UDAs. A system unfit for purpose.
Patients visit the dentist expecting professional care, honest treatment and transparency. But, as with any profession, not every dentist is working as honourably as they should. And unfortunately, stories like this one come up slightly more often than should ever happen.
Fariba Shameli, formerly of Findon Dental Care in Worthing, was sentenced to 3 years in prison after being found guilt of defrauding the NHS of more than £92,500 through fraudulent dental claims. Her case was heard in her absence, and she was sentenced at Lewes Crown Court just this week on the 21st of September.
This case highlights how fraudulent claims within the dental services can not only involve significant sums of public money, but also impact upon direct colleagues, hundreds of individual patients, and the public trust in the profession as a whole.
According the Crown Prosecution service, the offenses covered more than 1000 fraudulent claims submitted between 2013 and 2018.
These included claims for work that had not actually been carried out; claims for treatment that were also charged to the patient privately; and work carried out by colleagues but claimed by Ms Shameli.
This is all horrendous and entirely unacceptable. Patients were harmed. Colleagues were harmed. The public trust in the profession was harmed. It is right that she was found out and stopped, and I hope that these cases will continue to be the rare exception rather than the rule.
And yet.
There is another thing to consider here.
Ms Shameli reported one of the factors that encouraged her to put through fraudulent claims was the UDA system that is in place in England and Wales. And I find it hard not to have a certain level of understanding for this issue.
The UDA system is entirely unfit for purpose. It harms dentists, and harms patients alike. It pays a dentist less the harder they work, and actively encourages dentists not to treat patients with complex needs. It stops some dentists from being able to offer necessary NHS treatment if they’ve already met their UDA limits for the year.
This is a system that has been both dangerous for patients and unfit for purpose since its introduction in 2006, and has been known to be dangerous and unfit for every single day of the last 20 years. There is no excuse that this is still in place in England and Wales. Both patients and dentists deserve better from their government.
And the relevance to this case? The UDA system also penalises dentists if they fail to meet particular targets. Does that mean it’s acceptable for dentists to put through fraudulent claims in order to meet those targets? Of course not. But I think its hard not to see the incentive in undertaking such a practice.
One factor in keeping our profession honest is holding these individuals to account. This simply isn’t acceptable. But any patient wondering how we can make sure these things happen as infrequently as possible needs to be asking why multiple successive governments have policies in place that encourage such unacceptable behaviour.
If you care about getting the best dental treatment possible; if you care about keeping our profession one of professionals; if you care about minimising the fraud and abuse in the NHS: then you need to ask our government to replace the UDA system with something that works. It doesn’t need to be hard. It literally could not be a worse system, so almost anything would be an improvement.
In fact, Westminster doesn’t even need to look far. North of the border in Scotland, things are significantly better. I have worked for years in England under UDAs, and I could not be more glad I am now working in general practice in Rutherlgen. Is the fee-per-item system and the SDR perfect? Good God no. But it is at least a thousand times better for patients and dentists than the UDA system in England and Wales. We don’t do everything right in Scotland, but at least we’re not making as much of a mess of it as the English government is.