A Challenging Extraction – Dentistry and Leaving the EU

Posted by Dr Catherine Rutland on 31/01/2020
brexit-for-dentists

Since the General Election result in December, the uncertainty generated by the indecision over the UK’s relationship with the EU has evaporated, and a date for officially leaving the EU has been reached. For practices across the UK, the indecision over whether we would stay or go meant decisions delayed or forgone altogether. With a decisive result for Boris Jonson’s Conservative government delivered at the ballot box, we are now definitely leaving the EU on the 31 January 2020 – the questions now is what our future relationship with the EU will look like and how that will impact our profession.


While the 11 month transition period following the 31st January departure will maintain current EU membership arrangements, if a Free Trade Agreement (FTA) is not agreed to or ratified before the end of 2020, then the potential for disruption to medical supply chains and recruitment of EU nationals is possible. Many dental practices are reliant on a stable inflow of medicines, equipment and personnel from the European continent. Without an FTA or multiple reciprocal issue-by-issue arrangements in place by the end of this year, then we can expect disruption to supply chains similar to the ‘No Deal’ scenario we became familiar with last year. So, how will leaving the EU on the 31 January impact the delivery of dental care?


Supply chains

The smooth supply of medicines and drugs is vital to the efficient operation of any dental practice. Naturally, any scenario in which Britain leaves the EU will impact upon how medicines and medical devices originating from within the EU reach practices at the coal face. Without an agreed and ratified FTA in place by the end of 2020, the Royal Pharmaceutical Society has warned that this will cause shortages in the supply of medicines.

Under the Government’s Withdrawal Agreement – given assent from parliament this month – the continuation of supply chains over the Dover-Calais straits is guaranteed. However, this only applies for the duration of the ‘transition period’, and failure to reach an FTA would see the EU impose full ‘third country status’ controls on people and goods entering the EU from the UK which may prove disruptive to supply chains.

While current guidance from Whitehall assures us that stockpiling of medicines will be unnecessary, even in a No Deal scenario, the impact of the imposition of third-country trading status would be for the UK to lose its preferential trading relationship with the EU and likely disruption to supplies in the shirt to medium-term.


Workforce

Approximately 15% of dentists are EU/European Economic Area (EEA) nationals, and dental professionals such as dental nurses and hygienists have significant numbers of EU/EEA nationals UK-wide. With the BDA citing 75% of dental practices struggle to fill vacancies , there remains considerable regional disparities in recruitment levels, and the undersupply of dentists in some areas of the country is highlighting how the UK dental workforce is struggling to meet demand from practices.

EU citizens can register for ‘settled status’ in the UK through the EU Settlement Scheme if they have been here for five years or ‘pre-settled status’ if here for less time. This will guarantee their rights as EU citizens in the UK, their status and right to work. The government’s current guidelines advise EU citizens to apply for their right to remain by December 2020 in order to retain their settled status and rights to work in the UK.

The Conservative’s election pledge to create an ‘Australian-style points-based’ immigration system, after the UK leaves the EU, could help address skills shortages in dentistry. Still, there remains questions over whether this could be put in place by year’s end and it can’t guarantee to replicate the benefits of free movement of workers within the EU.


Professional Qualifications

To enable non-UK citizen colleagues to continue practising dentistry, the recognition of qualifications from EU/EEA member states is essential. The UK government has stated that professionals whose qualification has been recognised and registered in the UK before the UK leaves the EU will continue to be registered after this point. 

For dental professionals (including UK citizens) with EU/EEA or Swiss qualifications, who apply to have their qualification recognised after exiting the EU, they will have their applications processed under ‘future arrangements.’

As you can imagine, the rather ambiguous phrase ‘future arrangements’ is dependent on arrangements to be negotiated over the next year or more. In the long-term, bilateral arrangements will be required to ensure qualifications are recognised and registered both sides of the Channel.

Now that the Withdrawal Agreement has passed both the House of Commons and House of Lords and received Royal Assent, it is guaranteed that we shall leave the EU on 31 January. Until the end of December 2020, the UK will maintain its present relationship with the EU throughout this ‘transition period’ but without any say as a member state on EU laws or regulations. This means that EU regulations affecting your practice – from EU workers’ rights to professional qualifications – will remain unchanged until 2021.

However, in each of the areas listed above, there remains uncertainty about what the UK’s relationship with the EU will look like after 2020 and how this will impact recruitment and retention of staff, supplies of medicines and recognition of professional qualifications. Much of this will be determined by a potential future FTA with the EU – to allow for frictionless supply chains and the recruitment of much needed dental professionals from EU states – and reciprocal agreements between countries within the EU/EEA area for recognition of professional qualifications. None of which is guaranteed to be in place by 31 December 2020.

Therefore, while the government may have succeeded in its ambition to ‘Get Brexit Done’ – we are unlikely to hear the last of the dreaded B-word for at least another 12 months.


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