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I am fortunate enough to be writing this Comment while having a few days in Provence where, as compared with the UK, the summer seems to be extended by 6 weeks. However, the downside is that things here are costing me a lot more than a year ago, as I noticed when visiting the Bureaux de Change on the way here, with the pound in my pocket achieving 1.08 Euros as compared with 1.35 a year ago. The rate against the dollar is even worse, with the pound falling to a 35 year low. My thoughts then turned to UK dentists and the materials, devices and equipment that they need to buy on a daily basis. Most of it comes from Europe, Japan or the USA! Some, mainly amalgam, from Australia. Because of the fall in the value of the pound, a rise in the price of materials, devices and equipment is therefore inevitable. How can that be funded? Many readers will be in the fixed price contracts which are part of the NHS in the UK and I would be surprised if the NHS has a contingency fund at the ready to help dentists when the prices of their materials rises. For those working under private contract, the price can be passed on to patients, but will those patients be pleased when they see the cost of their treatment increasing? No! A crisis awaits.
While the drop in the pound if Brexit occurred was broadcast before the referendum, there are other aspects of Brexit for which no one knows the consequences. The numbers of dentists coming to work in the UK from Europe has been at a high level for years, with more dentists from Europe coming on to the GDC Dental Register than new graduates from UK dental schools. It seems likely, but is by no means certain, that those dentists who have arrived here in the last decade will be allowed to stay in the UK but, as that source of incoming dentists who are willing (perhaps not exactly the right word!) to work for large commercial organizations at reduced rates falls, those organizations will become less profitable and their ability to fulfil large NHS Contracts may become less viable. The NHS might therefore be left high and dry because sufficient numbers of dentists from Europe who will work for the reduced rates will not be available. Many UK post-Foundation Year graduates who I speak to have difficulty in filling their weekly diary other than by working in several different places, leading me to suspect that the UK now has too many dentists. The potentially increased barriers to dentists who have graduated in mainland Europe and who wish to come to work in the UK may change this.
Another potential Brexit consequence will be a reduction in Dental Tourism, in which UK-based patients attend surgeries in mainland Europe, being attracted by much reduced fees for treatment, as compared with the UK. Given the present currency fluctuation, this will become less attractive, not a bad thing when one recognizes that problems with treatment carried out abroad cannot be rectified as readily as a visit to one's local dentist when something goes wrong.
A final word on Brexit. This will remain a top news story for years, and the Government will be busy busy busy working out how to get ‘the best deal’. I cannot see that there will be an appetite, time or manpower for Government to organize a ‘new’ dental contract in England and Wales. We will therefore be left with the UDA system which was roundly condemned in 2009, probably until after 2020, or whenever Brexit actually is completed. More of this in another Comment.
Of course, much of the above is speculation, because not much has been decided with regard to how Brexit will actually happen. So, in this era of uncertainty, one thing remains – Dental Update! As the end of another year draws nigh, may I thank our readers for supporting the journal and wish you all an enjoyable, restful and peaceful holiday season, and very best wishes for 2017. Many thanks are also due to the team at Guildford, led ably by Stuart Thompson, Angela Stroud and Lisa Dunbar, and the Editorial Board, for producing another ten memorable issues of Dental Update. Next year there will be eleven, with the extra issue being published in January. You will no longer have to wait until February!