Indeed, the same applies to GPs, the vast majority of whom are still self-employed partnerships contracted by the NHS. The only way to get the NHS off the ground was to buy off the “family doctors” by making them the gatekeepers to, and patients’ advocates to, secondary/specialist services, and allowing them to carry on with private practice alongside NHS services. Until practically the last minute it was touch and go whether enough of them would sign up. Nowadays, they’re the service’s strongest advocates.
Dentistry is weird and it’s always seemed a bit wrong to me that, at least for acute care, it’s not just part of the services of every hospital, but the trouble I suppose is that the acute care offering from dentists is bundled with a whole load of other services, some of which are optional and others purely cosmetic, and it’s a sufficiently specialised set of disciplines that you can’t really split that up.
Unless I’m misunderstanding “acute care”, there is acute dental care in UK hospitals, on referral from your own dentist - I had my wisdom teeth out in hospital all in one go, and there must be other sorts of conditions requiring full surgery, which is presumably the dividing line.
Sure, but I think in general, you can’t just directly access that acute care in the same way you can for other stuff - like if you have a nasty infection in your toe, you can go immediately to A&E or Urgent Care pretty much any time; if it’s a nasty infection in your tooth or gum, you have to go to the dentist first (which is also typically only 9 to 5 Monday to Friday).
A couple of years ago I experienced the sudden onset of pain in what was either my upper jaw or cheek/sinuses - it really wasn’t easy to pinpont where the problem was; I got batted around a bit from GP to dentist to Urgent Care, over the course of several days; ultimately out of pragmatism and sympathy, the dentist prescribed antibiotics for what was probably not a dental problem. The antibiotics did seem to clear it up, but it was probably an ENT thing.
IMO, the patient should not have to decide the correct route to treatment, based on their perception of the precise location of pain in their head.