In The Spotlight - An Interview With The Secretary Of State For Health

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By @DentistGoneBadd


This is where I stand.

A few years ago, before David Cameron adopted the foetal position and waved the white flag to the advancing UKIPS, giving them the Brexit referendum, I was stopped by a ‘kipper’ in the high street of my adopted home city. I was asked if I wanted to forever remain ‘dominated’ by some ‘faceless European bureaucrat who would force us to consume straight bananas and live in dimly lit buildings powered by puny Dutch lightbulbs, or put the ‘Great’ back in Britain.

I answered thus:

“If I were the Prime Minister and had unlimited funds, I’d build a motorway bridge from here (the Midlands) directly to Paris.”

It was a nonsense answer – the sort that Donald Trump would have given – but I thought it got my point across. I am, and always will be, a European - a citizen of the world. I think Brexit is madness, and at a time when the world is becoming more and more fragmented, I strongly feel we need unity.

In the past couple of weeks, two of my closest dental friends – both from the EU, have indicated that they are thinking of returning to their countries of origin, having worked in UK dentistry for several years. Both were worried about the uncertainty surrounding their rights to residency – an issue still not absolutely clarified by the UK Government.

Another East European friend has recently left my corporate practice to go into independent dentistry, unable to cope with the madness of the NHS, UDA system. This has left the corporate practice critically short of clinicians and attempts to bring in either a permanent dentist or long-term locum has failed. (OK, fair enough, it IS a corporate after all). Many foreign dentists I have met have all been working for a UDA rate much lower than their home-grown counterparts and it is them in the main (it appears to me) that are prepared to work at a rate UK-born dentists would turn their noses up at.

One former corporate practice manager told me recently that she was told to offer prospective dental associates different UDA rates – foreign nationals being offered two pounds per UDA less than their UK counterparts.

Associate Shortages

I know of a number of NHS practices locally, which are currently struggling to find fully qualified associates of either UK, EU or other origin and this of course contributes to the lengthening of waiting lists and reception desk grumbling. With unattractive salaries on offer, particularly from the corporates, it is no wonder some practices are struggling to recruit. I once put myself on a few dental jobs websites and despite pleading to be taken off, am daily bombarded with all manner of associate jobs, from part-time to ‘whatever you can manage.’

Besides EU nationals going home as a result of Jacob Rees-Mogg, in 2017, a private Freedom Of Information request obtained from the General Dental Council showed that foreign dentist numbers dwindled in 2016, since nearly 40% of dentists who were found to have impairment of their fitness to practice originated from the EU or outside the UK and EU. This represented just over 3.7% of the total ‘foreign’ dentist workforce as contrasted to the 0.2% of naughty UK dentists based on 2018 registrant figures.

A search of the number of dental therapists in trouble with the GDC finds no such comparable statistics. Apart from one therapist in 2005 who was erased for performing a filling without a dentist prescription and one in 2013 who forgot to pay her Annual Retention Fee, there has been an exceptionally low rate of fitness to practice cases brought against therapists.

These days, since I work in a corporate, I meet very few therapists, but I have a very high opinion of them from personal experience. I will admit, I was forced into it because I couldn’t find an associate to move out into the sticks where my practice was located, but I employed a dental therapist in my own practice for a while a few years ago and her work was very good - providing a top-notch client service as well as taking patient appointment pressures off me. Her employment was also economically, a ‘no-brainer,’ being cheaper than employing an associate at 50% renumeration. I also trained with a mature dental therapist in the early 80’s. She flew through the dental course with ease, knocking spots of her classmates.

A Solution?

With many practices searching fruitlessly for fully-qualified post-vocational training dentists to replace fleeing dentists (for whatever reason), I wonder if we are missing a trick? Why not put these underutilised dental professionals to full use? Even the corporates haven’t caught on to this yet – presumably because they haven’t done the sums fully. Dental therapists can perform a wide range of tasks that can leave the corporate associates more time for searching for materials or stabbing the practice manager in the back. The only fly-in-the-ointment would be the stroppy associate who resents writing a prescription, but they can always be blackmailed with ‘OK. Do you want to do a radiograph audit after 5.00pm?”

In independent/NHS practice, remuneration would be a simple matter of a salary or hourly rate. In corporates, a nod to the associate’s prescription input would have to be acknowledged, so that he can get on to providing Band 3 mouthguards for someone who may have heard a vague click in their left TMJ in 1998.

Having said all that, I WILL miss my European colleagues if they do decide to go.

When I first met her, one of my EU friends was trying to pick up some British colloquialisms, mainly taught to her by her dental nurse, a girl with a mischievous sense of humour.

I arrived with my wife at the new house she was occupying with her now (British) husband. We had a lovely traditional meal from her home country, but then she apologised for the lack of furniture, and although we were perfectly comfortable at the dining table, she pointed to a couple of ample beanie’s in the lounge area and asked “Or would you prefer sitting on the douche-bags?”

David Cameron, what did you do?

The British Dental Industry Association (BDIA) and Federation of the European Dental Industry (FIDE), as the trade associations representing the dental industry in the United Kingdom and Europe, have today issued a joint letter outlining their priorities for the ongoing Brexit negotiations.

The initiative, proposed by the BDIA, saw a letter addressed to the European Chief Negotiator for Brexit, Michel Barnier and the Secretary of State for Exiting the European Union, David Davis, highlighting the important economic and public health role played by the dental technology and devices sector, and calling for action to be taken to safeguard it.

BDIA Chief Executive, Edmund Proffitt, comments, “The measures outlined by our associations would ensure that our industry is able to continue to provide access to innovative dental technology in the UK and throughout the EU, to the benefit of patient oral health and the economy, beyond the UK’s exit from the EU in March 2019”.

Chief amongst these measures is a commitment to parity of UK and EU legislation after Brexit. The UK’s decision to leave the European Union came at a critical point for the dental industry, coinciding with the publication of the EU Medical Device Regulations (MDR), and future divergence in legislation would risk disadvantaging both patients and businesses across Europe.

Other priorities to ensure a successful outcome to the negotiations include the maintenance of the Medicines and Healthcare products Regulatory Agency’s involvement in ongoing discussions concerning medical device regulation, the continued adoption of the CE marking process for medical devices and allowing UK Notified Bodies to operate under the MDR.

The Brexit vote has had an immediate and dramatic effect on the UK’s credit rating and the value of Sterling. The UK is now seen as a less safe place to invest in and less secure to lend money to.

PFM Dental Director, Jon Drysdale, says: “The decision to leave the EU could affect your plans to purchase a dental practice and makes it even more vital to have a robust business plan. Lenders will undoubtedly pass on the increased costs of borrowing although against this it unlikely the Bank of England will impose an interest rate rise.”

The UK remains one of the world’s largest and strongest economies with good banking liquidity, relatively low unemployment and perhaps the potential for improved terms with global export markets. If you subscribe to this view, the cost of borrowing money will probably stabilise and remain at a reasonable rate.

All of this emphasises the need for buyers to examine their business plan and the cost of running a business. Are you being realistic about the interest rate you can achieve? Do your projections stress test for rise in the cost of borrowing?

For more information about PFM Dental services go to: http://pfmdental.co.uk

Richard Lishman from Money4Dentists shares his thoughts on Brexit and what it will mean for Dentists in the UK.

So it’s happened. Voters in this country have supported a split from the European Union and, for the first time in just over forty years, the UK will be heading out into the future without its Continental neighbours.

When the news broke on the 24^th, there was a lot of panic and uncertainty. The FTSE 100 dropped approximately 8.7 per cent, the strength of the pound plummeted to levels unseen for almost 30 years and the Prime Minister, David Cameron, announced his plans to step down in October. A pall of hysteria seemed to envelop the country… but is it really that bad?

Well, the most important thing to remember is that nothing is going to happen over night. A lot of things are up in the air right now, but they will settle. The market has gone up and down for years but it has always normalised. If we look back to the Scottish referendum, the FTSE experienced similar turmoil, but it went back to normal quickly enough. The main thing is to stay calm and not be too hasty in despairing.

In some cases, there may even be a chance for people to make a little money. In terms of equities, some may stand to make money if they buy carefully whilst prices are down and wait patiently for when the market returns to normal. Indeed, by being careful and investing wisely there can be much to gain at the moment. Of course, many individuals may be tempted to sell rather than buy right now, but this is more a product of inexperience than financial foresight. People are anxious and when they start to see the risk, they can panic and make mistakes.

It would be far better to approach this change with consideration and patience. Once the market has settled and the smoke has cleared, people will almost certainly have forgotten about the day we Brexited.

For dentists, one of the most crucial things to remember is that people will always have teeth – whether they’re part of the EU or not. The population will not suddenly stop needing to go to the dentist. There may be an initial dip in attendance whilst uncertainty reigns, but this will more than likely return to normal in due course – dental pain, after all, is and likely always will be a constant.

One thing, however, that some dentists may need to consider, if they achieved their qualifications in the EU but now practise in Britain, is that these may not be valid once the UK become independent. Of course, this is an eventuality that is still a long way away from becoming a reality, but it is something that might be worth researching to cover your bases.

But on the other hand, there may even be a chance for the UK dental economy to flourish. UK dental laboratories could see an increase in business if practitioners no longer have the option to work with overseas laboratories due to quality and standards incompatibility. Similarly, dental tourism may begin to tail off if EU dental qualifications lose their value in the UK and flights abroad increase in price.  

There are a lot of negatives that could come out of Brexit, but there are also a lot of positives that can be found – and these are most certainly worth looking for. Of course, if you are ever uncertain or concerned about your financial situations in the days and weeks following Brexit, it is always worth contacting an Independent Financial Adviser for, if nothing else, a little reassurance.

For more information please call 0845 345 5060 or 0754DENTIST.

Email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit www.money4dentists.com

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Tony Jacobs BDS, dentist, publisher of GDPUK.com

Image credit -Fernando Butcher under CC licence - not modified.

As a GDP I am really struggling to focus on what my vote should be. So I have set myself the task of reading across the campaigns this weekend.

It’s a busy week, and you too need to do your final reading. If only this was vCPD eh? 

Well why not?    It’s clear that this affects your dental practice, so go reading, message me privately and I will send you a simple feedback document, and a certificate for vCPD. Allow 2 hours.

What is they say about a divorce? You must have a reason to go and a reason to leave.

Do we? Have we?

Here are your links for the Remain and Leave campaigns [also knon as the  “Innit” and  “Exit” !] and other information sources or repute.  If you read over these there will be lots of facts, and a degree of balance.  I have tried to avoid opinion.

https://leave.eu/

http://www.voteleavetakecontrol.org/campaign

http://www.strongerin.co.uk/

http://www.bbc.co.uk/news/politics/eu_referendum

http://www.telegraph.co.uk/eu-referendum/

http://www.theguardian.com/politics

EXIT  If at the end of this, you vote for the UK to exit, you will be lighting the fuse for the first cannon shot in a bloodless revolution.

No less, no more.  The aftermath will be a change in the political landscape of the UK not seen for centuries. Make no mistake, in the past, civil conflinct started over less.

REMAIN  If we vote to stay in, we will have the same group of leading politicians weakened by the arguments in the campaign, but a stronger case for lead influence in Brussels.  Perhaps a vote to remain is a vote for change we do not expect?

Polls

http://whatukthinks.org/eu/opinion-polls/poll-of-polls/

But if the polls are to be believed there is a groubndswell of decided opinion forming. Watch out - the UK electorate has a habit of suprising the pollsters.

If we do indeed vote to exit the political treaty that is the EU two things have to happen.

Firstly, the present political leadership must go.

Secondly, therefore, by any logic,  there must be a snap General Election.

And there begins 5 years hard work to re align our political and trading arrangement with the EU and the world, under new elected leadership.

And, guess what happens if we vote to remain?  Exactly the same.  UK politics will never be the same for this generation.

This is  a big job and on Thursday when you vote, you are not voting for no change.

You are voting for how you want the change to occur and when.

Should we lead from outside the EU and try and lead from within?

Whatever you do, Vote

Whatever you do, respect your neighbour and his or her opinions.

That right to vote is something we have taken for granted these last hundred years.

It’s a new privilege and a new right in many of our Eastern European neighbours home states

And good luck, friends and colleagues.

This really is a momentous event, in which you are free to both witness and partake.

Go use your your freedoms, as wisely as you can, and we will met on the other side.