Brexit and the Impact on UK Dental Recruitment

The all too dreaded term “Brexit” has brought on a challenging political climate in the UK. Brexit is the withdrawal of the UK from the European Union (EU) following the June 2016 referendum in which 52% voted to leave. The then Theresa May-led government issued a formal statement of the country’s withdrawal in March 2017. In March 2019, with unmet negotiations for the withdrawal, May was asked by the Parliament to delay Brexit until April, and then later October.

Succeeded by Boris Johnson soon after, a settlement of the revised withdrawal agreement with new arrangements for Northern Ireland was put into place in October 2019. Eventually, on 23rd January, 2020 the official withdrawal agreement was ratified by the UK and on 30th January 2020 by the EU, entering force on 31st January 2020. UK’s membership of the EU formally ended at 11 p.m. GMT on 31st January 2020 after 47 years of initially joining. As of today until December 2020, the UK remains in a transitionary period, which can end in “a deal” or a “no-deal” Brexit.

Impact of Brexit on the UK

Many effects of Brexit depend on how closely the UK will be affiliated with the EU. The resulting effects have been:

  • UK remains subject to EU law and remains part of the Customs Union and single market during the transition, but will no longer be a part of EU’s political bodies or institutions.
  • The financial settlement has concluded as ‘unsatisfactory’
  • The country’s economy has been under attack, reducing its real per capita income in the long term.
  • Likely to reduce immigration from European Economic Area (EEA) countries to the UK, challenges for UK’s higher education, academic research and security.
  • EU law and the Court of Justice no longer have supremacy over UK law and the Court of Justice, except temporary.

How does Brexit impact Dentistry?

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Following the tremendous shock of Brexit, an avalanche of sizeable impacts have been laid on various commercial sectors and modules irrespective of design and discipline. The field of dentistry is no exception where the very being and mores of the industry can be threatened and is likely to result in vastly impacting the constitution within the dental sphere as well.

According to the British Dental Association (BDA), there are some particular areas where the EU legislation can directly impact the viability of dentistry in the UK:

  • Movement of dentists and dental care professionals (including the various processes for the automatic recognition of qualifications)
  • Import and export of dental equipment and materials
  • Supply of medicines
  • Health and safety legislation
  • Data protection regulations
  • Research and development

Critical impacts of Brexit on Dentistry

1.EU dentists who are currently registered in the UK

As of today, the UK has officially left the EU and is currently serving a transitionary period that would likely last until the 31st of December 2020 after which negotiation is expected to reach. Fortunately, the Government has expressed that EEA or Swiss qualifications that are already registered in the UK, or registered in advance of the concluding transition span (31st December 2020), will not be affected.

Furthermore, EEA-qualified dentists and their families who are residents in the UK until the transitionary period concludes will be able to remain in the country and continue to work under the EU Settlement Scheme. EU citizens may, however, be required to apply for a settled status depending on the period of stay. Therefore the dentists who are presently working in the UK are safe as of now, nevertheless, it is still questionable as to how timescales and requirements for the settled status may alter with the final settlement of a deal or no-deal Brexit.

2. Recruitment of EU dentists in the UK

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In the wake of Brexit, recruitment of EEA-qualified dentists may see a standardised drop due to mutual recognition of qualifications that may be put into place. EU dentists who are pursuing a career in the UK may need to now give an Overseas Registration Examination (ORE) that could potentially further delay the staffing of the UK NHS or other vast medical sections.

EU dentists are becoming increasing uninterested to come to the UK in pursuit of a flourishing career due to the looming uncertainty of a potential no-deal Brexit and how that could devastatingly impact and toughen up the process of hiring of the workforce by the dental practices in the UK. There is also the implication that they would have to compete for work visas due to the fact that the Government is currently standing by their election pledge to reduce net migration to the “tens of thousands”, where only the person who obtains the job may be given permission to work in the UK for a defined period of time. Due to these feasible missteps, EU dentists have been reported to prefer their home countries as viable areas for practice, what with 380 EEA-qualified dentists leaving the register in 2017 because of their Brexit-endangered residence.

There is also the argument of the severely depreciated value of the Pound versus the Euro over the past three years that may be playing a significant role in further discouraging EU dentists to embark on a UK-based dental career. Although the Pound is still comparatively higher in value as compared to the Euro, following the 2016 referendum the gap has definitely narrowed. With a steady blow to the British Pound coupled with a more stringent set of checks and conditions for migration and recruitment, the NHS continues to remain understaffed and may see a valuable market in outsourcing dentists from overseas.

3. Current short-staffing of dentists in the UK

Understaffing is not a new issue in the UK dental sector. The BDA issued a report in 2018 that suggested that 68% of NHS practices and ventures have seen a steep decline in recruitment of new dentists and 58% of NHS dentists were considering leaving the UK in the next 5 years. They listed the uncertainty and onset of Brexit as the prime reason for their possible departure.

A report from specialist business property adviser, Christie & Co, published on the workforce crisis in the UK supported these claims and highlighted that “the overall impact of Brexit will be important for the dental sector where staffing is already a widespread challenge, thus will be on the radar particularly for the largest corporate operators who employ a higher percentage of non-UK trained dentists.”

The NHS and other corporate dental practices have greatly relied on the EU to fill in the huge vacancies in recent years and make up for the country’s shortcoming in the front of new recruits. Only second to the UK-trained dentists themselves, EEA-qualified dentists make up a whopping 16.3% of the total dentists registered with the GDC in the UK. A benchmark on the UK dental workforce crisis in 2017 reported the extreme shortage of dentists in the UK with values for Wales, England, Scotland and Northern Ireland respectively as follows: 1 per 1.9k people, 1 per 1.7k people, 1 per 1.4k people and 1 per 1.2k people. The Government is acutely aware of the strain on the NHS with respect to staffing especially with the increase in demands of a now ageing population.

4. Import of medicines and dental devices from Europe

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Apart from the lack of manpower in the UK dental sector, import of medicines and dental devices from European countries (including from the currently “soft” border between Northern Ireland and the Republic of Ireland) may eventuate as a result of Brexit. There is a big chance of an increase in the prices of equipment and consumables imported from the EU. While the Government continues to reassure the practices that medical supplies can continue to flow into the UK without disruption, dental practices are discouraged from stockpiling beyond stock levels.

With Brexit and a potentially a no-exit departure in the very plausible future, the Government continues to stress on the need to control immigration while at the same time making strong remarks for the NHS and other sectors of the economy to continue recruitment ventures from third party countries aside from the EU. In terms of recruitment not only in the dental sector but broadly across the NHS, it needs to be addressed at a national strategic level by striving to work with the Department of Health and Social Care, working with the overseas missions, the Department of International Trade, and supervising recruitment activities overseas in order to achieve an element of clarity for the future landscape of the UK.