With the date for Brexit rapidly approaching, Phil McCafferty looks at what this could mean for dentists.

There are very few dentists in practice before the UK joined the EEC (or Common Market) in 1973. I am old enough to remember the day the Act was passed.

In the post-war period, leading up to the 1960s, two European trading blocs were formed:

  • The European Free Trade Association (EFTA) – Norway, Sweden, Denmark, Switzerland, Austria, Portugal and the United Kingdom
  • The European Economic Community (EEC) – comprising France, West Germany, Italy, Netherlands, Belgium and Luxembourg.

The UK very quickly realised it had backed the wrong horse and tried to make amends for its error.

With the French and the Germans as key players, the EEC had more trading muscle and offered a bigger market for its own produce. Britain applied twice to join the EEC, in 1963 and 1967; on both occasions it was vetoed by the French President Charles de Gaulle. De Gaulle’s feeling was that the British were allies of the US first, with the Europeans a distinct second, and there had never been any love lost between him and the US. He also held a deep dislike of the British, believing the naming of the character of Dougal in the Magic Roundabout to be an act of entente discordiale, as it was one of personal mockery.

When De Gaulle resigned the Presidency in 1969, the UK’s third application for membership was finally accepted and the way was paved for entry to the Common Market.

What has all this to do with dentistry?

Well, quite a lot, actually. Having entrusted the Great British tabloid-reading, Strictly-watching, Bake Off-addicted public with the finer points of deciding our economic future by virtue of a referendum, we will leave the EU on 29 March 2019. The only thing that is certain is there will be uncertainty.

We have already seen a significant exodus of dentists who had come to practice in Scotland over the last 10 years. The incertitude surrounding Government plans, or lack of, with questions over the free movement of people between the UK and the EU after 2019, has meant a significant number of Polish dentists in particular have gone back home, as the economy of Poland has strengthened in recent years, while ours has stagnated.

Anyone who has tried to recruit an associate recently will recognise the challenges of a shrinking workforce, where the cities remain flooded with dentists, but the provincial practices struggle.

There has been much talk of the trade Armageddon that may befall the UK in the event of a failure to agree on an EU deal. Supply chains stretch across Europe and goods manufactured in mainland Europe are often transported into the UK on demand in a matter of a day or so of order. Most freight is brought in via the Channel ports and distributed from there by road. In the event of the introduction of border checks on goods, long queues are likely at Channel ports. This will make goods harder to obtain quickly and more expensive to buy. The introduction of tariffs will result in yet higher prices to us as dentists.

You may remember the fiasco that resulted in a shortage of local anaesthetics a few years ago? We may see that situation return, with a lot of the supplies we order every week on back order if the lorries simply cannot get through the logjam at customs.

Change mismanagement?

What better time to introduce additional uncertainty into our lives by way of projects such as the Oral Health Improvement Plan (OHIP) and Edental? The Edental project has rattled a few cages recently. The way I see it, Practitioner Services has bought into the paperless office in a big way.

Nothing wrong with that, in the whole scheme of things, but the truth of the matter is it is being starved of resources and the Scottish Government has given it a sow’s ear and is expecting a silk purse in return.

Practitioner Services realises employing human beings to process paper costs money. However, the technology it has at its end to process our claims electronically is, according to my computer support man, like something from the steam age, because Practitioner Services has not been given the resources to modernise and replace it. Instead, it has had to bolt on change every time it is introduced, and the strain on the system is beginning to tell.

In general, medical practice software systems are provided by the NHS. By comparison, dental practitioners in non-salaried practice have to provide software systems themselves and fund them in full. Our software suppliers have large teams of software developers, working with the latest systems and servers, but every time a change is introduced into the payment process they have to deal with the conundrum of adapting modern technology to the machinery of the steam age. For these developers, mostly based in England or even abroad, Scotland is but a small part of their market, which gives them a lot of grief, on a regular basis, with the regularity of these changes. Some are rumoured to be evaluating whether the Scottish market is in fact worth the hassle.

I noticed the other day there is someone in charge of business change at Practitioner Services. That suggests to me a culture of change for the sake of it. My suggestion is that they leave things alone for a bit and perhaps change the job role to one of business continuity.


For more information, Phil McCafferty can be contacted through Dentistry Scotland. Responses to the article should be emailed to the editor, seb.evans@fmc.co.uk.