Top-Up Fees, An Indemnifier's View

Top-Up Fees, An Indemnifier’s View

While registrants have begun to think about the wider ramifications of the Court of Appeal top up decision, it has taken a little while for professional organisations and indemnifiers to comment.

The GDC, who sought the now refused appeal, put up only a terse 200 word statement on their website following the verdict. In it, they largely washed their hands of the resulting turmoil which has resulted from their unwillingness to accept an earlier judgement. They did manage to provide a hospital pass to the DHSC and NHS England, making clear that it would be up to them to deal with the consequences of the Court of Appeal decision.

Most dental organisations appear to be still digesting the news and considering its implications. The CDO’s periodic Oral Health Bulletin sent out five days after the judgement, made no reference to it at all. The BDA have now added their thoughts, in the form of a commentary from Kevin Lewis, Special Advisor and former head of Dental Protection, and Len D’Cruz who is the Head of BDA Indemnity. Topping up NHS charges with private fees accepted in Appeal Court decision (

Now the Dental Defence Union (DDU) have provided their initial statement.

John Makin, Head of the DDU said: This is a very complex case which has raised a number of issues. It has created uncertainty and we are now considering the implications of the judgment on behalf of our members.

“If dental regulation is to be fair, it needs to be consistent, and dental professionals need and deserve clarity on the regulatory position. Following this judgment, we do not have that clarity. It is necessary for the Department of Health and Social Care to provide urgent clarity on what the precise regulatory position is concerning top up fees.”

The DDU is writing to the Government, urging them in collaboration with NHS England, in an attempt which it hopes will resolve the matter swiftly. John Makin added that, “Dental professionals deserve nothing less.”

With a great deal of speculation about whether and in what specific circumstances it might be ‘safe’ to charge top up fees, John Makin concluded: “We understand that dental professionals are currently in an uncertain position over the issue of top up fees. However, until further guidance is available, the DDU would suggest that practice owners and contract holders proceed cautiously before introducing any changes. Members are welcome to contact our expert dentolegal advisers for clarification on their individual circumstances.” 

The DDU will not be making the contents of their letter public, but have told GDPUK that it will set out the concerns contained in their statement – that the recent judgement highlights the lack of clarity in the regulations and there is a need for urgent action from the Department to clarify this situation for dental professionals.

With indemnity providers tending to take a cautious position by default, it is likely that dentists can expect a series of similar statements from the other providers.



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