Morale among UK dentists is at its lowest level in ten years and recruitment firms say increasing numbers of clinicians are relocating to countries such as Australia and New Zealand. Our new series 'Dentistry around the world' will be looking at some of those dentists who have left the UK and starts with Dr Jason Mandle, who moved with his young family from East Lothian in Scotland to Auckland, New Zealand in March 2020

Why did you decide to move to Auckland?

Lifestyle, in terms of better weather and beaches. I grew up in Cumbria in the Lake District, and then moved to Scotland. If you're walking on a Scottish beach, you've got a coat and a hat on, usually. In Auckland, there's probably a good four or five months of the year where you can just go swimming in the sea. It's a fifteen-minute drive away, and you can bodyboard and just be in the water all the time.

Also, my wife wasn't very happy living in the UK. She's Russian and had a Latvian passport. She had British citizenship, she's lived in the UK from when she was nineteen, but just didn't feel very welcome. She's always wanted to come to this part of the World.

But it was quite bad timing. We’d planned it for two years but we moved over in March 2020, which was right in the middle of covid. We got here on the last day they were accepting international flights.

We left the UK six years ago now and we haven't been back. Flights are now much more expensive. I bought into a dental practice here and we bought a house. We have three young kids and a toy poodle. We got permanent residency after a year. We're now applying for the citizenship.

How did you find your job and get a visa?

I spammed dental practices with my CV in areas that I wanted to live and work. There's a big chain over here called Lumino. They offered me a choice of four practices and after one interview and two weeks I had a job.

I got a five-year work visa although we paid an immigration agency to do the paperwork for us. We applied for permanent residency at the same time and it came through about five or six months after we’d been living in New Zealand.

Dentists aren’t on a 'shortage profession' list in New Zealand and to obtain permanent residency, you need a minimum of six points. You get points for things like professional qualifications, having a degree, earning a higher income and being under 55. My wife and I both have degrees and we were young with kids, so we didn't have any issues with having enough points to get the residency.

I worked for Lumino for a couple of years and I moved around a few of their practices to see the country a bit. I went and lived in the South Island and just worked in a Lumino practice down there for a while.

Then I came back to Auckland and I worked in the same clinic, just for an independent practice for about two and a half years. The lady who owned that decided to sell it, but she wanted more money than what I thought it was worth, so she sold it to someone else and I bought a different practice.

What are the main differences between working as a dentist in New Zealand compared to Scotland?

The major difference is just private versus NHS. So, if you're working in a fully private practice in the UK, you probably wouldn't notice a great deal of difference. But coming from an NHS practice, you’ve got more time to spend with your patients and generally have half an hour for a check-up, clean and x-rays.

In the UK there was no want of patients. In the practice I was working in, in Dunbar, East Lothian, we were turning patients away. I had over 3,000 patients registered to my name. Over here, in Auckland especially, there's probably too many dentists and you're fighting and competing a little bit for business. You get times when books can be quiet and your income is not as guaranteed, certainly.

Is there an equivalent of NHS dentistry in New Zealand?

In New Zealand, there is funded dentistry for under 18s. And then after that, it's only if you're quite deprived, you can apply for a grant. Patients can have $1,000 (£400) a year of dental treatment, but they don't have to pay that money back.

Children’s dental care is split into two tiers. High school ages, from 13 to 18, can go to any private practice which has a contract with the Ministry of Health to provide that care. For those under 13, they go to the community dental clinics, which tend not to have oral health therapists rather than dentists that see and treat children there. If there's anything they're not capable of doing, they refer the child, to one of the private contracting dentists. But not as many dentists do that because who likes taking a five-year-old kid’s teeth out?

How does the pay compare with the UK?

When I first started, it probably was quite similar. But now I'm earning a good 30% more than I used to. I've had the time and the drive to learn new skills, because obviously the more things you can do, the more money you can make. I've learned to do clear aligners in New Zealand, I've learned to restore implants and do more bonded ceramic work.

Once you've done a ten-hour day working in the NHS, the last thing you want to do is look at something else tooth-related when you get home. Over here, whilst I think burnout is still an issue for dentists, you've got more time and energy to spend learning new things. The other day I did a day's course on hands-on bone grafting, just to learn something new. You’ve got the time and energy to learn new things,

Associates’ salaries are similar to the UK and they generally get 40% commission. If you're in some of the more deprived areas where a dentist might not want to live you can get more. I’ve seen job ads where they're offering a higher commission to attract someone to travel into one of those areas of up to 45 or 50%.

But in New Zealand, you're probably worse off from a tax perspective. If you’re self-employed and earn over $60,000 (£25,000), you have to register for GST (Goods and Service Tax), which is like VAT. That's 15%, so on top of your income tax, you've got to pay GST. If you're an associate, you don't really have expenses that you can deduct from that, so you can end up paying 45% tax. There’s no tax-free income. You pay tax on every dollar.


What piece of advice would you give to any UK dentist who is looking to move to New Zealand?

It's not for everyone. My work and my job that I was in, in Scotland, I was happy there. I wasn't unhappy at work that I wanted to leave the country or anything like that. I'd say initially I did probably miss the people that I worked with, especially when I joined a corporate practice. It was a very different kind of work environment.

I’d also say don't bring your possessions. We spent quite a lot of money shipping furniture but I would say unless it's got materialistic value to you, minimise that stuff. Houses are very different here. It's all glass, big open glass walls, and some of the English furniture doesn't really go. We brought stuff over and it ended up in the garage store or we've sold it or chucked it out.

I speak to my parents once a week on a Teams meeting and they keep saying they're going to come over. It's been six years; they've not made it. Hopefully they'll come over one day. But it's quite expensive for me to go back with three kids and a wife. It's not something I can afford right now.

When we first left the UK, we thought we’d go and spend a few years there or whatever and if we don't like it, we'll come back and worst thing, it’s an adventure.

But now we're definitely staying.

Interview by Jaimie Kaffash; edited by Cameron Bowles