Dentists extract profit from workers

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Dentists, in the main, are not simply a professionally skilled section of the middle class, but fully fledged-if small scale-members of the bourgeoisie.

90% of them act as independent contractors to the NHS, own their own "means of production' (drills, chairs, spitoons, amalgam and old magazines) and employ wage labour.

A complicated calculation is carried out to ensure that the dentist is reimbursed for the use of these means of production. Each fee for an item of treatment is loaded 56% to cover his "expenses".

Dentists are not obliged by contract to treat any particular number of NHS patients -they can take as many or as few as they wish.

One Course Their obligation to a particular patient extends Correspondent only for the duration of one course of treatment designed to make that individual "adequately dentally fit"-a deliberately vague term.

But despite this it is estimated that the average general dental practitioner rakes in 90% of his or her income from providing treatment to NHS patients.

No pressure Dentists were the last professional group to complete negotiations with the Department of Health and Welfare in 1948, and have insisted on their 'independent' status.

Even today there is no pressure among dentists for abolition of the piecework system of payment and the introduction of a salaried scale.

36% of the students at a London teaching hospital, questioned on their preferred career wanted to practice privately-as against only 6% wanting a salaried service.

Interestingly, over 50% of those same students had attended private or direct grant schools!

This bourgeois-middle class grouping exhibits a complete contempt for the workers it employs.

Most of those employed by dentists are women, non-union, low paid and provided with few facilities.

Many also face health hazards: an estimated 50% of the X-ray machines in use in dental surgeries scatter too much radiation.

As for the dentists' patients, they too get a rough deal if they come from the working class.

Disease of affluent

When sugar was a luxury item dental caries (decay) was a disease of the affluent. But now dental decay among working class children is much more prevalent than among children other classes.

In Camden a survey revealed 10% of workir g class children suffering from rampant caries-with 10 or more teeth decayed.

Inferior

As workers get older they face barriers to dental care. Hourly paid workers generally lose wages on top of the cost of treatment-whereas the middle class gets time off with pay.

When they go to a dentist, workers frequently receive inferior treatment. Many working class patients are fitted with dentures called 'gum strippers' by dentists.

These speed up the loss of support for remaining teeth and hasten tooth loss. Dentists will often not go through the procedure of supplying the alternative, superior, types that are in theory available on the NHSfeeling that the profit margin involved in the job is too low.

This profit factor is also why crowns and bridges are so seldom supplied on the NHS.

Meanwhile a majority of patients given private dental treatment turn out to be workers-often persuaded under pressure of pain and the fact that they have no 'regular' dentist to pay penal fees for basic treatment.

The dental profession, despite the fact that it is trained in state-run facilities, stands almost united against the most elementary concept of socialised provision of health care.

The fight for the reversal of NHS cuts-involving the breaking of the Lib-Lab coalition-must include not only the nationalisation of private clinics suppliers and drug monopolies, but • also measures to introduce a planned, state run provision of dental care. ship.

"The frightful difficulties of socialist construction in an isolated and backward country coupled with the false policies of the leadership —which in the last analysis also reflects the pressure of backwardness and isolationhave led to the result that the bureaucracy has expropriated the proletariat politically in order to guard its social conquests with its own methods.

"The anatomy of society is determined by its economic relations. So long as the forms of property that have been created by the October revolution are not overthrown, the proletariat remains the ruling class"

No responsibility Trotsky, in other words, argued that one must distinguish the policies of the Stalinist bureaucracy from the social base on which Soviet society is founded.

Revolutionaries can accept no responsibility and give no support to the counter-revolutionary policies of Stalinism. int the contrar assery at evers Trotskyists to distinguish themselves from these positions, to fight in the workers movement to reveal the dangers to which these policies expose the working class.

It is our task to advance precisely those policies which can mobilise the working class around their own independent class interests.

At the same time, however, it is the duty of revolutionaries to give unconditional support to the defence of those gains of the October revolution that still remain, and in particular the nationalised property relations.

Continued

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