I hate dentists. I’ve been working like a lunatic recently to get some flexitime built up, because time spent at a dentist or doctor’s appointment has to be made up. Accordingly, I’ve been leaving the office later than six this week. It was partly to get time made up for some early days and partly to build some time up against my dentist’s appointment this afternoon.
So I duly left at 3:00 today, and got down there for 3:45, where I saw a strange dentist (as in unknown to me, rather than in a purple hat and singing or something), who told me that my previous dentist wouldn’t see me because of missed appointments.
I was rather miffed, as you can imagine. I’d cancelled one previous appointment because I felt like shit, one appointment was missed because the receptionist gave me the wrong time, and the last one got cancelled because the dentist was ill! He’s now having a hissyfit because he missed an appointment with me!
The same strange-as-in-unknown-to-me dentist was cagey about taking me on as a patient, but once I made significant dinosaur noises and such and explained the situation further, she agreed, and I now have appointments booked to finally get my fillings done.
What a pain.
Many of you will now be asking, as did my wife, why the hell I still go to this practice. And the answer is that I have no choice but to do so.
The practice is the only NHS dentists’ practice within ten miles that will take on new patients. Most of those which accept NHS patients will only accept a certain number of people, or will put you on a waiting list, or only let you sign up at certain points in the year. The rest are private patient only, meaning that they cost you not only an arm and a leg, but possibly one of your kidneys to boot.
The reason that there are so few NHS-only dentists in practice relates to the provisioning of healthcare via the trusts. This is something of a sore point with me. NHS trusts were introduced by the last Conservative government under the stewardship of Kenneth Clarke, otherwise a relatively-sound, middle-of-the-road Tory, in the name of introducing patient choice and internal competition. Like so many ideas emanating from the wretched old beast which is the Conservative Party, it looked like a winner in the short term, but has ultimately led to major problems, notably the postcode lottery for certain kinds of drugs.
The PCT, or Primary Care Trust, is the major unit of local provisioning under the current system. They operate as public sector corporations which receive fixed funds from central government, which they then allocate as needed, or so the theory goes. The internal market system introduced in the 1990s was supposed to stimulate competition and competitiveness, and thus, according to market principles, make things better by the unrestricted driving force of the market.
Yeah, well. We all know how well that particular gem of theoretical, ideology-driven economics works, now don’t we? Come in, Mr Friedman, your time is up, you monetarist bastard.
The provision of public goods according to private principles always, but always, results in failure. This is because public goods must be monopolistic and outside market principles; there cannot by definition be any competitor to the public good, because there is only one public, and only one good.
Yeesh. The sooner the policy ghosts of that rat-faced old fuck, Reagan, and his ginger concubineare exorcised, the better. Now that Milton Friedman is dead, perhaps we can abandon the nonsense and get back to some real economics.
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