Private or NHS General Dental Service care in the United Kingdom? A study of public perceptions and experiences

Background Recent changes in the NHS General Dental Service have led to a r eduction in the availability of NHS dental care and increased charges. This study explores public and user views and experiences of NHS and private de ntal care in the light of these changes. Methods The study employed a combination of quantitative and qualitative me thods. The first phase involved a postal survey of a random sample of adult s on the electoral registers in a county in Southern England, which yielded a response rate of 55 per cent (n = 1506). Follow-up face-to-face intervie ws were carried out with sub-samples (n = 50) selected from survey responde nts. Results The evidence shows greater satisfaction with certain aspects of pri vate care than with NHS dental care and suggests that the decline in percei ved quality of NHS care is less to do with the quality of dental technical skills and more to do with perceived access and availability. However, ther e was general support for the egalitarian principles associated with NHS de ntistry, although payment for dental care by users was acceptable even thou gh dentistry on the NHS was preferred. Conclusion The shift in the balance of NHS and private dental care reflects the interests and preferences of dentists rather than of the public. It su ggests, however, that a continued shift towards private practice is a trend that the public will not find acceptable, which might limit the extent of expansion of private practice.