Dental Service Time to Stop the Rot

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Less than 40% of the population attend a dentist once a London has one dentist for every 2,000 people: but only one for every 9,700. The National Health Service * Dentists operate a piecework system. There is no quality control over their work. So doing rapid shoddy work with old-fashioned equipment in dingy surroundings with underpaid assistants increases the dentist's Anyone who has tried to get NHS dental treatment knows there are problems. The majority of private dental patients are working class people who are unable to get the NHS treatment they are supposedly entitled to.

And when they get in to see the dentist, working class children are нвоте likely than middle class children to have their teeth pulled but instead of filled.

The problems in other words are completely tied in with the oppresdion of the working class. This fact completely escaped the Socialist Medical Association's panel of speakers at a sparsely attended conference on "The Future of Dental Services' last weekend.

The SMA could only suggest esagning a new form to make patients aware that it is up to them do find out if they are being treated Ravately or on the NHS!

Certainly the problems are daunting. The dental service is completely unlike the general practitioner service in the NHS-in which a patient has certain rights as a member of a doctor's "list' As a dental patient you have no rights. No dentist is obliged • see jou, no matter how serious the pain you are suffering.

It is entirely at the dentist's decretion whether you or your duldren are taken for a course of treatment. And his obligation cerges the moment he gets your goature on the lengthy form that marks the end of the treatment.

Even if you are in agony the next day he is not required ever to ace you again. And of course daring the treatment he is only obliged to do such work at his own discretion as necessary to make you adequately dentally fit" - a compietely meaningiess term.

von derelop pam outside torical ontoe hours™ even while des a dentist's treatment. he does familiar problem gency dental care.

basis tissue in then pie evory basis unique filling, every item of treatment has its agreed price.

This is negotiated by the British Dental Association so that an "average" dentist, working a 35hour week with six weeks holiday a year and deriving 90% of his income from NHS work will earn the 'target salary' This arbritary figure is calculated from the notoriously low estimates to be found on dentists' tax returns. The target salary also incorporates 56% to pay the dentists' practice expenses, (rent; wages; equipment, etc), to produce the target gross income of over £18,000 per annum.

over dentists-who cost £40,000 each to train.

profits.

* Only 200 out of 1 Only 1 in 8 regular clean their teeth to teeth only an average The result is that the faster dentists work, the more corners they cut, the less they pay for staff and equipment, the more cash they make.

And the other side of the coin is that as more patients are forced to seek private treatment, and the number of hours spent on NHS work falls year by year, the price of each item of treatment is increased to ensure dentists still make their target salary!

Dentists as a result have a rested mterest in the continuation of

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Unscathed after the Guatamala earthquake, the finance ministry building.

Until recent years generally regarded with fear and mystery as "acts of god" earthquakes are now beginning to be much better understood by scientists. This is opening up the possibility of improved methods of avoiding large scale destruction and loss of life.

Key to minimising the consequences of earthquakes is work towards accurately predicting them, combined with a readiness to take measures to cater for the health and social problems that earthquakes bring.

Most important in earthquake prediction has been a new concept for analysing the structure of the earth's surface and its relationship to the immediately underlying layer.

This concept, called plate tectonics, sees the upper layer of the earth (the "lithosphere') as divided into a small number of semi-rigid plates that move both relative to each other, and relative to the underlying layer (the 'mantle').

EGG SHELL

These plates can be likened to «floating» of cracked egg shell fragments of cracked shell contents of the egg-which are not unlike the deeper layers of the earth.

99% of all earthquakes occur because of movements at plate boundaries. This is why the major earthquake zones are on the most active plate boundaries.

Thus earthquakes are most common in the mid Pacific region and in a zone stretching from the Himalayas into central Asia and China, and westwards across Afghanistan, Iran, Turkey and parts which attaches much priority to this work.

But it has been the Chinese, making use of 100,000 workers throughout the country who monitor continuously for signs of earthquakes, who have made the first two successful predictions of damaging earthquakes.

The most impressive was that which occurred near Haicheng, in Lianong Province in February, 1975.

EVACUATION

As a result of mass evacuation from the area very few of the one million people whó lived in the earthquake zone were killed, despite the fact that the town was completely destroyed and many factories were badly damaged.

The Chinese make disaster preparations immediately in response to an earthquake prediction.

People are re-housed in simple shelters they are helped to construct themselves, and medical and rescue teams are organized. Importantly, financial losses due to an earthquake. do not fall on individuals.

This contrasts with what is expected to happen in California should the US government issue an earthquake prediction in the near future.

Immediately, the sale of earthquake insurance policies would be banned and property values would fall to about half their pre-prediction value.

Property speculators would step in and encourage panic selling of real estate in order to make huge profits when property values rise after the earthquake.

Many of those affluent enough to leave the earthquake area would probably do so.

Factories would close and SCIENCE ESPONDENT of the cost of reparing the likely earthquake damage and of the social costs of injuries, deaths, disease, loss of production capacity and environmental damage, is trivial.

For multi-storey steel and reinforced concrete buildings the extra cost would vary from about 5% to 20% of the present construction COSt. - Even small one or two storey masonry buildings could be similarly strengthened to resist structural damage at a cost of about 15%30% of the basic construction cost.

A good example of the contrast in response to earthquakes of different structures and of how earthquake disasters affect workers and peasants far more than the bourgeoisie and rich landowners is given by the experience of the large Guatamalan earthquake of February 1976, which was felt over an area of at least 100,000 square kilometres, claimed more| than 22,700 lives and injured more than 76,000 people. Loss estimates total at least $1,100 million.

The principal hazard to life (as in most earthquakes,) was in the collapse of man-made structures. At the time of the 1976 earthquake there were no laws governing building codes in Guatamala and it was not mandatory to design structures to withstand large earthquakes.

Most poor people lived in adobe or wood and mud houses which collapsed under the slightest shaking. 88,000 such houses were destroyed in the vicinity of Guatamala City alone and 435,000 people were left homelss.

The bourgeois families of Guatamala lived in better designed and constructed houses on firm foundations which were not seriously affected by the earthquake.

Large, modern buildings designed to be resistant to earthCity, were completely undamaged.

This contrast was nowhere more acute than in the vicinity of the Rio La Barranca, a steep-sided gully which forms the western boundary to Guatamala City.

A road bridge, cited as a shining example of earthquake resistant design, crosses this gully near an area where workers and unemployed were forced to build mud and adobe houses perched on the very edge of the gully.

After the earthquake the bridge was undamaged but the houses collapsed and were destroyed in their thousands with great loss of life and enormous numbers of injuries.

"FIRST AID"

After the earthquake the "First Aid" from the US was used to rebuild the communications linking the interior with the sea, to ensure that material the US needed to import from Guatamala could flow once again. Meanwhile, workers, peasants and the unemployed remained homeless.

A balanced approach to the reduction of earthquake hazards must include the widest possible use of the technology of both earthquake prediction and of the engineering of earthquake resistan! structures.

Scientific and other worker: must organise now to draw up safe land-use and building codes They must press for the immediate strengthening potentially dangerous •existing structures, especially high TISE offices and flats, dams, houses, etc make he same time woker and They must demand to oversee the At the same time workers and peasants must establish their owr earthquake defence committees to prepare to meet their food, water housing : and medical requirement that will be even more urgentl felt in the aftermath of an earth Aroke den rest tre bond workers and peasants into con flict with bourgeois nents and must form part of : capitalismeneral struggle against nore

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quakes, such as the new Finance Ministry Building in Guatamala