Why we ought to consider ‘employment’ status for some dental associates

employmentDentists should be involved in the argument over the employment status of associates, Neel Kothari says.

By now some of you may be aware of reports that HMRC has recently written to several dental associates indicating that they are reviewing their employment status.

The initial responses from dental associations and accountancy groups has been one of caution, advising that associates seek further advice prior to talking directly with HMRC – the clear implication being that a change in status may have a financially negative impact on them.

My view is rather different.

What would be the benefits?

Let me start by saying that this has been a long time coming and taking an adversarial stance with HMRC is unlikely to do our profession any favours.

Rather than relying on accountants or professional representatives to liaise with HMRC we ought to be asking ourselves whether some in our profession would benefit from this change, and how we go about separating those who have true autonomous control over their working lives, compared with those who are simply hired to meet company targets.

Whilst I do feel that this would result in financial hardship for some, it would also help improve the working rights of many.

For instance, it would be incredibly difficult to sack someone for working ethically, a practice would have a vested interest in the quality of the works provided and disputes relating to maternity/paternity rights, failure to pay the final month’s wages etc would become considerably easier to resolve.

I don’t believe that there is a one size fits all solution for dental associates and do not feel that this should apply to all associates, but in the eyes of our patients I think that it’s rather hypocritical for dental practices to hark on about how great their team is, but in the event of a complaint remind patients that each dentist is ‘self-employed’, with their own GDC registration and indemnity policy (yes this really does happen!).

Burying heads in the sand

In my opinion, some practices are abusing the self-employed status of dentists, who are often working under a restrictive NHS system with very little control over their working conditions.

This is not only detrimental to the profession but allows the 2006 contract to flourish, as practice owners and the Department of Health collude to meet access figures.

As a practice owner myself I recognise the difficulties that this would bring to the profession, but feel that ducking our heads in the sand is unlikely to make this issue go away.

Clearly each case will need to be looked at on its individual merits, but if there are associates who truly want their rights to be respected and wish to practice in an ethically sound manner with employment rights in place, perhaps the price of that would be a reduction in salary.

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Comments (4)

I would be more than happy to accept a reasonable pay cut as long as my employer will pay my indemnity and GDC retention fee. Plus obviously paid annual leave , medical/maternity / paternity leave. But something tells me the owners would lose out too much and they would be liable for paying taxes as well (NI), it will just not going to happen.

This is an interesting article and we need to look at all the possibilities. There are clearly many problems with the current system and these issues are creating much stress.
There are simple ways to assess from different perspectives and see the pros and the cons from each side.
There are always pros and cons for each side but just like an individual dentist might be ok with a reduction in salary for other benefits, employers also might be willing to compromise on some issues to get benefits.
All in all, I agree with Neel that a conversation needs to begin and see what the various parties are trying to achieve.
An interesting exercise is to ask one party to work to achieve another parties objectives and to see if objectives can be made synergistic to any degree.
The cooperative spirit allows a body with billions of individual cells and thousands of specific tissues and hundreds of specific organs with very different needs and purpose to operate as a coherent whole.
It must be possible to find a way to bring harmony to any workplace.

There is one financial envelope in NHS practice which can only be expanded by doing more Private work.
Profit margins are tight for NHS dependent practices and if employer NI and increased employee rights are to be paid for it can only come from the associate OR an increase in contract values. There simply isn’t the margin on the nhs element to cover employee rights for associates. No good practice owner dismissed a good ethical associate but imagine the employment law red tape of trying to move on a poorly performing employed associate. No thanks.

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