Calm Down, Calm Down, Calm Down

The words of Harry Enfield’s bubble permed Scouse's of the 1990’s are perhaps the most apt at the moment to describe how I feel about the outpouring of angst on the result of the EU Referendum.

Alternatively, to plagiarise somewhat Winston Churchill,

            "Never has so little sense been spoken by so many in so few hours"

I am probably about to join that increasing pile of rubbish, but thought rather than add fuel to what appears to be some as a bonfire of Liberalism and Tolerance I’d try to get a bit of perspective back. I’m certainly no political commentator, (and once you read this you’ll probably agree!!) but I do feel quite strongly how this has developed over the weekend. The sheer vitriol that has been produced in such a short time has been nothing short of shocking, but at least we now have got some real political debate and possibly change on our hands. However, we all need to calm down and stop falling out, because BOTH sides have valid points in my opinion and the only way to move forward now is if we calmly look at the big picture once again.

Because we haven’t actually left Europe. Not yet, and we will not in the next few weeks, months, or years. The referendum was a non-binding one, and merely the biggest opinion poll that has been run in this country for years, albeit with slightly more weight than most have. Unlike the Alternative Voting referendum in 2011, which had a legally binding result, there is no legal duty for a Government to act upon the result of Thursday’s result.

That’s right, Government has no obligation at all to actually heed the result.

It’s certainly monumental that the UK has voted in the way that it has, and there are a multitude of reasons why individuals will have done so. Many of them will have been misguided in other’s eyes, but all of them were personally valid ones to the person who was actually entitled to put their cross in the box. But we have seen the biggest turnout for years that has galvanised the electorate in way that I thought would never happen (now if only we could mobilise dentistry the same way…). This was always going to be a subject dear to the hearts and minds of the populous. It’s a shame that many of the most vocal of those who now feel betrayed by the decision were the ones with the lowest percentage turn out (the 18-24’s having less than 40% turnout). Perhaps there should have been a button on Facebook, or Text your Vote to allow that sector to vote? After all, many of them expect instant and easy solutions without having to actually physically get up and do something…. In addition, a democracy can keep continuing to vote and vote and vote until it gets the answer it wants.

Politically, I am of the opinion that David Cameron has played a political masterstroke. Unlike many, I was not shocked at all when I heard of his resignation. This is a man with an exceptionally astute political mind, and the outcome (although unexpected by many) will have been modelled by advisors. If we read into what he has said in the past, he had only alluded to the fact that a leave vote would result in the British public ‘expecting’ the process to leave the EU to be started straightaway.

An expectation by the public is not the same has an obligation by a politician though, and with his resignation, he has delivered what can only be described as a Hospital Pass to his successor as Prime Minister. For the formal process of leaving the EU to begin, Article 50 of the EU agreement relating to departure has to be formally invoked. Now, it is unclear if the invocation of this can be made by only the Prime Minister, or whether (more likely in my opinion) it has to have been voted on by Parliament in order to become formal. However, the result of the referendum, DID NOT invoke this process, and no matter what the EU Bureaucrats say, the UK is the only entity that can start this process.

So, a political hot potato has been deftly delivered by David Cameron as his last act in office. A new Tory Leader from the Leave side will have to either go against the referendum result, which will immediately destroy their personal credibility and therefore the faith of many people in their suitability to be Prime Minister, or they will have to activate Article 50, which then will probably have to go through parliament to be voted on. If they don’t do this immediately, then doubts about the suitability of the new leader to govern will set in as well. Is this not a most beautiful revenge on his once close allies Boris and Michael? In one fell swoop Cameron has called their bluff magnificently. ‘Leave’ now has to put up or shut up, and either enter into negotiations with the EU saying it was all a ploy to get further concessions, or activate the Article 50 clause, which might be their own political suicide if they don’t truly believe in what they have achieved.

I think we will then have the prospect of a snap General Election that could once again change the political face of the UK and re-establish a new political balance. One that might have Remaining in the EU as one of its fundamental promises. That’ll give the electorate who are currently appealing for a ‘best of 3’ approach to democracy to have another go at influencing the decision. However, quite as possibly with be a further endorsement of the desire to leave, but then there becomes a true mandate for a new Government to act upon. It’s like pressing the Reboot switch.

We have now heard that the Scottish MPs under Sturgeon will actively block the departure of the UK from the EU if this goes through parliament for a vote. So nothing at the moment is a given for the UK actually managing to leave the United States of Europe. The majority of the political commentators will know all this but cynically I’m of the opinion it serves the purpose of the media to keep all the froth and agitation going at the moment to confuse the populous even more and influence how they think whilst selling papers.

And the leaders of country with such political ability in the world didn’t see this outcome as possible?????

I suppose I should have a few opinions on what this means in Dentistry then. Well, for a start the GDC isn’t going to be affected by it at all. The Dentists Act 1984 is a piece of UK legislation and whilst it has EU aspects covered by such as the Human Rights Act and Data Protection Act, and has to be compatible with EU tenets of law, nothing within the day to day interpretation of the Act is likely to be affected by what happened last week. The same is true with the CQC. The UK is wonderful at developing infrastructure like this, and certainly doesn’t need the EU to make a business out of bureaucracy. There certainly won’t be a bonfire of the dental Quangos whether we stay in or out is my prediction.

There are a significant number of EU graduates working in the UK, and I don’t see any evidence that coachloads will be shipped back through the Channel Tunnel before it is bricked up overnight. What might actually happen though is that the corporates might find their supply of naïve EU dentists dries up due to the uncertainty of the future direction of the UK, and they might actually have to pay a competitive income to get people to work for them. This will no doubt affect their bottom line somewhat, and they might actually find they are now susceptible to the same pressures that normal practices are under and have to adapt the same way as we have all done. This can only be a good thing in order to restore the competitive balance in our profession.

What also might be beneficial to dentistry from leaving is the restoration of parity to our own graduates. Those who graduate from the UK have to complete foundation training before being allowed to work in the NHS, yet those from the EU don’t. Not only that, because the EU training is seen as equivalent to the UK, we cannot impose requirements like the ORE on them. Are all the EU Dental training courses the same quality? I think some of us might disagree that every single course is.  Surely this has benefitted those from the EU more than our homegrown graduates, and this potential discrimination can be possibly now be addressed in the future.

We still don’t really know what will happen with the prices of dental goods in the long term. Much of it is indeed made in the EU, but the USA and Asia are also vast markets, and not necessarily unified like the EU. China as an emerging market has already rocked the world of the dental technicians, and there is no reason why that cannot happen in the rest of dentistry. Admittedly controlling quality is going to be the issue, which worries me, but there are also some highly ethical businesses there that would work well within dentistry. There will be inevitably be some adjustments of prices because of the strength of the pound, but equally there is now an opportunity for entrepreneurs within the dental supply chain to start ‘disrupting’ the usual model.

The one thing we are unsure of is the overall effect on the general public and their incomes. Potentially this is huge, and the instability that is coming will affect them to an unknown degree. It is notable that the professional advice from the likes of the Bank Of England is to keep calm, whereas those who have a self interest, either towards the EU, or financially, in keeping the markets volatile is to Panic and Run Away. I know what I shall be doing. At times like this speculators usually manage to be the overall winners anyhow, so it’s in their interest to keep earning their money how they always have done.

But all this pre-assumes we will actually leave. I’m afraid I don’t believe the upper echelons of political power (and by that I don’t mean government but the high level civil servants who are in post despite what political flag is flying over Westminster) haven’t already worked out what their long game is and planned their chess moves accordingly.

So, we need to keep calm, because we haven’t actually left yet, and I personally don’t think we were ever going to….

Though the real question is can we trust any of them anymore?

Image credit - Muffinn under CC licence - not modified.