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ePaper created 2016-07-20, 11:29:31 | version 1.38.0
04 Dental Tribune United Kingdom Edition | 6/2016 UK NEWS “We need to consider carefully how to plan for the future workforce” An interview with Health Education England’s Sam Shah and Dental Core Trainee Edward Sinclair After the vote to leave in the Euro- pean Union Referendum last month and the appointment of Theresa May as Prime Minister, negotiations between Westminster and Brussels are expected to commence soon. In an article published by the British Dental Journal, researchers from Health Education England in Lon- don already in May drafted a possi- ble Brexit scenario and its implica- tions for dentistry in the UK. Dental Tribune had the opportunity to speak with authors Edward Sinclair and Sam Shah in London about the possible impact of this historic deci- sion on dental regulations and the workforce. Dental Tribune: In the EU referen- dum, the majority of Brits voted for the UK to leave the EU. What impact could an upcoming Brexit have on the British health care sector and dentistry in particular? Edward Sinclair: To give an exact and short answer to your question would be difficult. I would say that in the short term very little will change. After that it will really depend on the outcome of any negotiations. One would hope that there would be minimal disruption to the existing systems. One of the areas that could be affected is workforce. At the mo- ment, the UK has many workers from other EU countries who fall under the freedom of movement arrangement and benefit in gen- eral from mutual recognition of their professional qualifications. One of the reasons the leave vote triumphed was because a lot of people seemed unhappy with the whole concept of freedom of movement. In the future, it is pos- sible that it will be restricted in some way. What we might end up with is something like the arrangement in North America where professionals are able to come to the UK if they have a job offer. Sam Shah: There is a whole myriad of legislation that will need to be unravelled, reinstated or recreated. Those responsible for the workforce will need to con- sider both the existing EU mi- grant workforce and various UK residents are currently training in other EU countries. They will probably be planning to return to the UK in the hope that their qualifications are going to be rec- ognised. As a nation we also benefit from products and material being manufactured elsewhere in Eu- rope that get imported in the UK for use in dentistry, for example in the fields of implant dentistry or endodontics. If there are going to be changes, there will need to be trade agreements in place between the EU and the UK. Inevitably this is likely to have an impact on price which in turn will have affect sup- ply and demand. Last year alone, more EU dentists registered with the General Dental Council than the number of dentists that graduated from UK dental schools. How dependent is den- tistry on the migrant workforce and would the UK be able to cope with the potential loss of this workforce through stricter immigration regu- lation? Shah: The workforce is an im- portant aspect of the way den- tistry as a clinical service operates. There will be implications re- garding the workforce because at the moment we have the benefit of both the EU workforce com- bined with the UK workforce which provide us with stable ser- vices to meet the needs of our population. The likelihood is that future barriers to movement will have an impact on supply and demand within the workforce. This means that for us in the UK we need to consider carefully how to plan for future workforce because our modelling has been based on what happened over the last 10 to 15 years. The implications on dentistry won’t be seen for some years to come and it will probably take at least 5 to 10 years before we see any real impact from the Brexit. Sinclair: There was a time 15 years ago when it was more difficult for people in rural areas to find an NHS dentist. Recently, that has become less of a problem and this could be because a lot of EU dentists were willing to work in those areas. Whilst the economic problems of the eurozone remain, there will still be demand from dentists from EU countries to work in the UK. We know that certain coun- tries like Spain and Romania pro- duce far more dentists than they may actually need. Even if we erect barriers to entry, the UK is still an attractive place for postgraduate training or just to work. In addition to immigration, one of the topics that leavers put forward in the referendum was regulation. To what extent is the dental in- dustry in the UK regulated by EU laws? Sinclair: As an example, the Health and Safety (Sharps Instru- ments in Healthcare) Regulations 2013 became UK regulation in 2013. This originates from EU Council Directive 2010/32/EU on the pre- vention of sharps injuries in the hospital and healthcare sector. For something like this it would now be up to the UK legislature to decide upon. It’s important to note however, that there are some coun- tries in the EU that have a much lower regulatory burden. I think it was a distortion in the run-up to the referendum to state that leav- ing the EU would somehow reduce the amount of red tape. Shah: You also have to consider other European rules for example on ionising radiation or the trans- fer of clinical images. The reality is whether we are part of the EU or not, there will need to be some- thing whether it is a policy or reg- ulation that addresses matters such as these. It is unlikely that the State would just dismantle the rules without any replacement because there have to be some safeguards in place for society. The type of regulation that dentists may be more familiar with are EU competition laws. The UK has its own version of compe- tition laws in any event. There is a chance that we will need an al- teration of these rules however they will probably still exist. At the moment, I am yet to be convinced that any EU regulation would not continue to apply in some form if the UK does continue to leave the EU. “...it was a distortion in the run-up to the referendum to state that leaving the EU would somehow reduce the amount of red tape.”