UK dentistry is affected by the UK's membership of the EU, and by the decision to leave, in a number of ways. These include:
- The movement of dentists and dental care professionals (including the various processes for the recognition of qualifications, and immigration)
- The import and export of dental equipment and materials, the supply of medicines
- Health and safety legislation
- Data protection regulations
- Research and development
The draft Withdrawal Agreement, which has been voted down in Parliament several times, foresees a quasi-continuation of current systems up to December 2020, while the new relationship with the EU is negotiated. In a no-deal scenario, all current systems that involve any links with the EU would cease immediately on exit day.
The current UK government has declared that it will not be seeking any further extension to UK's exit from the EU scheduled for 31 October 2019.
While discussions with the EU are ongoing, it remains to be seen if a new or changed agreement will be possible. In the meantime, no-deal guidance across all sectors has been stepped up.
EU dentists working in the UK
At present, EU/EEA dentists are eligible to work in the UK, if they met relevant language knowledge criteria, registration is straightforward.
Around 16-17% of the UK dentist workforce is registered on the basis of an EU/EEA degree; this includes UK citizens who have studied in Europe.
The registration of those currently registered should not be jeopardised by Brexit. Draft legislation, to come into force once the exit date has been set, foresees a continuation of the recognition of qualifications for around two years, while future systems are considered.
These potential new systems are currently unclear and come with their own challenges around cost and workability. In addition to probable formal assessment by the GDC, it is possible that EU nationals will in future have to go through a more formal process of performers' list validation by experience (PLVE/VT equivalence).
If the UK wants to maintain current levels of international recruitment, this might necessitate higher numbers of practices being willing to provide training potentially on an employed, rather than self-employed basis, because EU citizens will likely require a relevant work visa. A new immigration system is currently being debated to reflect this change.
The UK Government has set up the EU Settlement Scheme to enable EU citizens who are already based in the UK to register so they can retain access to many of the rights they currently have. All EU/EEA nationals in the UK will need to apply to the scheme unless they have obtained British citizenship.
Dentists are encouraged to raise this issue with any colleagues who may be in the UK on the basis of current freedom-of-movement rights.
UK dentists working in the EU
As UK citizens will cease to be EU citizens post-Brexit, the current expectation is that they will no longer be able to benefit from free movement and automatic recognition in the EU; instead, recognition is most likely to depend on the arrangements for third-country nationals in any given country.
Medicines and medical devices
UK medicines and medical devices have been subject to a central EU system of accreditation. Significant concerns have been raised about the short to medium-term availability of medicines, medical devices and non-clinical consumables.
We have been involved in discussions with the government on this issue, and the Department for Health and Social Care has issued guidance specifically in relation to a no-deal scenario.
The Irish border
One of the main issues of the Brexit negotiations is the potential return of border checks of people and goods moving between Northern Ireland and the Republic of Ireland. Within medicine and dentistry, there is a flow of workforce and patients in both directions.
A potential hard border would have implications for patients, workforce, service provision, data flow, availability of medicines and other goods.
Brexit and the UK economy
A number of forecasts have predicted a potential economic downturn as a consequence of Brexit. We know from previous experience that such downturns can affect patient behaviour in seeking dental treatment, which could affect dental practice incomes – for both NHS and private dentistry. We are keeping a watching brief on this issue.
What is the BDA doing?
We have kept a politically neutral position on Brexit. However, we have continuously engaged in discussions on the impact of Brexit on healthcare professionals and the healthcare system.
We have met with key stakeholders to represent dentistry and have responded to relevant Government calls for evidence and consultations.
We are also providing advice to individuals, as best we can, given the lack of clarity about the current situation.
At the European level, we continue to be an active member of the Council of European Dentists (CED), the professional association for dental associations in Europe, where the BDA has had a leading role on important subjects such as amalgam, tooth whitening and antimicrobial resistance for many years.
Whatever the arrangements for the UK's exit will be, there will be a need to continue such involvement to understand regulatory decisions taken by the EU on issues relevant to dentistry and wider healthcare.