigger. And to trivialise it down to simply not reading the small print is ridiculous. People need to take some responsibility for their lives. And putting your signature on an official document without at least giving it a cursory glance is foolhardy. People's tendency to assume in their financial favour costs the NHS pot millions each year and we all suffer.

While I have sympathy for the frightened poor, living hand to mouth, and their scope for making mistakes, I get your point.

The NHS is a litmus test for society's worst characteristics. For example making appointments and not turning up. Demanding antibiotics for colds. And, as I recall when I visited a surgery in Hove each week as part of my part time job in a pharmacy in the 70s, families turning up every week to 'get their money's worth' because they are 'entitled to see the doctor'. The NHS is a privilege. It is sad this has been forgotten.

I am not in favour of charging in the NHS, but a charge certainly focuses the mind.

On this occasion if there are thousands (tens of? Hundreds of?) that have been caught out then perhaps there is an issue over communication. Much the same, certain speed cameras, positioned 'unreasonably' have become massive cash cows instead of doing what they should be doing - calming speeding.

Not entirely sure what I feel about this one, but I agree with your general points.

 

[METALMICKY]

While I have sympathy for the frightened poor, living hand to mouth, and their scope for making mistakes, I get your point.

The NHS is a litmus test for society's worst characteristics. For example making appointments and not turning up. Demanding antibiotics for colds. And, as I recall when I visited a surgery in Hove each week as part of my part time job in a pharmacy in the 70s, families turning up every week to 'get their money's worth' because they are 'entitled to see the doctor'. The NHS is a privilege. It is sad this has been forgotten.

I am not in favour of charging in the NHS, but a charge certainly focuses the mind.

On this occasion if there are thousands (tens of? Hundreds of?) that have been caught out then perhaps there is an issue over communication. Much the same, certain speed cameras, positioned 'unreasonably' have become massive cash cows instead of doing what they should be doing - calming speeding.

Not entirely sure what I feel about this one, but I agree with your general points.

Look at my previous comments. I totally agree about the communication issue and sometimes the system of benefits really didn't help. The fact that many of the benefits that people mistakenly thought were qualifying benefits ( DLA & Incapacity Benefit ) have now been absorbed into Universal Credit might help the situation. I'm out of the business now so can't really comment.

One of my biggest problems was the thought that the system was going after easy targets a bit. From doing the job over a number of years I could have told them that we should target males between 19 -30 who had claimed to be in receipt of Income Based JSA. They invariably weren't, they would pay up quickly with minimal protest and were usually working and on no benefits whatsoever. However, the powers that be had no interest in more targeted checks. What compounded the issue was that we were outsourced from working for the NHS to working for Capita. Once the private sector gets involved it's Kerching time at all costs!

 

[trueblue]

That attitude is just one of the problems with "the official mind" nowadays. If a private company, eg. a parking company, were to charge a woman on benefits several hundred or thousand pounds because she hadn't read the small print on the sign, and saved the penalty up for a year so as to charge a bigger penalty, there would be outrage. But because it's petty government bureaucracy, the attitude of the officials is that it's her own fault, making a mistake is just as bad as fraud, so pay up even if it costs you your house and your job.

The major difference is that a parking company makes its 'rules' as obscure as possible, deliberately looking to line the pockets of its owners. That helps nobody but them.

The "official mind" in this case is protecting taxpayer's money so it is spent wisely - which most people (taxpayers anyway) would surely think is a good idea.

The rules on that dental form look pretty easy to follow. If the person signing doesn't understand them or is not sure, best to ask.

 

[dsr-burnley]

The major difference is that a parking company makes its 'rules' as obscure as possible, deliberately looking to line the pockets of its owners. That helps nobody but them.

The "official mind" in this case is protecting taxpayer's money so it is spent wisely - which most people (taxpayers anyway) would surely think is a good idea.

The rules on that dental form look pretty easy to follow. If the person signing doesn't understand them or is not sure, best to ask.

Obviously if you are given a long list of conditions to read before you sign a document, the same document 52 times a year, you need to read it in detail every time. Not everyone knows that.

My problem with the "official mind" is that it is interested (like the parking companies) in getting as much money as it can regardless of fairness. This is why I got a parking fine for stopping on an empty electric car charging zone to pick up my disabled mother - not because the council feels that it is heinous that only 7 charging spaces are available where there should be 8, but because they want the money. This is why Blackburn Council picks up thousands every year from bus lane cameras at the end of bus lanes - not because pulling into the bus lane 10 yards too early when turning right is holding up traffic, but because they want the money. This is why you get the same penalty fro putting a car park ticket in the window upside down as you do for not buying a ticket at all - not because the council has lost out, but because they want more money.

The official mind thinks the rules are there because rules are a good thing in themselves. They are not there to make life easier, or fairer, they are there to raise money for the official purse. Officials, or many of them, need to learn common sense and to stop behaving like car parking cowboys.

 

[METALMICKY]

Obviously if you are given a long list of conditions to read before you sign a document, the same document 52 times a year, you need to read it in detail every time. Not everyone knows that.

My problem with the "official mind" is that it is interested (like the parking companies) in getting as much money as it can regardless of fairness. This is why I got a parking fine for stopping on an empty electric car charging zone to pick up my disabled mother - not because the council feels that it is heinous that only 7 charging spaces are available where there should be 8, but because they want the money. This is why Blackburn Council picks up thousands every year from bus lane cameras at the end of bus lanes - not because pulling into the bus lane 10 yards too early when turning right is holding up traffic, but because they want the money. This is why you get the same penalty fro putting a car park ticket in the window upside down as you do for not buying a ticket at all - not because the council has lost out, but because they want more money.

The official mind thinks the rules are there because rules are a good thing in themselves. They are not there to make life easier, or fairer, they are there to raise money for the official purse. Officials, or many of them, need to learn common sense and to stop behaving like car parking cowboys.

"Not everyone knows" you should read any official looking document that you've just put your signature on?

 

[trueblue]

Obviously if you are given a long list of conditions to read before you sign a document, the same document 52 times a year, you need to read it in detail every time. Not everyone knows that.

My problem with the "official mind" is that it is interested (like the parking companies) in getting as much money as it can regardless of fairness. This is why I got a parking fine for stopping on an empty electric car charging zone to pick up my disabled mother - not because the council feels that it is heinous that only 7 charging spaces are available where there should be 8, but because they want the money. This is why Blackburn Council picks up thousands every year from bus lane cameras at the end of bus lanes - not because pulling into the bus lane 10 yards too early when turning right is holding up traffic, but because they want the money. This is why you get the same penalty fro putting a car park ticket in the window upside down as you do for not buying a ticket at all - not because the council has lost out, but because they want more money.

The official mind thinks the rules are there because rules are a good thing in themselves. They are not there to make life easier, or fairer, they are there to raise money for the official purse. Officials, or many of them, need to learn common sense and to stop behaving like car parking cowboys.

Who goes to the dentist 52 times a year?