The war has erupted between the remnants of the Department of Health and what seems to be NHS England. The issue that has caused such unrest are the salaries for dental foundation trainees, previously known as vocational dental practitioners. Salaries for vocational dental practitioners were dealt with under the statement of financial entitlement so were somewhat different to salaries for other employed medical and dental staff. Unlike other salaried staff working in the NHS or delivering services on behalf of the NHS, DFT salary or any increment was not part of the annual negotiations that take place between NHS Employers and the unions including the BDA.
For at least the last 10 years there has always been some level of dissatisfaction with the salary of vocational practitioners moving into salaried posts in hospital or community settings. There has been variation around the country as to how pay protection or assimilation should operate. This has only resulted in further confusion and complication when the individuals went on to other posts such as higher training posts. At one stage there was a letter from the Department of Health setting out the protective arrangements; however the strength of that letter has since been eroded and now individual
NHS employing bodies make these decisions.
Over the years I have seen this argument unfold where occasionally postgraduate deans have even expressed that vocational trainees are already paid more than other graduates and should be grateful. The difficulty in this argument is that it seems futile to compare dental graduates to other
graduates from any other course. The entry requirements; and competitive
nature of dental training; results in highly performing individuals gaining the few places that exist. With the same token, other professional graduates with shorter university courses are paid considerably more than dental graduates following graduation.
The position that policy makers have adopted seems quite wrong when compared to the way in which other medical and dental professionals are treated. In effect, the policy makers have found the most vulnerable and weakest of all dentists and singled them out. Most of this group also happen to be the youngest members of our profession and it could be that NHS England is operating a policy that is designed to disadvantage younger dentists over any other age group of dentist. It remains to be seen whether this could even amount to a form of discrimination.
It seems unlikely that the BMA or any other union would accept an estimated eight per cent salary cut for their members. This unilateral stance by policy makers is only going to result in an erosion of professional goodwill from hard working dentists and gives the impression that the Government and senior members of the profession do not value their younger colleagues in the same way. There is also a lack of recognition that the cost of being a young dentist has increased substantially with little job security after foundation training. Already those in foundation training are struggling to secure work for year two, let alone year three. A couple of years ago, one deanery even advertised and recruited to a postgraduate training post which had a zero salary attached to it, even then the profession were fairly passive in challenging this type of approach.
It would also be a slightly different situation if these individuals had control over their time and workload, however they don’t. It has been convention for quite some time that dental foundation trainees are restricted from undertaking private work. Even this restriction should be questioned as there are probably some elements of private work that these young dentists would be willing and able to carry out.
Others may even argue that the Government has intentionally created a situation where they oversupply the market with dentists and use this as a mechanism to start reducing the cost of providing NHS dentistry. This could be the start of things to come and indicative of the Government’s general attitude towards dentists, an easy political target. It may be that DFT is the first type of training post to be attacked in this way and other training posts will follow with more unpaid posts to follow.
In my view, the Government and its senior policy makers need to reconsider this step and perhaps identify other ways of making savings such as further reducing the number of undergraduate places.