[00:00:00] I worked hard, I never cut any corners. I have done nothing wrong. And what’s happened to me is simply a greedy act to protect a business or make a profit basically profiteer. And I just felt like obviously, you know, I had to stand up for myself and clear my name. This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts Payman Langroudi and Prav Solanki.

[00:00:40] The pandemic’s been responsible for highlighting some of the best parts of our profession and some of the worst divides as well. Many advice been exposed. I mean, things between private and NHS dentists. There’s been the divide between management and staff. Corporate and independent practise seems to come to mind. Crucially, the divide between practise principles and practise associates and out of out of that divide. During the pandemic, there was the payment dispute between some principals and associates, particularly in the NHS system and one of the many groups that actually did come out of the pandemic. I mean, there’s been lots of different groups of different subjects has been the British Dental Action Group, headed by Shazia Kalsoume, who actually it’s known mainly on on on the internet as Shazia Ahmed, but her her real name is Shazia Kelsie. It’s a pleasure to have you on the show, Shazia. We tend to start these things with sort of. Where were you born? How did you grow up kind of question?

[00:01:50] Oh, OK. Well, Payman, thank you for inviting me. First of all, I know you’ve been asking me for a few weeks and I just feel ready denied. I didn’t think I had much to talk about. But anyway, now we’re here. So a bit about my history. I was born in Birmingham. I was the third child in the family and the first child born in born in England. My father came here as a 15 year old and my mother married and came here and and then I was born. And so Birmingham working class family. And what else is there to say? Yeah. Born and bred Brummie University, what was

[00:02:34] What was childhood like? I mean, what kind of a kid were you studious?

[00:02:39] Yes, playful, quite playful. Not very ambitious as a child in a city playing outside, enjoying the outdoors, you know, it was a different time then. Yes, just played with your friends and it came in when it was dark, you know, carefree and went to a girls school because very traditional family wasn’t allowed to, you know, free mix with boys had to go to a single sex school. And at the age of 16 was meant to just like, you know, conform and stay at home. But my mother had a lot of ambitions for me and my sister. So obviously, you know, when they come from abroad, they scared their daughters might do the wrong thing. So you know, you got to protect them and keep the family name. And my grandfather was a headmaster in in India back in the day in Calcutta, but we’re actually from Pakistan. And he was very ambitious for us, children, grandchildren. So he kept encouraging us to get further education, especially as my father left his parents behind in Pakistan and came here worked. And my grandfather wanted us as children to get a good education in England. And so growing up, my mum wanted me to enter the medical field and she was very she really wanted me to become a doctor, but I couldn’t see myself doing on calls. I loved my sleep too much, so I said, Mum, OK, I’ll do dentistry because I was very practical and artistic. And although I loved art, you know, parents in an Asian family, arts is not your favourite subject in medicine, dentistry or law. So my sister was meant to do law and I was meant to do something in the medical field, so I chose dentistry.

[00:04:35] So then was that protective thing? Did that extend to university as well? Was it did it go without saying that you were going to go study in Birmingham or did you have ambitions of leaving?

[00:04:46] No, no, no, no. That said, no, that said no to university.

[00:04:50] You know, obviously

[00:04:51] That single girl girls not going to university really said mum said, No, my daughters will get a degree. Don’t worry about anything else. I guarantee you. You know, they’ll make you proud. And so based on that, my dad put his trust in me and my sister and both of us graduated. My sister’s got two degrees. The girls, my whole family, all the girls are very, very studious.

[00:05:17] So did you study in Birmingham?

[00:05:19] Yes. University of Birmingham all the way from Leeds to Masters.

[00:05:23] What was it? What was it like going from that relatively sheltered existence to being in Dental school? Did you? Did you? Did you? Did you take to it well or did you not?

[00:05:34] Very shy. I think I was very I was an introvert all the way through, not confident in speaking speeches and but obviously, you know, all the levers we have, we have to just get over that and get on with it. So it took a year or so just to be normal, but it was a new environment. It was scary, but it was it was really good. We had a bunch of friends, my my friends from university, we’re all still friends, we’re still in touch. And they had left Manchester, Liverpool and all these other places. So because I was a Brummie, I was the one looking after them and their parents were entrusting my family to take care of them as well. So we became good friends. So I was really good. Actually, I was glad I stayed in, but. Did you qualify?

[00:06:26] 2002 2002 OK. And then your first job?

[00:06:32] So this job, so it was very hard and competitive to actually get a place. There was a lot of favouritism in those days. The favourite students got all the vet places close by. And a lot of them wouldn’t get in place until the February scheme. And I was lucky enough to get in the first cohort. But I ended up in Stoke on Trent all the way in Stoke on Trent. But that was good as well, actually.

[00:06:59] And were you living, still living at home and commuting?

[00:07:01] No, no, no. My dad was. My dad was fine. You know, he knew. I think he was just a fear of, you know, first daughter in the UK, the first girl in the family going to university and no one was staying in Stoke on Trent with another friend of mine. So, yeah, no.

[00:07:20] So that was really the first time you’d lived out, right? Yes. Yes. Interesting, interesting. And so you’ve obviously still an associate, is that right? Must be right? Yeah. Doing this? Yeah. So did you never have any any ambitions to open your own practise?

[00:07:37] Oh, many ambitions to open my own practise. First, I kept putting it off up until 2006, when I got married. I kept putting it off thinking, Oh, I don’t know where I’ll end up in which city, and what’s the point of buying a practise when I don’t know where I’ll end up? Because for me, marriage and children and family were very important, so that was a first stage and then second stage would be practise. And then 2006 new contract happened and I was actually in a very good contract with my boss. I didn’t see the need to open a practise at that moment in time, because had he kept me on after my maternity leave, I was on a very good package because I worked extremely hard in the in the in the what was it called the testier when they were doing the figures for everybody. And I made sure I took no holidays. I just worked so that I can get a good package. And then I got married.

[00:08:36] Yeah. So you got married and then and then the kids come along and then that was the end of it.

[00:08:41] And I got married. I had my first child, went on maternity leave, was about to come back, and the boss said, Sorry, Shazia, there’s no job for you.

[00:08:51] Oh yes, he

[00:08:53] Took the lovely contract that I had to work hard on to create for myself. I took it, put it in a practise based contract from my individual contract and decided to say goodbye to me.

[00:09:07] So was this was this the original seed that started this idea of fighting against injustice, which I kind of every every word you write on that on that group just has that for me, resonating with sort of unfairness and injustice being the your driving force in the profession, was that the first time where you felt hard?

[00:09:30] That was the first episode of an unfair treatment where I’d worked extremely hard to make myself a good working career lifestyle as an associate, only for someone else to push me out. And and it was done by a person who was very high up. That was the worst thing for me. And to

[00:09:58] Be someone you were someone

[00:09:59] I highly respected and was highly respected by by the leadership in Birmingham and somebody who was looking after hundreds of young associates to I had because of his position, and when it happened to me, I was just in total shock and I wasn’t going to let it be because I felt if it happened, if it’s happened to me, it will happen to all these hundreds of people going through this person every year. So I did, I did pick. I did end up in tribunal employment. I did. And well, I was a first person to put a test case through to determine our status, whether we’re employees or, oh, really? Yeah, whether we are employees. Because the way we were being treated in the new contract, we were being treated like employees, but there was no precedent. So my case was used to create the worker status for associates. It was found that although we’re self-employed, the way we are treated, we are not employees. Although the judge said to me, If you today, if you were an employee, you were treated very unfairly and you would have won this case outright. But because you’re not an employee, you are a worker. Your case is not thrown out. It’s carrying on under discrimination. So now you’ve got to prove that this was discrimination. And then the judge also turned around and said to my boss, And all you have to do is bring some of your members, some of your employees, and say that you were given the impression that you should get rid of it. And based on what you were told, you terminated the contract. It was nothing to do with basically discrimination, so it’s very difficult for me to now prove that I was being discriminated against.

[00:12:02] Tell me, tell me the pressures that you were going through at that time, it must have been, I mean, if you’ve got someone who’s who’s very respected in the profession and you were a young associate at the end of the day and you decide to take that person on. At some point, did you think, you know, what the hell am I doing here?

[00:12:20] No, this was a case of I was very much confident that there was nothing wrong with my work. The only fear anybody in my situation would have that they’re a poor performer and GDC should be the only fear. And I knew I worked hard. I never got any corners. I have done nothing wrong. And what’s happened to me is simply a greedy business act, an act to protect a business or make a profit, basically profiteer. And I just felt like obviously, you know, I had to stand up for myself and clear my name because I needed a job. I was I was young. I had many years ahead of me. And how can I just let this person terminate my contract and carry on? I couldn’t pick myself up after that. I’ve just had a baby and so

[00:13:20] Many other people, many other people, would have just moved on from it. But you decided to take it on. Yeah, what is it about you? What is it about you that makes you that cat?

[00:13:32] I can’t take injustice if somebody’s done somebody unfairly. I feel like I had. Maybe my father’s the same. Maybe stems from my father, my father. He was my grandfather as well. They all stood up for justice from Pakistan to England. My father was the first independent councillor in Birmingham, really, who took on the Labour Party. Wow. Yeah. So so you feel

[00:14:01] Like you feel like in your upbringing, that idea of justice and fairness was something that was something they actually talked about, something that was actually instilled,

[00:14:10] Instilled as a child, I think. I always just saw people knocking on the door. I never saw my father. All I heard was people asking for his help all the time. I never saw my father until my mother passed away in that year when he, my boss, did that to me. My mother got cancer and I was all I was. I had a child, my mother was terminal, and this was going on so. It was a battle that I unfortunately, you know, because of my status, I couldn’t fight, but I wanted to protect others and I wanted to clear my name and I wanted to move on with my head held high because I wasn’t going to let a guy at the top tell people, lies about me.

[00:15:02] Hmm. So then when, when, when we were all there during the pandemic, when the initial stories started coming out about principals who weren’t giving the what was it one twelfth of the contract value to their associates? Did this suddenly sort of bring back sort of flashback to your previous experience? And you said, I’m going to stand up for this. I mean, you know, why is it? Why is it that you were doing that and I was barbecuing? I mean, you know what I mean was it was that what it was?

[00:15:34] No. So basically, I mean, the group initially started off. I mean, I hadn’t been on my Facebook for years, years, really. Honestly, I have not been on my Facebook for years and my my husband’s an ICU consultant, and he was looking after COVID patients while I was still treating patients with no mask. I mean, surgical mask, no PPE. So when he was coming home and I was unprotected and he was coming home exhausted with all those marks on his nose and exhausted from PPE. And yet he was incubating people that were asleep who can’t even cough. But yeah, he was saying to me, How come you are creating aerosols on 30 patients a day plus and you’re just wearing a surgical mask? I mean, what’s the point of me going to work full PPE? I mean, they were ahead of the curve they were and this is March. This is February, Jan, February 2020. We closed down in March, April. Yeah. And he’s coming home and he’s saying, What is this? I’m dying at work. Know in this PPE and you’re bringing these viruses home? Yeah. And what is the point? And I’m looking after patients in intensive care. Can you find out what’s going on because this is not right? So then BDA, no information. Facebook So you know, DeFodi, they must have something. Nothing. Couldn’t see anything on PPE. I was the first person to mention that there’s something called an FFP3 mask and we’ve got to get fit tested. And weeks later, these things started emerging for us after lockdown. So and so. So that’s how my group started because people were asking these questions on the other groups. And there’s a habit of on other groups. People get shot down for asking questions and they get humiliated. And I’m like, I don’t like being humiliated, especially in public.

[00:17:39] So I’m not going to go there just to be shut down. So I said to my colleague, I said, Do you think I should separate group for exchanging information because we all don’t know what’s going on? And she said to me, Shazia, if anybody can do it, you can because I’m always trying to organise things and I’m always trying to read up on subjects and in the practise. And so I thought, you know, why not? What have I got to lose? So I started off the page for that really information and just asking questions in a safe environment. Lo and behold, query started coming in. And I think the case that really put me into action was a young dentist. Well, probably middle age because she’s she came along and she said, Shazia, my practise hasn’t paid me. They’re not even answering my phone calls. And I’m a single mother and I’ve got my daughters, my daughter’s university loan. I’ve asked her to take a loan so that I can pay the rent. You know, and that I just couldn’t. For me, that was a case that made me feel like what is going on. So then more people started coming through and then I started saying to them, Why don’t you go to the LDC? Ldc would say, Well, you need to talk to your principal or go to the BDA. Bda would say, Well, you need to be a member. But initially, although media did actually give free advice to non-members as well. But in order to get actual face to face advice, they’d have to upgrade to the thousand pound membership. And remember, these guys can’t even afford to pay their rent. How can they afford to pay the BDA that kind of money?

[00:19:22] And did you have a grasp on how big a problem it was?

[00:19:26] No, I had no idea. All I saw was people going around in circles like headless chickens. Yeah. At that point, and this was a couple of months in now at that point. Lots of stories coming in. My boss is only paying me 30 percent of my one twelfth. My boss is only paying me 40 percent. My boss has got to me to sign a new contract. And my boss has shot down the practise. They’re not even answering the phone calls. There were so many stories, and at that point I felt like right. I need to do something here. And because, you know, my dad was a chemist as well. He said, This is not right. You’ve got to go. This is a legal thing. You’ve got to go to solicitors and barristers, but I’m the type know we need to speak to the authorities first. So then I started writing these. Well, first I thought, What do I do? So I wrote, I did. I did a petition. First, I thought, I do. I don’t know who to contact, which door to knock for these people. So let’s do a petition. Let’s get about 1000 people to sign the petition, and then I’ll just send it to any email I can find. So then I contacted the BDA and I said, Could you give me some emails I need to send this petition to? They gave me some emails and I think one was a CDO. One was the NHS, one was the NHS leadership anywhere and everywhere. And then luckily, Jason Wong picked up this email and was able to draught a new letter to send out to the providers, outlining their obligation towards as contract holders towards associates.

[00:21:06] So let me just understand this correctly is is it in law that they had to give this or is it not? Because my understanding in law was that it was a kind of advice from the BDA as opposed to.

[00:21:21] That’s correct. It was that the police, it was advised and it wasn’t a law because, you know, anything that has that requires contractual change. So that’s that’s too long winded. So it’s an obligation, but it’s a condition and a condition still must be respected because if it’s not, it’s a breach.

[00:21:44] Yeah, yeah. So so when I say, did you have a grasp of the numbers? Do you have a grasp of the numbers now? I mean, what percentage? Because, you know, obviously I’d say the vast majority did pay, didn’t they? Oh yeah, tiny minority. But how many are we talking?

[00:22:00] Well, well, the thing is, initially, from what I’m told, there was about a thousand people that filled out the complex this new survey. But then they closed the compost pages survey and they asked people to do it again with second time round. Many people didn’t because, you know, it’s it’s a traumatic experience to write out what’s happened to you over and over again. And a lot of the times people felt that they couldn’t, even because some of them are still working for the same. Yeah, yeah.

[00:22:36] So so then on your website, you did it like a complaint forum log in thing.

[00:22:44] So what happened was, I did. I did one first and then I asked the NHS to do one, and I said, Look, I can do it, but shouldn’t you be doing this? Yeah. And then they did it.

[00:22:58] Because so you think you think at least a thousand disputes on pay?

[00:23:05] I think there was definitely at least at least, yes, but remember, a lot of people will just stay quiet. They will not rattle the cage because they don’t pay their bills.

[00:23:19] And do you do you in any way understand. The practise owner’s position. In this. Or not, do you think it’s just pure profiteering? I mean,

[00:23:32] I don’t think it’s pure profiteering. No, not in all the cases. There are some people going through hard times. Look, the NHS contract, we all know that it’s not fit for purpose, right? We all know that. Yeah, a lot of people have taken out huge loans to have the security of a contract, to pay their outgoings to run a business. So I totally understand that some of these people have taken a huge risk, and for them to pay out what is required without activity would mean the loss of the business. I totally understand that. Yeah, and some people have got very small contracts and they actually earn their living or, you know, the overheads by the other activity, the non NHS activity and when that’s down. Surely these people can’t afford to pass on this money, this contractual pay for to somebody who hasn’t actually done any work. So I totally understand that. And no one, I don’t believe it’s total it was profiteering on behalf of the on the expense of the associate, but I can understand that there were reasons behind some of these cases. But then there was corporates. There was big, many corporates as well. We were doing it, so there was a definite profiteering aspect to it.

[00:24:57] So tell me, tell me some of the worst stories. I mean, you said that one.

[00:25:01] And so that was one of the worst ones. And I mean, to be honest, you know, it’s been a whirlwind for me since all of this. Every day is my brain is saturated. To be honest, I can’t.

[00:25:14] I mean, I read one on on on your group. Maybe, maybe it wasn’t right at that time, but later than the with foreign dentists getting really nasty deals with their paying people to work in their practise. Is that. I mean, did I read that right?

[00:25:29] No. Well, sorry.

[00:25:30] The paying to work in a practise.

[00:25:33] Some associates, you mean the I live on? Yeah, the PLV e ones. I think in London and some places like that. In order for these guys to get a performer. No, yeah, they they work for free.

[00:25:46] I’ve heard work for free, but also pay, pay, pay a thousand pounds a month for mentoring fees. Yes, I can believe yes.

[00:25:54] Yes, yes. The mentorship. Yes, the mentorship means that these guys have to find a private tutor to to watch over them, and they’ve got to pay these mentors. That’s right. Yeah.

[00:26:09] And what about what about non dentists disputes, staff hygienists, receptionists? Are you saying BDG is also representing those people too?

[00:26:19] Yeah, we had many enquiries from hygienists as well, and we also have cleaners and all of these people. Yeah, yeah. Yeah, yeah. Money was just not being passed on and and it was sad because these people couldn’t be furloughed. These people still had bills to pay and nurses were going to food banks at that time. I remember many nurses saying that and even associates were going to food banks at that time. So that’s what made me feel like I needed to start writing some letters, and so once the Jason Wong letter was picked up, then I was writing weekly monthly letters to the NHS saying This is still happening and this is what’s going on. Could you do this? We’re doing this on the blog. Could you do this instead? And so I hope I helped. I mean, there’s many stories, many people who are pointing out the many, many people have said that, you know, so I’ve had a few handful of emails to say that, you know, BDD saved their life.

[00:27:22] Really? Yeah. And and so now it’s it’s sort of moved on from that, that basic COVID pay dispute, yes, to anything and everything where it’s kind of principle versus it’s a little bit adversarial and not that I’ve got a problem with it because, you know, the way I think of it is the associate nurses, hygienists, receptionists, they probably form my staff 90 might be too much. 70 percent of the Dental workforce. Yeah, or more. Eight, Let’s call it 80 percent of the Dental workforce didn’t have or don’t don’t have kind of a place to talk and represent themselves. And you know, there are groups for practise owners, right? There’s this code and all of that. You know, the BDA in many ways represents NHS practise owners. It’s the way I think of it.

[00:28:24] Well, a lot of people see it.

[00:28:26] And yeah, and if you think about it, it’s actually quite a small number of people. Nhs practise owners? Yeah. Yeah, could be, I don’t know, 15 percent of the workforce. And it’s so clear looking at the Buddha’s moves that they are the priority. You know, and so this group that you’ve now I see questions coming up where people say, Oh, I’ve just got a I’m looking to get a job with so-and-so corporate who has anyone else worked there? And what are the problems? And suddenly, 42 responses on that subject. I saw some sort of naming and shaming going on on the group. Yeah, what what do you think about that?

[00:29:10] Well, I don’t advocate using the use of any particular name on the group because we don’t want to get involved in any vicarious liability. However, we’ve had several people. I mean, there was one situation where Robert Jamison on the group has helped many people get money out of a particular small corporate quite successfully. These people thought they had lost thousands of pounds and there were ever so grateful to him, and this person who was doing this to these people was actually very, very bad to the point that he made these young associates feel like they were incapable of being dentists.

[00:29:55] Yeah. So talk me through the

[00:29:57] Mental health psychological.

[00:30:00] Yeah, it was to do with sort of sort of, first of all, obviously withholding pay. And then when they were going after their pay, he was sort of threatening GDC.

[00:30:09] Mm hmm. Oh, that’s a common tactic used by, isn’t it many? Many, I mean, when? Now, I had to do a presentation for the Kdo. I had to run a workshop and remember the all the stakeholders BDA, GDC, NHS University Deans, everyone sits at that meeting. And I did tell them that GDC is being used as a weapon to get associates to keep their mouth shut and move on. And then they did produce a statement to say that if we find any provider doing that, they will be in more trouble than the associates, so they better, they better watch out.

[00:30:52] But so you know of examples where it’s actually happened, where they’ve they have been reported to the CDC or is it the threat of the threat of it is?

[00:31:00] No, no, no. The people have. And there are a couple of cases where the associate has been reported to the NHS and then the NHS is bound to report it to the GDC. And whether the case is kept on or thrown out because of causes, all this pain and agony to disassociate. And there are several cases like that

[00:31:26] Has the opposite also happened. It must have, right? So we’re associates have referred the principle to the NHS or the GDC. Well, retaliatory.

[00:31:36] I am not sure of that, I think. I think associates are very careful to rattle the cage. I’m not I don’t know of any cases, but several lots have actually reported on the pay to the NHS on campus on pay dispute, for sure.

[00:31:55] I mean, look, Sasha, we’ve got this sort of face sad state of affairs then, isn’t it? There’s I mean, we know about it, right? There’s massive disunity in the profession. And every time we try and change something, what tends to happen is there’s so many little factions that break out. But we never sort of can do something with one voice at the same time. How long did it take for your group to get up to 3000 4000? How many members?

[00:32:26] We reach the 3000 mark within within six months, I’d say.

[00:32:30] Yeah. So it’s at the same time as that general. You know, that disunity that we see every time we try and do something, you do sometimes see things like BDG, or maybe, you know, the the private group that started as well quickly gaining ground because there’s that there is a need for, you know, there’s a vacuum of representation and so forth. So what are some of your ideas around fixing this issue? I mean, we can fight and fight amongst ourselves, but how do we how do we become more unified profession so that, you know, you must have act your brains about how do we make this NHS system work? Well, how do we, first of all, get together to play this game?

[00:33:12] I think it’s taken me a long time to figure out that how the NHS works. Firstly, I mean, I was a normal associate not bothered about Dental politics before all of this, and when I was thrust into this position, I had to quickly learn. I had to join my LDC. I had to stand up for the PEC election I had to. I was then made a stakeholder for the CD monthly meetings. Every month I learnt from them. I learnt so much. I’m also on Contract Reform Committee as at an advisory level, representing associates and of course, providers to when I can. And I’ve learnt, I’ve learnt a lot. I mean, you know, all of these groups are trying to improve the working conditions and improve dentistry. What the big elephant in the room is that the NHS contract, I mean, NHS dentistry is a luxury in the NHS and we are taking up money that they want to use in other services such as cancer etc. Yeah. When they know that dentistry is a preventable disease, I get the feeling that they don’t really want to.

[00:34:29] You know, they’d rather put this money elsewhere, so the more of the more of us that understand the figures, I mean, because I mean, OK, on contract reform, we’ve given some guidelines as to OK, you guys have got to sit in this room and every month and we’ve got to talk about improving our health outcomes. We’ve got to improve access, we’ve got to do X, Y and Z, but there’s no increase in funding. You’ve got to see more people, you’ve got to produce better work, you’ve got to do all these things. But by the way, there’s no extra funding. Yeah. Now on a contract which has been prototyped since 20 2009, I believe and apparently all the prototypes have not been able to improve outcomes. Dental health outcomes. How are we supposed to on this NHS in this new contract reform, supposed to improve outcomes and increase access with the same old money? I just don’t understand how I can physically happen. So are you saying that it should become a core service? Because that’s the only way I see numbers increasing and access increasing?

[00:35:45] And are you cool with that?

[00:35:46] Am I call me that? Not really, because I know that there are people that do need the NHS beyond a call service. I’m not cool with it. But on the other hand, if principals are going to do over associates because they’re not in the right contract because the NHS is not paying them properly, if it’s going to sort out all the headache, I’m getting on the BDG for free on a voluntary basis. And if people are not, leadership is not going to take responsibility for all of these associates and treat the workforce properly. Then, you know, just be honest, just be honest with us. Tell us what’s on the table, tell us this is it. This is all you’ve got and get on with it. Then associates can decide whether they’re going private or whether they’re staying on in community and specialisation or whatever. It’s about time we had honesty.

[00:36:40] When you say when you say honesty, do you mean honesty to the public?

[00:36:44] Well, both the workforce, the the associates are in limbo. Yeah. None of us knew. I mean, BDG members of the BDG are learning about the NHS system and the funding and the money and the pot we’re learning now. Prior to the pandemic, most of us just had our heads buried in people’s mouths, getting on with our nine to five. That was it.

[00:37:11] So look, you’re probably more privy to these numbers than I am. Yeah, but my understanding is two and a half three percent of health care spending goes on dentistry. Yeah. Is that right? Something like that’s about, yeah, I think so. Let’s imagine that that that that is fixed, that’s not going to increase because as you said, there’s cancer treatments and all the, you know, the cost of health care is, you know, mushrooming anyway. So let’s imagine no more money is going to go into it. So Shahzia, Health Secretary, what are you going to do with that two and a half, three percent differently to what we are doing right now? Because I think your idea with the core service, I think that’s a great idea. Well, you know, I know it wasn’t your idea, but but

[00:38:00] But my idea,

[00:38:01] I think, I think it’s

[00:38:02] Workable. Firstly, look, firstly, there’s two or three percent that’s invested in dentistry doesn’t even cover 50 percent of the population of the UK. Like, if all of us decided every single one of us decided to go and have a dental check-up and treatment, we would run out half of the population or less, obviously would would not get the treatment right.

[00:38:27] Yeah, we get less. Yeah.

[00:38:29] So I mean, on the news, all I hear at the moment is we need access. Patients want to get in. They can’t find an NHS dentist now as NHS providers and performers. How can we take on more new patients when we haven’t been given extra funding? How do they expect us? I mean, it’s logical, isn’t it? We either we start seeing urgent cases and treating them on our existing contracts and make the numbers add up. Oh, we carry on with routine dentistry with our existing cohort of patients. How can we be asked to increase access with the same amount of money? So what’s the solution? What’s the solution? What is the solution? The solution? I mean, these contract reform meetings are going on. I think they’re carrying on until January. There are supposed to be some quick wins at the moment. So there was some talk about keeping like 20 percent of the contract for other activities of the practise, 20 percent of the contract, which won’t won’t be UDAS. You can do other things with it so you can choose what you want to do with that. Whether you want to see new patients or go to care homes or I don’t know. I don’t know. So definitely reshuffling there is some reshuffling taking place. I don’t think anybody’s come up with a solution, but I think it’s time that the workhorse, the performers providers all got together instead of being so disunited decided that, look, this is they keep on the 11th hour. They give us these targets and we say, yes, you know, they say jump, we say how high. You know, we’ve got to say, look for God’s sake, give us some respect, give us some respect and let. And I don’t think anybody is going to give it to us. We have to demand it. Yeah, we have to come together and we’ve got to demand the contract that we want because without us, there is no NHS contract with all. If we go on strike for two weeks, the public will be telling the governments to sort us out. And that’s well,

[00:40:50] That’s not always how it works, right? That’s always how it works. That’s not always how it works. Sometimes, you know, people go on strike, train drivers go on strike, five minutes go on strike and the public go against them sometimes. But look, look for me,

[00:41:05] The lorry drivers at the

[00:41:06] Moment, lorry drivers them. For me, it’s a funny thing. Look, I did. I did. Yeah, and I hated this. By the way, this was nineteen ninety six when it was. Everyone thought how wonderful the NHS was 50 per item and all of that. You hated it. I hated the fact that I had to think about what the government’s position is before I can do whatever I want to do on this patient. The idea that I could only do what the government would let me do was so disgusting to me that I decided I was never going to work in the NHS. Come with me. Whatever happened? Yeah, OK, so, so so. I went in 1996 and made an offer to an associate to a principle he couldn’t refuse. I said, I’ll take 40 percent, not 50 percent. Back then it was 50 percent right and I got out of it. Yeah. Now it’s not feasible for everyone, all of us to get out of it. Yeah. But one thing that I’ve noticed and one of the sort of for me, one of the nicer things that’s happened through the pandemic is that patients who could afford to take care of their own Dental treatment, but we’re still being seen on the NHS, are now moving over to private because they can’t be seen on the NHS.

[00:42:19] And for me, that’s a good outcome of the pandemic because these guys, they could afford it. They had enough money to see a private dentist, but they were still stuck to their NHS. And so you know, what should happen going forward should be that we need to, you know, it’s a bit sad that every time you talk to an NHS dentist, you the complete experts at the sort of the the money side of it and how much they can do for what and the regulations. And this sort of red tape, for me, really sad that. Much of the workforce specialised on this aspect of dentistry, which doesn’t exist in lots of other countries at all. And rather than going ahead and learning about endo or going ahead and learning about whatever bit of dentistry interests you, we’ve got to do almost have to be an accountant and a lawyer first. Yeah, before you can even. And then and then when I talk to my indemnity friends, they say, Oh, much more legal problems happen with NHS patients than with private ones, which is a double whammy. You’ve got loads of patients, not enough money. And now this GDC thing, you know the indemnity problem as well. No wonder people are demoralised right now. One.

[00:43:42] Their hands are tied. Hands are tied limited. A limited time, limited

[00:43:49] Materials,

[00:43:50] Materials, you know, and we’re supposed to produce the best, best outcomes.

[00:43:55] Yeah, so, so, so personally for you. What made you stick at NHS dentistry? I mean, did you not think, Hey,

[00:44:04] I’ll go private? For me, I’ve actually worked in high needs areas most of my life, and

[00:44:13] It’s even harder, right?

[00:44:15] Very, very difficult. Yeah, very difficult. And you know, when you’re a woman and you’ve got young children, yeah, sometimes you have to take on a bad deal just to be there for your kids. Yeah. And I was one of them. I took on the hard jobs just so that I could finish work at three o’clock and pick my kids up myself. And the beauty of that is that you do become a very good dentist. You learn, you learn techniques, you become the best dentist you can be.

[00:44:53] Under the circumstances,

[00:44:55] Yeah, under the circumstances, and of course, if you’re willing to learn and I’ve continued, I’ve done a masters as well, you know, advanced general dentistry, I’ve done all the courses under the Sun, I’ve done a certificate in implant ology, I’ve done all the Botox and the fillers and the

[00:45:10] Has.

[00:45:13] My CV is brilliant. I have never been declined a job and my next ambition is to have my own place.

[00:45:20] Tell me, tell me, tell me about being a woman and then being, You’re wearing hijab, being sort of a minority woman in dentistry, is it? Do you find that, you know, it’s problematic? Do you not find it’s problematic? Tell me about it.

[00:45:38] Patient wise, it’s absolutely no problems. Never had an issue with patient touch. What patients judge you by your skills, your kindness, your care? Yeah. And I’ve had people follow me from practise to practise and people. Patients begging me never to leave so patient was never a problem.

[00:45:57] Getting a job wise, if you have people sort of, you know, judge you or your

[00:46:01] Wise again, I think I do get the how does she fit the part? Will she fit in? But I’m quite a warm person and sociable person. I think open minded people straight away, they see beyond they look at my skills, my CV and the way I am as a person, my characteristics. So so far I think I do. It’s harder and I’ve never thought of leadership, never, ever thought to put myself in leadership. I’ve been thrown into that. Never thought I would be. In fact, now I people contact me because they need my opinion. I it seems

[00:46:43] Like you’re thriving, though, in the leadership role. It seems like you like it.

[00:46:48] I enjoy it, I do enjoy it. I was I was before I was frustrated in why are things not happening? Why are we in such a situation? But now I feel like people are listening to us. I feel like people are taking me quite seriously and people are listening to what I have to say. And often my contribution is take welcomed and it’s almost people tell me at leadership level that you’re the breath of fresh air that we we had been waiting for. So that’s given me the confidence to forget about my job and forget that I’m a Muslim woman. It’s actually all the gremlins. I had all the barriers I had put up. They’ve all gone.

[00:47:33] When I’ve spoken, I’ve spoken to Sophina Ahmed, who I know you, you know to. I’ve spoken. I’ve spoken to several ladies who say to me that one of their drivers is the idea that people think this, this this lady with a hijab, it’s just not going to have anything of value to to contribute. You know, they’ve got that sort of basic idea in their head that someone who’s downtrodden or whatever it is and the driver,

[00:48:04] You know, the media portrays the image of a hijabi woman as an oppressed,

[00:48:09] Oppressed, oppressed. Exactly.

[00:48:10] And we are not oppressed, for sure. Well, the liberated women we are, you know, our husbands, you know, they what they earn is ours, and what we earn is ours to part with a penny of our money. If we do, it is, you know, if are religious Islamically, if we part with a penny of our money, it’s written down as a charitable cause. So it’s a double whammy for us. We are. I’m so glad I’m a Muslim woman because I have got, you know, I’ve got I’m liberated because, you know, my husband has to take care of me. I don’t even have to work if I want to. I work with because I want to. I love my job and

[00:48:56] What I’m saying about a driver, it’s like the drive, the deep drive to make a difference. And these ladies, for me, was something that and they said it themselves as well was was to do with the fact that, Oh, you think I’m an oppressed, silent person, but actually, I’m going to show you. Yeah, yeah, absolutely. Do you have that within your zone?

[00:49:18] Oh, yeah, absolutely. Driving the air, we need to show people that please, for God’s sake, media is the media is out there to put their own stunts and to brainwash you. We are very happy, liberated women.

[00:49:34] And interestingly, you said it was your mum who who had all the ambitions for you, right? Yeah, even one generation back that was still

[00:49:43] My mom was a businesswoman in her own right. I mean, she was a she. She was a property entrepreneur. She had encouraged my father to buy properties. And, you know, he’d just want to work and go and do his politics. He was so engrossed in his political world and she’d expect him to invest in property. So, yeah, yeah, no, no, no women. Muslim women are definitely liberated, not oppressed.

[00:50:10] Tell me this during this little journey that you’ve been on, and it hasn’t been long as it’s this part of your journey. It’s been about 18 months now. Yeah. What’s been the darkest day?

[00:50:22] Well, darkest days, darkest day, darkest day. Ok, you shall I don’t want this one.

[00:50:28] Yes.

[00:50:35] Ok, I lost a job, I lost the job because my boss was told that I’m rattling cages.

[00:50:43] She lost a job that you had one that you were going through,

[00:50:46] Just started helping out at one that I had lost. So I’ve got my main job and I have a couple of days to help other people and I normally go by word of mouth and I help friends or friends. And locally in Birmingham, I had helped somebody before. And he had asked me to come and help him again. And whilst I was helping him, he got a phone call from these top boys in Birmingham and to say that you know, your associate is rattling cages. They thought I wouldn’t find out, but the manager told me.

[00:51:27] And that’s that scared him enough for that. What are you saying?

[00:51:30] Yeah, that scared him to think so. So these people are talking about. Yeah. Trying to say that. Look, you need to like scare. I think they were trying to scare me to stop doing what I’m doing because I won’t have a job. But that won’t again, if I’m not worried about my work. Nothing’s going to scare me.

[00:51:50] But but you are casting that as your darkest day right now, a

[00:51:53] Dark time for me because I was I felt scared. I felt scared and then I thought, OK, so you’re going to do this, I’m going to come and join you. So I joined them as well. Mm hmm. So I got elected and I joined them too.

[00:52:06] And what about if you regret sort of mistakes, but you think you’ve made along this journey, what would you’ve done differently?

[00:52:16] At the moment, at the moment, I have no regrets, perhaps one regret I have is I think I’ve been too engrossed in this, and I’ve kind of my kids have to get on with things like, you know, I’ve neglected my time with my children a bit. I prioritise my group and some like we’ll go out with family on family occasions and I’m sort of on my phone checking who sent me an anonymous post or if I can help somebody and a went on a walk with me and we’ve got her across the road and I’ll quickly check my messages and start replying. So my regret is not really a regret, but I feel like I was just too engrossed in. I was on a family holiday last year in Turkey and I was still on my phone. I just can’t let go of the group. It’s like a baby.

[00:53:05] It’s a labour of love love. But you know, I’ve talked to other people about this, and again, I don’t want to bring up the woman thing again. But women are the ones who seem to have guilt on this subject more than men in my in my experience. And in a way, if you want, it is what’s your kid learning when they see you working and engaged? And, you know, as passionate as you are, the kids learning that the kids are just just like, just like you when you saw your mum, tell your dad, buy these properties and take these risks. And you know, at the moment at the time when your mom was looking at those property leaflets or whatever, she wasn’t playing games with you. But but you learn loads from that. Yeah. And I tell you something else that the one thing that I hear from some people is that, you know, as a mother, I’ve got to look after myself first before I can give. By the way, I know loads of mothers who don’t do that right. Only, you know, they become the master of the situation. But, but but that bit of advice of, hey, only I can only look after my family once they’ve looked after myself is actually quite beautiful to take the guilt out of motherhood. Yeah. You know, and and your kid says once they how old are they now?

[00:54:31] 14, 12 and seven

[00:54:34] Are three kids? Well, then you know they’re old enough to understand now. Yeah. So definitely your 14 year old is old enough to understand, you know what my mom is, you know, helping people with their careers right and and and helping people with their health and all that. That’s a great thing. You’re setting a great standard. You’re setting for your kid. You know, a good example you’re setting for your kids. It’s. Don’t feel guilty about it. That’s that’s all I’m saying. All right. Going forward, what do you think is going to happen to the group number one? What’s going to happen to the contract? Do we know anything? You seem to be privy to these meetings?

[00:55:14] Yeah. Number two. Ok, so number one, the group, the group, the group will carry on, the Facebook group is there every day. Anybody can come and post their query anonymously. The group has definitely got its own niche and if anything, the best thing the any, any big group they can do is take it on officially.

[00:55:38] And by the way, does anyone help you? How many have you got? People you know, who also help on the group are the dentists.

[00:55:44] I thought, I’ve got to. I’ve got a website team, so the it side, they help me, but they dentists, no non dentists. I’ve got somebody helping me, my website and membership. So there’s a free membership website on WW British Dental Blockchain.com, so

[00:56:04] Paid for all of that that the group pay or did you pay what

[00:56:07] I pay for that I’ve paid for it. And if I want from my pocket because I felt like if people are going to take me seriously, I need to. I need to look the part because remember, the group was actually initially just called associates. Yeah, I remember it was Charles Yeomans, Associate, Facebook Facebook page. And then when I was put into fifth gear with all the letters, I thought, Oh gosh, we need a name, we need a name. And then we came up with British Dental Action Group, and I’ve been privileged to have some advisors in the background that I can turn to ministerial level who can guide me slightly. And that’s really helped. And then I’ve got some little helpers on the group that will send me the odd motivational post for associates. And I’ve got Nayar who helps me with the queries that come through. So I’ve got people who are very passionate about what’s going on in NHS dentistry, at different levels and non dentists that are very keen to know what’s happened and. People that are following my journey who couldn’t believe what had happened.

[00:57:20] I’m certainly following your journey. Tell me about the BDA elections and your thinking around. You almost got it. Didn’t you almost got elected?

[00:57:32] Well, I was a third or fourth place, wasn’t I? It was really good result for somebody who was like five months ago. And that was again, I mean, when I when I started the associate group, I was very, very pro BDA. You know, we need to help the beat. We need to reform. The BDA and BDA has got to become a better group and the all encompassing umbrella body for us. And when I started to get the posts about the queries about that, we’re being asked to upgrade and I can’t afford it. And the media was really trying. They were trying. I can’t knock them for that. They weren’t really working hard in the pandemic, but I think they thought they had too many, too many, too many people to look after, and I think it must have been a difficult time for them. Let’s just put it that way. Yeah. So people were saying to me, Look, you guys are all just ranting on this Facebook group, you know, put your money where your mouth is. Come and join up the Valdez’s and join the PDP and join all these organisations. You know, don’t just shout. So I thought, You know what I mean, business? I will. I will do this. I really want change and and people at leadership level were saying, Shazia, please stand. We need people like you in there. We need people like you for change. The same old people are there, which is why we’re not seeing any change. And in order for you to make a change, you need to be inside, not outside. So I thought, you know what? I will give it a shot. I will. So I did. And unfortunately, there’s a lot of apathy out there, isn’t there, if it doesn’t work to you. It doesn’t matter. So lots of people did vote for me, but many couldn’t be bothered to post their postal votes. Many didn’t. I mean, out of four thousand one hundred odd votes I got.

[00:59:35] I mean, listen to this Shazier. We’ve done 102 episodes of this podcast and the the one that was listened to the least. Or maybe the other thing was the least it was be the second or third worst listen to one was the one about the BDA recollections.

[00:59:53] You know, it wouldn’t have completely detached themselves from media. And that’s such a shame because I think politics in general are union

[01:00:02] Politics in general. Yeah, is is is a difficulty when it comes to dentists because, you know, dentists feel so powerless. And so let’s get onto that previous question that I asked. You’re on these in these high level meetings. What’s what’s your view on where the contract’s going? And will it be a contract worth having for anyone?

[01:00:24] I think a huge, huge reform is required if the funding is not going to increase, a huge transformation is required.

[01:00:33] I mean, are you talking each performer having their own contract? Are you talking that

[01:00:38] Kind of move? I don’t. I don’t think they can afford to give each performer a contract. Well, I tell you something. If they came every single person or performer and it just performer a small contract, say a hundred grand. Right. One hundred and fifty grand and said to them, Go just do your emergencies with this. Every single person, every single person with a performer, no get 100 or 200 grand contract. Yeah. Right. Go, go. Increase access. I tell you something. The access problem will finish because people will invest their savings on the high street, set up a practise, see NHS patients, take them out of pain and say, Right now you need X, Y and Z. I can do that for a small charge. It’s that if that’s the deal, that this is all there is, then doesn’t it make sense? Well, of course we don’t want that. We want everything and everything on the energies.

[01:01:38] Yeah, yeah. I mean, it’s a difficult one man because, you know, you’d imagine someone in my position. I saw teeth whitening systems, right? You’d imagine someone in my position wouldn’t be affected too much by the NHS. But but I’m not silly enough to think that. I mean, I know many of my biggest users got to where they got to by initially having an NHS contract and the security that that gives you. Like you said, the borrowing you can do on the back of that set up set up their practises and now they’re doing teeth whitening and now they’re talking to me. So you know this, this two point five percent that’s going into our profession, it’s got to keep going. But, but but at the

[01:02:24] Same time, how is it distributed? Is a question.

[01:02:27] Yeah. At the same time, I’d like to know, I mean, I don’t know this. Maybe you’ve got a clearer idea in Canada, in Australia, in New Zealand, in America, how much per capita goes into Dental and what are the other systems? Are they are any of them better than ours in that sense, you know, per capita that

[01:02:48] We did, we actually do something on the BTG about this, and many people did their research and sent in all the different systems in many, many countries, and I passed them all onto the NHS. I passed them all on and they asked me, Shazia, could you find out and send them? And I did, and I’m not sure what they’ve done with it. But they they will see that there are lots of systems, and I think some of the successful systems are whereby there is actually everybody gets this voucher scheme whereby they here you go. You can have this amount on the NHS. Anything extra, you’ll have to top it up yourself.

[01:03:27] Yeah, yeah. And my uncle works in Canada or worked in Canada, and there was a similar thing, although it was sort of via the insurance company. So, you know, there wasn’t proper NHS, but the government would pay up to X amount for Dental insurance and anything above that. You know, it’s an interesting idea, right, that if you take that 2.5 percent split it by the number of people in the country means test it. So if you earn over a certain amount, you don’t get it kits and so forth. Everyone comes in with their three hundred pound voucher. Do what you like with the 300 pound voucher as long as you spend it at a dentist.

[01:04:07] Yeah, interesting.

[01:04:09] Yeah.

[01:04:10] Well, that requires huge reform, doesn’t it? Because don’t forget these people who are holding massive contracts and these corporates. Can you imagine redistributing their contracts? They’ll be up in arms. I mean, yeah,

[01:04:22] They’ll get down. Some of them will go down.

[01:04:24] Yeah. So it’s a difficult one. Very difficult one.

[01:04:29] Definitely. Well, it’s been a massive pleasure. Speaking to you shows you and you know what was in my head. The question I had in my head is kind of been answered nicely, you know, like y y you, you know, this combination that you’ve explained to me, if your dad the sort of the idealist he’s, you know, a politician as well, you know, you know, for me, I always think I’m never going to change anything in this, you know, I’ve always like scared of it. And on the other hand, oh, I think I’ll change the world of toothpaste. Yeah, so so, you know, I think I can change something. But when it comes to these sort of thing or or sitting around a table, listening to everyone, talking and the agenda and all that just drives me crazy. But but obviously, you know, you’re good at that. So the combination of your dad and everything that he stood for and your mum and the ambition and all of that, it’s answered my questions nicely about why, you know, Shazia from Birmingham is the one who decided to stand up and and do this. We always end this show with the same questions to Prav famous final questions. I do apologise because they’re a little bit dark. Some people think of them as dark, but I don’t. You’re on your deathbed. Oh yeah. You’ve got all your nearest and dearest with you. What are three pieces of advice you want to leave?

[01:05:59] Oh. Be kind. Be honest. And I’ll work hard.

[01:06:12] Nice. Nice. The second question. It’s also dark. You’ve got a month to live. You’ve got your health. But, you know, you’ve got a month to live. What do you do in that month?

[01:06:30] Spend it with my family. Yeah, spend it with my family. Blow some cash on handbags.

[01:06:42] No holidays.

[01:06:45] The best shroud going. Choose a nicer plot. No, no. Just make sure you know, spend some quality time in the family. Make sure the kids are all, you know, sorted. All my financial affairs are in order. Yeah. Okay. So close friends. Close family.

[01:07:13] It’s not a great question, really, but you know, privately will admit it. But looking back on, you know, places you’ve been times you’ve been with the family where it’s been your happiest times. When when was that? Where was that? How was that like?

[01:07:27] The happiest times. Oh, God, there’s been several happy times on holidays, holidays.

[01:07:33] Where’s your favourite place for holiday? All Disney. Oh, really? Florida best. I hated it.

[01:07:41] Know coasters are amazing.

[01:07:43] What can I tell you? Well, I didn’t realise you could jump the queues by buying this other ticket. Yes.

[01:07:48] The children’s yeah. With your kids, you can skip all the queues.

[01:07:50] I didn’t know that.

[01:07:53] Do you like roller coasters?

[01:07:54] Not really. Not really.

[01:07:56] Well, that’s why you like the final.

[01:07:59] The final, final question. Perhaps final, final question. How would you like to be remembered?

[01:08:05] Shazia was Shazia Shazia, the woman from the pandemic who helped to change dentistry, NHS dentistry. She just changed the whole of NHS dentistry.

[01:08:18] Lovely. Well, it’s been a real, real pleasure having you.

[01:08:22] Thank you very much for inviting me. This is Dental Leaders, the podcast where you get to go one on one with emerging leaders in dentistry. Your hosts Payman Langroudi and Prav Solanki. Thanks for listening, guys.

[01:08:43] If you got this far, you must have listened to the whole thing and just a huge thank you both from me and pay for actually sticking through and listening to what we had to say and what our guest has had to say, because I’m assuming you’ve got some value out of it if you did get some value out of it. Think about subscribing and if you would share this with a friend who you think might get some value out of it too. Thank you so, so, so much for listening. Thanks. And don’t forget our six star rating.