One thing that really gets my goat is the unfounded criticism of the NHS.

There can’t be many of us that don’t appreciate just what an amazing service we have and how unique it is among other countries.

How different life would be if we had the American system of healthcare where every teeny bit of medical intervention is shrouded in mountains of paperwork and dictated by what insurance companies would pay for. Thankfully, apart from three hospital births, I have yet to call on the NHS for much, but doubtless my time will come and how grateful I will be.

I also know that the NHS is not perfect, mainly because there just isn’t a bottomless pit of money. We’re all living longer, expecting better treatments, medicines are getting more expensive and all this has to be paid for somehow. NHS dentistry changed in 1991 when costs were introduced and many dentists opted out of a system which sometimes limits the options we can give to patients. Each dental practice, whether it provides NHS or private services or sometimes both, is a separate entity with fees charged per item which is one of the fundamental differences between dental and medical services. In an ideal world, everything in a dental surgery would be free at the point of use but this would cripple the NHS in a matter of months. Each dental practice is its own little business, reliant on keeping costs under control and generating income to support its staff.

Unlike a hospital, everything has to be accounted for and costed to make sure the business survives.

Which is why I was appalled to hear a recent conversation between a surgeon at the John Radcliffe and the principal dentist at our practice in Botley. The surgeon was trying to work out the exact cost of each procedure she performed; how much were the materials, what was the cost of sterilising and equipping the theatre, what were the staff costs. Quite unbelievably, no one had a clue. In fact, it’s worse than that – there was no way of working it out. No one even knew the costs of basic items like dressings and bandages and staff couldn’t even make a guesstimate as to the annual cost of items like swabs.

In a well run dental practice, this is a totally alien concept. If we needed to work out the annual cost of cotton wool rolls, within a couple of hours, we’d have the figures. We know exactly what is spent on gloves, masks and anaesthetic and all the staff are made aware so wastage is kept to a minimum. Dental practices take the time to shop around to get good deals. In most cases all this administration is done by the same people who are doing the work – us dentists.

Of course I realise that running a hospital is different to running a small dental practice but it can’t be that different and we dentists often don’t have the luxury of a tier of managers who should be working this sort of stuff out. How is it that in a system with such enormous budgets, no one seems to be looking at bottom-line costs. It goes without saying that a hospital needs to be well equipped but if no one knows what things cost, how can they know they’re paying a fair price. ‘On the floor’ hospital staff, appear to have no idea of the just how much is being wasted and the knock on cost this is having. If the well known saying about looking after the pennies is anything to go by, the NHS seems to be failing in its wastage of materials. This same surgeon talked about a backlog of materials that are often over ordered, go out of date and can’t be used so get thrown away. Someone is paying for all this and in an organisation like a hospital this is a complete travesty and unrivalled waste of taxpayer’s money.

Our NHS is one of the biggest assets we have, a system to be truly proud of and serviced by well trained dedicated staff.

I don’t begrudge paying tax to fund it when it works efficiently but I do object to funding a system if it is wasteful and inefficient.

Watch this space, Oxford Mail headline: Botley dentist now in charge of John Radcliffe hospital...A very unlikely story if ever I’ve heard one.