The BDA Makes Case - Improved Pay and Conditions
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- Published: Thursday, 10 March 2022 07:38
- Written by Peter Ingle
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It may seem like putting on a mime performance for the visually impaired, but each year the BDA does it’s best to explain to those in charge, why dentists and their teams deserve to be properly paid.
The mechanism for this is not straightforward. The Dentists and Doctors Review Body (DDRB) is an appointed group and has the task of recommending the level of any pay increases. It was set up in 1960 following a Royal Commission report on pay for doctors and dentists. In theory it is supposed to keep pay in line with that of others doing similar jobs. However government is not bound to accept its recommendations, and on some occasions has not paid the amount that the DDRB had advised. The Review Body takes evidence from a variety of stakeholders representing both sides. One of these is the BDA, and looking at the list of those making representations in its 2021 report, it is apparent that they will be the sole voice speaking for GDPs. With NHS dentistry on a knife edge, this years’ evidence from the BDA will need to cut through.
The BDA’s headline request is for an award of inflation plus 3%. In his blog, Peter Crooks, Chair of the BDA’s Review Body and Evidence Committee, outlines this years submission to the DDRB. He argues that both investment in dentistry and pay should be rising above the cost of living, following a decade of real-terms pay cuts. Indeed the 3% is described as only, “a start.” Recommending it would also send a message of value to those delivering NHS dentistry. NHS dentistry needs to be sustainable and an attractive proposition for young dentists.
Key messages are that, real-terms pay is falling, the NHS dental workforce is shrinking and that change is needed to save NHS dentistry.
The BDA quote their figures showing a decline in dental pay, noting that take-home pay is now well below that of a decade ago. Interestingly the decline varies significantly across the home nations. Between 2008-09 and 2019-20 practice owner taxable income has fallen by 23.5% in Northern Ireland, 19.2% in Wales, 14.4% in England, and 12.6% in Scotland. The same figures for associates are 14.2%, 6.9%, 14.3% and 13.1%, respectively, which would suggest that overall they have had a less bad time, although there are surprising regional variations. The BDA states that the rising levels of inflation combined with these pay cuts, are forcing practices to leave the NHS as it becomes financially unsustainable.
When it comes to the workforce, BDA figures reveal that 93% of heavily-committed NHS practice owners had experienced difficulties when trying to recruit. There are also problems in both recruiting and then retaining dental nurses, with 80% of those practices trying to recruit between April and September 2021, having difficulty. Tellingly, among associates with a high NHS commitment, a chilling 76% would not recommend dentistry as a career. Given this, the reported loss of 1038 dentists to NHS primary care in 2020/21 is no surprise. Further, morale among dentists is described as “rock bottom”.
The BDA has a familiar list of changes required to save NHS dentistry including contract reform, proper funding for the service, and fair pay. It asks the DDRB to award dental inflation plus 3% for GDP’s, and RPI plus 3% for employed dentists. Apart from the headlined figure the BDA have also asked for timely implementation of the pay award, reinstatement of commitment awards in England, Wales and Northern Ireland, and an increase in the Northern Irish prior approval limit. Peter Crooks concludes that “These aren’t nice-to-haves. This action is essential to ensuring that NHS dentistry across the UK can recover from the pandemic and go on to provide essential healthcare across the UK.”
76% of NHS associates may have already concluded that for the Government, NHS dentistry is more of a “can-manage-without” than a “nice-to-have.”
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