January was named after the Roman God of the doorway, Janus, usually depicted with two heads looking backwards and forwards. Looking back over the 50 and more years, I have been in dentistry and, looking forward as a newly qualified dentist might, I am struck by major differences.
Back then, one had every expectation of spending one’s professional life in the NHS, for most of the time in the same practice. Even when working as an associate you had the guarantee of your individual contract with the NHS.
'As one older dentist told me once, the only things standing in the way of financial success for a young man were slow horses or fast women'
The harder you worker the more money you earned. There were no university tuition fees to repay and you could expect to earn enough to but a practice, start a family and buy a house. As one older dentist told me once, the only things standing in the way of financial success for a young man were slow horses or fast women.
Your word was law in the practice, and there were opportunities to improve your professional knowledge by taking on more complex cases. Finally, you could sell your practice goodwill and retire on a generous NHS pension.
Compare these ‘great expectations’ with the ‘bleak house’ that faces today’s graduate. They leave university with massive student debt and can only work in the NHS as an associate once they have completed foundation training.
Last year, 35 graduates failed to get a place on these courses, their career was blighted at the first hurdle. Even once through the training, there is no guarantee of a position as an associate.
They will be in competition with dentists from the EU prepared to work for low salaries. Much of the dentistry currently being piloted in England can be, and is being, carried out by dental care professionals. There is a real and increasing danger of dentists being unemployed, something inconceivable only 10 years ago.
What of the chances of owning a practice and having an NHS contract? Even now three quarters of all dentists are associates, working in practices owned by other dentists or corporates. The possibilities of a career enjoyed by the older dentist are being denied to their successors.
In 2013, I will be writing about the plight of the younger generation of dentists and what can and should be done about them.
By Michael Watson, news correspondent