Simon Thackeray: So they knew that the reason I was going private and that prices would change significantly. [00:00:05] They knew it wasn’t because I was wanting to earn more. They knew it was [00:00:10] because I wanted to do the dentistry that I’d been trained to do. And once you’ve got your staff knowing [00:00:15] that it’s going to be better for everybody, not just you, [00:00:20] but they’re going to get the benefit from it. And the patients particularly are going to get the [00:00:25] benefit.

Payman Langroudi: Tricky financial situation, psychological situation, because the team [00:00:30] will be thinking, this is a place that serves me and my family. Yeah. And then suddenly [00:00:35] the thought process might be, this place isn’t for me and my family anymore.

Simon Thackeray: Absolutely.

Payman Langroudi: And so it’s [00:00:40] it’s it’s a negotiation that needs to be taken very seriously.

Simon Thackeray: It was very difficult [00:00:45] because, you know, part of your I would say anybody thinking of doing it has got to have a plan B. [00:00:50] And part of that plan B is you get smaller, you actually contract in order to expand [00:00:55] again.

[VOICE]: This [00:01:00] is Dental Leaders the podcast [00:01:05] where you get to go one on one with emerging leaders in dentistry. Your [00:01:10] hosts Payman Langroudi [00:01:15] and Prav Solanki.

Payman Langroudi: It gives me great pleasure to welcome Simon [00:01:20] Thackery onto the podcast. Simon is a straight talker [00:01:25] extraordinaire. Yes. Legal Eagle [00:01:30] Dental politician. I would class you as Simon and the practice principal. [00:01:35]

Simon Thackeray: Thank you for inviting me.

Payman Langroudi: Thackery Dental in Mansfield.

Simon Thackeray: That’s right. Yeah. I’m not so sure about [00:01:40] the legal eagle and the dental politics.

Payman Langroudi: You know.

Simon Thackeray: I’ve got a I’ve got a master’s in law. Yeah. [00:01:45] And I do, I do do a fair amount of legal based stuff. But the more [00:01:50] you learn about the law, the less you realise you know about it.

Payman Langroudi: A bit like occlusion. Well, [00:01:55] does occlusion actually exist? Oh, I should say founder member of Bapd. [00:02:00]

Simon Thackeray: Yes, actually.

Payman Langroudi: British association private dentists.

Simon Thackeray: That’s right. That’s right. [00:02:05] Yeah. That came out of, um, that came out of Covid. Yeah. One of the [00:02:10] many things that did appear.

Payman Langroudi: Let’s start with that. Yeah. Let’s start with that. My wife’s a dentist. [00:02:15] A private dentist. And in Covid, she got [00:02:20] nothing. No support whatsoever. She’s an associate. Yeah. And, you know, we were okay. But [00:02:25] I was thinking, what if she was a single mum? Oh, God. And, [00:02:30] you know, working full time and paying school fees or whatever it was. She got nothing. Zero. [00:02:35]

Simon Thackeray: And I think that was that was what we realised very, very quickly. Um, [00:02:40] we were all waiting for this big announcement. Um, probably. [00:02:45] What was it, a week, two weeks into the lockdown, we were waiting for the big announcement as to what was likely to happen [00:02:50] with dentistry. And of course, the CDO came on. And one of the first things that [00:02:55] was said is I don’t speak for private dentists, so. Hang on. Where [00:03:00] are we? You know, what is this? I don’t think, uh, anything [00:03:05] like furlough had been announced at that point. So, you know, [00:03:10] we sat there with these businesses that employ people. And, you know, I’ve [00:03:15] always looked at me as having multiple responsibilities. I have a responsibility to my family. [00:03:20] I have a responsibility to myself. But I’ve got a responsibility to 19 people who work for me [00:03:25] or work with me. And you think, hang on a minute, how am I going to look after all these [00:03:30] people? What are they going to be thinking? Um, and, you know, that weekend [00:03:35] was a lot of, you know, chatting around with various people [00:03:40] who then I didn’t know all that well, but I’d been in email contact with and [00:03:45] it finished with a big meeting on zoom with [00:03:50] about 20 or 30 of us. And the bapd APD formed [00:03:55] out of that and we realised that actually there isn’t anybody [00:04:00] speaking for private dentistry. The BDA speak for dentistry and private [00:04:05] dentistry as part of it. But when you start drilling down into the intricacies of of what [00:04:10] we do in dentistry. Private dentistry didn’t have any [00:04:15] specific representation. And the problems that we had were [00:04:20] entirely down to the fact that we weren’t then supported in any way apart from furlough, which [00:04:25] of course, we’re now paying back, aren’t we, with with higher tax rates.

Simon Thackeray: And we could get the the [00:04:30] bounce back loans. But there was nothing else. There was no information coming out fast [00:04:35] enough. And I realised that there probably wasn’t any information, but it it made [00:04:40] us realise that we needed something in place to look at the representation for private dentists, [00:04:45] and was the intention for it to continue after, you know, [00:04:50] Covid initially all you could see was Covid. It was, how do we get everybody back [00:04:55] to it? How do we keep our businesses running? How do we look after our patients? What’s the patient safety issue here? But [00:05:00] then we realised that as we look more into it, this would continue [00:05:05] because of the things that were so allied to, you know, the GDC, [00:05:10] what was their remit in Covid, what was the Cqc’s remit in Covid? [00:05:15] And of course, as a private organisation, you’re not it’s not in your lane to [00:05:20] be discussing NHS contracts. Yeah. So, you know, do [00:05:25] we have to have a position on that. And we tried to keep away from, from, you [00:05:30] know, the NHS side of it if we could, but we realised that the NHS side was actually what was potentially [00:05:35] stopping us working because everybody would listen to the, [00:05:40] the authority of the Dental Leaders and the Dental Leaders [00:05:45] were seen to be people like the the office of the Chief Dental Officer. So by default [00:05:50] the GDC would listen to that, the CQC would listen to that and then we would be [00:05:55] governed, if you like, by that. Although in reality were we. But did [00:06:00] any of us actually want to take that legal risk?

Payman Langroudi: There was a vacuum, there was a vacuum. There was a [00:06:05] huge vacuum. I think the stress tested the professional, stress tested the the country. [00:06:10] Right?

Simon Thackeray: Absolutely.

Payman Langroudi: And every country for that matter. I mean, talking to friends who live abroad, there [00:06:15] were different approaches. Mhm. Um, whether it was down to lockdown vaccinations [00:06:20] um.

Simon Thackeray: Or non lockdown as some countries actually.

Payman Langroudi: Non lockdown Sweden [00:06:25] and all that. Yeah. Um how, how quickly people were made [00:06:30] to feel like outcasts if they didn’t follow the. Yeah the, the [00:06:35] sort of the government line and how quickly we all fell into place. And if you.

Simon Thackeray: Questioned [00:06:40] it in any way. Yeah. You were suddenly some kind of outlier. And either, [00:06:45] you know, somebody who would deny the existence of it. And, you know, we did get a lot of pushback [00:06:50] from some people when we were we were trying to get I remember a lot of the work that we [00:06:55] were doing, and Dom Joly did an awful lot of research. [00:07:00] I have never seen anybody with a capacity to research and read around a subject. Hyper [00:07:05] focussed, laser focussed and, you know, trying to get people [00:07:10] back to work and coming up with a, a pragmatic [00:07:15] way of doing it that wasn’t ridiculously onerous. And as it turns out, I think we were [00:07:20] probably looking back now, we were probably quite over the top with what we ended [00:07:25] up having to do, but we didn’t know that at the time. Yeah. Um, but [00:07:30] but having people criticise us and saying that, you know, we were potentially playing games with people’s [00:07:35] lives and we actually didn’t know, you know, did we need FFP three. [00:07:40] Did we need all that barrier stuff? Was it over the top? I [00:07:45] mean.

Payman Langroudi: It’s interesting because in Germany, one of my colleagues said the practices were legally [00:07:50] mandated to stay open. Yeah, exactly.

Simon Thackeray: So they had to stay open. [00:07:55] So did they have all the PPE? Is that why did the Germans have it? And we couldn’t get any. [00:08:00] But I we actually looked at this and Tiff Tiff Qureshi’s got a lot of contacts [00:08:05] um, abroad abroad. And he was we had this big list of what other [00:08:10] countries were doing, and I’d forgotten that Germany would were staying [00:08:15] open. They had to stay. But we seem to be it was almost like dentistry [00:08:20] had been forgotten and that the NHS was so focussed [00:08:25] on the the pandemic aspect which it needed to. [00:08:30] And, you know, we can get on to whether the, whether the, the NHS is, is funded [00:08:35] appropriately, was it funded appropriately to survive a pandemic anyway. Um, [00:08:40] and was it planned, you know, did did the right people plan [00:08:45] the right stuff and did we have enough PPE? Because we knew a pandemic was going to be coming [00:08:50] because we’d had work. We’d had pandemic planning probably ten years previously for a flu [00:08:55] epidemic. Um, but that all seemed to then [00:09:00] just go by the wayside and as if to say, oh, well, we didn’t see this coming. And [00:09:05] dentistry just seemed to be like, okay, we’ll just forget about dentistry because nobody’s going to die from [00:09:10] dental problems. Well, actually, some people did. Yeah. And there [00:09:15] was this huge issue of a lack of a [00:09:20] fundamental, basic part of healthcare because you could gain access to your doctor [00:09:25] somehow.

Simon Thackeray: Yeah. Yes. A lot of it was the online stuff. But, you [00:09:30] know, dentistry is a bit difficult to do online. You know, show us your teeth. You can’t [00:09:35] trust a patient sometimes to get the camera in the right place to show you the teeth. So I’m not sure how we were going [00:09:40] to do these kind of online things. And then fundamentally, all you can do is write a Prescription. [00:09:45] And of course, then it was it was interesting that what two years later, [00:09:50] we were all shouted at because the amount of antibiotic prescriptions had gone up. [00:09:55] Well, if all you can tell us to do is write an antibiotic prescription [00:10:00] or refer them into a an emergency centre that [00:10:05] isn’t actually open in some respects, in some in some areas. What do you expect? [00:10:10] Tell us to do something. We are actually I think we were as a profession. We were very obedient. Whether [00:10:15] or not you think that means we were very sheep like and we followed it without questioning [00:10:20] it. I think to a degree we did, and there were people out there questioning it quite a [00:10:25] lot more than even the Bapd did. You know, because we did question [00:10:30] a lot of of why why is that? You know, there is no research.

Simon Thackeray: We realise [00:10:35] the research is being written as a result of what is happening. So you can’t react [00:10:40] to it because you haven’t got any research. But some of the things just seemed illogical. Yeah. [00:10:45] And, you know, to actually close down a fundamental part of the nation’s [00:10:50] healthcare overnight. Yeah. It was the 23rd of March, [00:10:55] wasn’t it? It was a Monday. You shut. Bang. And I [00:11:00] remember that day vividly because I we’d got everybody into work and [00:11:05] I was it was the most emotional thing I think [00:11:10] I’ve ever had to deal with in my professional life, because I wasn’t sure [00:11:15] if I would have a business when I came back. And if I would see any [00:11:20] of these people again, who as a team, you know, I care for my team. I’ve got a very [00:11:25] good relationship with them. And one of my therapists came up to me and she [00:11:30] said, I don’t know how you did that. I don’t know how you didn’t burst into tears through that. And I said, I [00:11:35] don’t know either. And burst into tears, um, because, you [00:11:40] know, there were so many unknowns. And I’m not saying we were unique. You will have had the same kind [00:11:45] of thing as a business owner.

Payman Langroudi: Think of it as exactly the same thing. One of the hardest days of my business life, [00:11:50] and we got all the team together and said before furlough was announced and [00:11:55] we said, look, either everyone has to take a 50% pay cut or we have to lose [00:12:00] half the team. Yeah, because there was no furlough. Our turnover went from I think back [00:12:05] then it was like £30,000 a day to zero. Yeah. Overnight. Yeah. Um, [00:12:10] but I think it’s symptomatic of the fact that, you know, we complain about it all the time as a [00:12:15] profession of where dentistry is as a priority in this country. [00:12:20] And is it possible to change that? [00:12:25] I don’t think we should ever bank on any further cash. No. Centrally [00:12:30] coming to us? Absolutely not. You know, so there’s that. The resources, the resource, the amount of [00:12:35] money coming to us will no, not go up. It probably will go down. Yeah. And [00:12:40] so as a nation, we we as a as a as a population, [00:12:45] we’re not used to saving up for teeth. No. Whereas, you know, cousins [00:12:50] in America, cousins in Germany, wherever they are, you know, your kids braces are something [00:12:55] you think about from the day the kids are born. Yeah.

Simon Thackeray: You’re trained.

Payman Langroudi: Yeah. And so we can’t [00:13:00] overnight change things here because the system is set up in a particular way [00:13:05] whereby, for instance, my team don’t get dental insurance with their work. [00:13:10] You know, if there was no NHS, that that would be one of the benefits of [00:13:15] work. And so it’s something that has to evolve. But, you know, if you were the king [00:13:20] of the world. Oh, God.

Simon Thackeray: I bet that would be an interesting concept. [00:13:25] There’d be some interesting things.

Payman Langroudi: Yeah. If outside of dentistry. [00:13:30] Yeah.

Simon Thackeray: Let’s not talk.

Payman Langroudi: Politics. If you were the king of the world, how would you change [00:13:35] things? I mean, we’ve got the regulator.

Simon Thackeray: Okay. We. You have to start with the legislation. [00:13:40] You have to start with the way that dentistry is governed [00:13:45] and provided in this, in this country. And everything [00:13:50] comes from the Dentists Act, because without that, you know, you would just have a free [00:13:55] for all and anybody could practice dentistry. And that it came in as a result of the barber [00:14:00] surgeon kind of thing. The 1923, you know, formalising it. But you’ve got [00:14:05] an act that was written in 1984 and has barely been changed, [00:14:10] unless it’s been for the convenience of the government to bring things in, like registration of dental [00:14:15] nurses and DSPs. I don’t like the term DSPs, but they [00:14:20] change it when they need to change it. But what it hasn’t taken into [00:14:25] account is the way dentistry has developed in the last five [00:14:30] years, let alone the last 30, 40 years that the dentist act has been there. You [00:14:35] know, you have got remote working. I might not agree [00:14:40] with some of the things like remote monitoring of, um, ortho, ortho, but it’s [00:14:45] there and that then needs to be managed, governed [00:14:50] and regulated because otherwise you’ve got this. There’s [00:14:55] a lack of morale within the profession because all the GDC can police [00:15:00] are the people. It’s it has as registrants. It can’t really do a lot [00:15:05] about the other stuff that’s that’s outside its remit. And unless the [00:15:10] legislation has a change to allow it to deal with things [00:15:15] that currently are outside of its remit and also to deal with things in a more [00:15:20] modern manner, like fitness to practice, you’re still going to have these [00:15:25] these problems where the GDC is going to be seen as you know, [00:15:30] it’s it’s a leviathan. It’s a very, very slow thing to change. It’s I think [00:15:35] I’m quite confident. I’ve been quite confident just recently with the [00:15:40] the new incumbent at the GDC, Tom Whiting, and it’s he does seem to have [00:15:45] a completely different view to previous people [00:15:50] in that position, and I’m quietly hopeful. It’s still early days, but [00:15:55] I’m quietly hopeful that he will. He’ll bring this modernisation [00:16:00] kind of thing into dentistry.

Payman Langroudi: Because, look, the law [00:16:05] is always a bit slower than events.

Simon Thackeray: Absolutely.

Payman Langroudi: I mean, I was listening to your episode, I should say you’re [00:16:10] a podcast host as well for the APD podcast. What’s it called?

Simon Thackeray: Private matters. Private matters. Private [00:16:15] matters.

Payman Langroudi: Yeah. I was listening to an episode of that where you guys were discussing Smiledirectclub. Yeah. And [00:16:20] you know, the law written in 1984, or let alone 1920 or [00:16:25] whatever. Yeah. Just hasn’t accounted for, you know, things [00:16:30] like that. Yeah.

Simon Thackeray: It wasn’t a thing. We’d only just got ZX spectrum, for God’s sake, aren’t we?

Payman Langroudi: Yeah. [00:16:35] So? So then that goes down to either it needs to change in a, in a way that is, [00:16:40] is sort of it needs to be lighter touch. Yeah. So you know or [00:16:45] it needs to be quicker to be able to change it. And I mean [00:16:50] would you, would you say it’s a problem with the country as a whole. [00:16:55]

Simon Thackeray: The, the country as.

Payman Langroudi: In, as in are we slow to move [00:17:00] as a country.

Simon Thackeray: I don’t think we necessarily slow to move as a country that slow.

Payman Langroudi: Were we [00:17:05] with the vaccines?

Simon Thackeray: No. No. I think when we need to move quick, we do move [00:17:10] quick. And I think sometimes we might move too quick in some things. Um, and, you know, particularly [00:17:15] when we, you know, we’re still a bit of a warmongering nation and we can move quite quickly when we don’t [00:17:20] like what somebody else is doing somewhere else. But the the priority [00:17:25] of dentistry, I think, needs to be higher in everybody’s [00:17:30] mind. And that’s not just in dentists because it’s all it’s it’s the thing that we always [00:17:35] talk about. My wife’s always saying, God, you only ever talk about dentistry. You’re always, ever doing something about dentistry. [00:17:40] So it’s high in my priorities. Is it high in Mrs. Smith’s down the Road, [00:17:45] who is currently juggling all the other cost of living expenses [00:17:50] and has never really had the [00:17:55] the exposure to the education that they need? And I don’t mean that in a way that they’re not [00:18:00] educated enough, because there’s some very educated people who know very little about the teeth and how to look [00:18:05] after them. Yeah. But I think as a priority, when you’ve got a finite amount of [00:18:10] money and it’s a state run system, you have to look at [00:18:15] how that money is spent appropriately. And is it appropriate to provide [00:18:20] so much for people who can afford to pay [00:18:25] for the treatment? And again, it’s it’s a bit of a, you know, it might make [00:18:30] some of the NHS people listening to this annoyed. But I actually do think [00:18:35] the time has come for us to really face up to the fact that a core service that’s appropriately [00:18:40] funded and targeted at those people who can’t afford [00:18:45] private dentistry.

Payman Langroudi: Kind of like the urgent care centres they put together during Covid. Yeah. Yeah. [00:18:50]

Simon Thackeray: They should have stayed. Yeah they should. But the problem with that is you’ll [00:18:55] remember when when we had the dental access centres, when Tony Blair promised [00:19:00] everybody have access. And the cost of a single patient visit [00:19:05] was so high compared to the cost of a visit [00:19:10] to a general dentist on the high street. Why? Well, because of all the systems that [00:19:15] are put around it. The fact that it’s a bureaucratically run system. I mean, a dental practice is largely [00:19:20] now a building surrounded with reams and reams of red tape. But [00:19:25] when you start to make it a a situation that’s run by. [00:19:30]

Payman Langroudi: Government facilities.

Simon Thackeray: A government facility. Oh my God, yes, you are going to pay £48 for a [00:19:35] light bulb to be changed, whereas I’m going to send one of the girls down to it. I can’t send them to Wilko any more. But you’d like to [00:19:40] go and get us a light bulb. £0.49 and I’ll change it. You know, when you’ve got [00:19:45] all these layers and layers of bureaucracy and procurement? Yeah, it increases [00:19:50] the costs massively. So the value isn’t there. Plus, in systems [00:19:55] like that, you tend to have people who are salaried. And as soon as you introduce a salaried system into [00:20:00] dentistry, you can watch the access go down. Because effectively this is what’s happened [00:20:05] with, you know, Covid as as the dentists were given certain [00:20:10] amounts of money for different amounts of targeted, you know, to hit, [00:20:15] they would hit those targets. There’s no incentive then to work beyond those targets. So [00:20:20] once you, you know, you’re you’re employed to do eight hours of work a day. You’ll do [00:20:25] eight hours of work in a day. Will you see the same number of patients in those eight hours? Or [00:20:30] will you then suddenly start to do the dentistry at the speed which we were taught to [00:20:35] do it at, and spend half an hour on a new patient consultation, or 50 minutes or an hour [00:20:40] like I have to spend an hour now.

Simon Thackeray: You know, you’ll work [00:20:45] differently so your output goes down. So of course, what happens? Your productivity goes down. [00:20:50] The cost to the government will of course go up per patient visit. So [00:20:55] I think there needs to be a and there needs to be an [00:21:00] appetite, I think for people to discuss more [00:21:05] publicly core service. And I think a lot of people have shied away from it because [00:21:10] I fundamentally believe in the NHS. I’m 100% private, but I believe in the concept [00:21:15] of the NHS to pick up and to care for those who [00:21:20] can’t necessarily pay for it themselves, and a Dental system as a as an emergency [00:21:25] C core. Define it. Write it down on a piece of paper. We used to [00:21:30] have the statement of dental remuneration. You knew what you could do and you knew what you could do it on what tooth. [00:21:35] Whereas now it’s this nebulous thing. All this is necessary to maintain a patient’s [00:21:40] dental health. Well, what does that mean?

Payman Langroudi: Yeah, it means nothing.

Simon Thackeray: It [00:21:45] means nothing. But it also means everything. Potentially, you could find yourself in a horrific [00:21:50] situation. And I think that’s why now, when when you look at the fact that the output has gone [00:21:55] down so much, I mean, we’re talking about what 85% of, of [00:22:00] the output that it was before Covid. And a lot of that is because [00:22:05] the contract is now being operated, how [00:22:10] the contract was probably always meant to operate, and that you did have to take on these high needs [00:22:15] patients and you couldn’t necessarily cherry pick the the regular ones. [00:22:20] There is no registration, and it fits the government’s agenda to not tell anybody [00:22:25] that there’s no registration. And because nobody leaves the dentist when they say there’s no registration, because all the [00:22:30] all the patients think they registered, they want to be registered and they would like [00:22:35] to be registered. So if you operate the contract [00:22:40] the way it’s now being operated, you’re going to get this massive drop in [00:22:45] an output. So you’re now measuring the wrong things because you know you shouldn’t [00:22:50] work to targets. The GDC actually makes a stipulation that you shouldn’t have any incentives [00:22:55] or disincentives to work in a certain way, yet they end the entire NHS is [00:23:00] based on hitting targets. Well, is that not an incentive or a disincentive one way [00:23:05] or the other? Look, the.

Payman Langroudi: Reason I ask you about the country as a whole is because, look, [00:23:10] I live here, so I choose I think this is the best place in the world to live. Yeah. So I don’t want to complain [00:23:15] about it. No, but you can find the best [00:23:20] restaurants in the world. In this country? Yeah. Yeah. The [00:23:25] best universities in the world, in this country that you can find the best of [00:23:30] everything. The best dentists in the world. You can find them in this country.

Simon Thackeray: Yeah.

Payman Langroudi: But [00:23:35] if you walk into a random restaurant in this country or a random [00:23:40] education, a school. Yeah, yeah. You can find the best schools in the world in this country. But if you [00:23:45] walk into a random school in this country, the standard will be slightly lower than [00:23:50] the ones you find in comparable countries. Yeah. Now. [00:23:55] And so as a country, we have this skew of the very best. And in the middle, the [00:24:00] middle is, is, is is missing sort of thing. And there’s a bunch at the bottom. [00:24:05] And dentistry has been set up that way as well interestingly.

Simon Thackeray: Yeah I think you’re right.

Payman Langroudi: We’ve [00:24:10] got the very best and then we’ve got the NHS underneath. And no disrespect to the NHS. I mean, I couldn’t [00:24:15] manage as an NHS dentist myself. No. Did you ever I mean, [00:24:20] you’re a Yorkshireman. I don’t know. Am I making any assumptions here? Yeah. Please do. Did you. Did [00:24:25] you start left leaning? And now you’re right leaning as a as a person politically. I think I’ve.

Simon Thackeray: Always [00:24:30] been more right leaning, but with the. That [00:24:35] depends how right you you look at it. Because my [00:24:40] family are all working class. I’m the first person in my immediate family, the second person after [00:24:45] my cousin, but the first person to to do a professional degree. Um, [00:24:50] my dad worked his way through from an office post boy [00:24:55] to the director, the financial director of a big refractories company. So he’d gone [00:25:00] from the proper, you know, the lowest of the low job to running [00:25:05] the actual company and a big company at that. So I think I would obviously [00:25:10] picked up some of the right leaning things there. But I’ve still got that socialist [00:25:15] side of me that I believe that you’ve got to look after those less [00:25:20] fortunate. And it’s my [00:25:25] you know, we’ve been given a gift as dentist to be able to look after another [00:25:30] human being. And there’s probably no bigger privilege than doing that, looking after somebody else and [00:25:35] making them better in some way. And I don’t think we should ever forget that. [00:25:40] But I think my my leftness has gradually [00:25:45] disappeared as I’ve seen how badly it’s been used. But that doesn’t [00:25:50] mean to say I don’t support it, and I don’t still have those, you know, those [00:25:55] those feelings. But I would say now I’m strongly in the centre, right. [00:26:00] Not, you know, not radically, but I [00:26:05] can, you know, you’ve got to be careful when you say these things sometimes because, um, you know, you do these little, [00:26:10] that little square thing where it puts you, it puts a spot where your political leanings [00:26:15] are. And I’ve always just been to the right.

Payman Langroudi: Just I think even even [00:26:20] staunch conservatives would say this. They care about those less fortunate. It’s just about how you manage [00:26:25] that. It’s how you do it.

Simon Thackeray: Yeah.

Payman Langroudi: But do you think that we still have the same social mobility now as we [00:26:30] had when your dad went from the bottom to the top? But instinctively I think not. [00:26:35]

Simon Thackeray: I think it’s a different social mobility. I think there’s there’s a [00:26:40] lot. What?

Payman Langroudi: You can become an Instagram influencer.

Simon Thackeray: And is that is. Yeah. [00:26:45] It’s a different it’s a.

Payman Langroudi: Democratisation of that. Right.

Simon Thackeray: Yeah. That’s that’s a different [00:26:50] way of looking at it I think the traditional way where you would, you know, [00:26:55] my dad was an orphan.

Payman Langroudi: Someone like your dad today in the same situation.

Simon Thackeray: Would. [00:27:00]

Payman Langroudi: Struggle to do what he did.

Simon Thackeray: Absolutely. Even even it is sad because even as [00:27:05] driven as he was, he created certain chances and there were certain [00:27:10] chances there for him to actually take. And I don’t think they are the same as they were. [00:27:15] And I think some of this is, you know, the the poles [00:27:20] have got further apart, I think in some ways. And you just sort of said it there. You’ve got the best restaurants [00:27:25] in the world and you could have the worst and we’ve actually got this massive spread. Yeah. I [00:27:30] don’t think it’s unique. I’m not travelled enough to know enough about [00:27:35] many other countries, but I’d say that we’ve got a very, very big spread [00:27:40] of of poverty to affluence. [00:27:45]

Payman Langroudi: And, you know, and whether that came from the old feudal system or whatever, [00:27:50] I think in the US they have a similar issue. Yeah. But many European countries, the middles populated. [00:27:55] Yes. And they don’t. By the way, uh, we have a distributor in Sweden, [00:28:00] and when he came over said, oh, let’s go to this private members club. And [00:28:05] I said, do you guys have these? And he went, it definitely wouldn’t work over there. I said, why? [00:28:10] And he said, because there’s no cachet in saying you can do something that [00:28:15] someone else can’t in Sweden, whereas here it’s almost like a cachet [00:28:20] thing, you know, like.

Simon Thackeray: This is where you still get to the fact we’ve still got a class system. Mhm. And [00:28:25] you know, I know a lot of what has been talked about recently with regards [00:28:30] the working people and the budget, and [00:28:35] is that a hangover from what’s left of the class system [00:28:40] because you still have this, you know, is there a working class. Yes. [00:28:45] Is there a middle class. Yes. Is there an elite. Yes. [00:28:50]

Payman Langroudi: Is there.

Simon Thackeray: Mobility. Is there mobility between? I think it’s quite difficult, I. [00:28:55]

Payman Langroudi: Think not, it’s not as obvious in the US. It’s purely about money. Yeah. If you’ve got the money. [00:29:00]

Simon Thackeray: You can be in whatever class.

Payman Langroudi: Whoever you want to be.

Simon Thackeray: Yeah.

Payman Langroudi: Here it’s not purely about money. It’s [00:29:05] a funny thing. It’s about this other thing also like which school you went to, your, sort of your, [00:29:10] your accent, uh, you know, that sort of thing, you know? And it’s a funny [00:29:15] thing about, like, you know, are we going to get out of that? Do we want to get out of that? I mean, is [00:29:20] that what is that what defines.

Simon Thackeray: This totally equitable society? Yeah. That, [00:29:25] you know, there are there are.

Payman Langroudi: Anarchist.

Simon Thackeray: I do yes, I am [00:29:30] a bit of a monarchist. Um, I do believe that. I think that’s the way I was [00:29:35] brought up. I think it’s the way I was brought up. And it’s the it’s. I do like traditions, [00:29:40] and I do like the, the patriotic side of, [00:29:45] you know, as you said, Britain has got the best of a lot of things. It’s also got the best [00:29:50] at organising events like Jubilees. Nobody else does it like we do. And, you [00:29:55] know, part of that comes from the fact that on the other side of my, my family, there’s a [00:30:00] big military background. So when I was young, I would have the stories [00:30:05] from my grandma, whose husband was a Royal Marine, and she’d dance [00:30:10] with Lord Mountbatten and the Emperor of Japan when she was with him on the royal yacht. [00:30:15] So stories like that they may be out of date in [00:30:20] today’s society. Out of date?

Payman Langroudi: Simon, you know I’m from Iran. Yeah. Well, and [00:30:25] the national myth in Iran, every kid is taught we had an empire, [00:30:30] even though our empire was 2000 years ago. Now the UK, [00:30:35] the empire was just the last generation.

Simon Thackeray: I was going to say it’s not that long ago.

Payman Langroudi: It’s nothing. It’s [00:30:40] literally your grandfather’s time. Yeah.

Simon Thackeray: Yeah.

Payman Langroudi: Britain ruled the world in your grandfather’s [00:30:45] time. So I wouldn’t worry about that. You know, as I say, we’re still talking about it 2000 years later.

Simon Thackeray: I [00:30:50] suppose I suppose we can carry on then.

Payman Langroudi: But but but there is a downside to it as well. So, [00:30:55] for instance, I mean, whether or not you agree with Brexit. Yeah. I think it came down to two things. One, [00:31:00] immigration. Yeah for sure. But two, this kind of these stories that you’re telling [00:31:05] about your grandfather talking about the war and which, [00:31:10] you know, by the way, of course he can talk about the war if he was in it. Yeah, but that [00:31:15] sort of general notion that we can’t trust the Germans and the French, um, because of what [00:31:20] happened in the 40s or 30s or.

Simon Thackeray: Whatever.

Payman Langroudi: Was one of the drivers, one [00:31:25] of the.

Simon Thackeray: Drivers of Brexit. I think I think you’re probably right that there is that there’s [00:31:30] that ingrained history, isn’t there? And it [00:31:35] depends how you were, I suppose, how you were brought up. I mean, I was I [00:31:40] was quite open about the whole Brexit thing. Um, and I [00:31:45] think my main issue with it was the setting of our laws abroad. [00:31:50] Nothing to do with immigration because, you know, you’ve got to accept this country is all the richer for [00:31:55] the kind of immigration that we’ve had. Yeah. And I think, you know, [00:32:00] without getting into a lot of the, the deep politics of that, the [00:32:05] the type of immigration that came back in the day when it was, um, [00:32:10] you know, when we were perhaps a little bit less [00:32:15] considerate in the way that we were seen to, to allow [00:32:20] immigration. And by that, I mean taking people out of the countries and bringing them here. Yeah. Um, [00:32:25] the country is better for that. I think when you you [00:32:30] bring in a situation where you look at the size of the country and the infrastructure of the country [00:32:35] and the amount of money that’s in the country, and this is where dentistry sort of fits in as well. Can [00:32:40] you cope with unlimited immigration [00:32:45] when you’ve only got an island? It’s not like we’ve got a bit we can expand into a bit more continent [00:32:50] somewhere. At what point do you not have enough room for [00:32:55] all the, you know, all the immigration that could come in now? [00:33:00] I think we’ve got plenty of room. I don’t know that we’ve got plenty of infrastructure, [00:33:05] and I think that’s the problem. You’ve got schools that are overflowing, the NHS [00:33:10] is failing. This is not all down to immigration. This is down to the multitude of things.

Payman Langroudi: If you look at it from [00:33:15] a financial you’re looking at there, you’re looking at it from a financial perspective. Yeah. When we went [00:33:20] into Iraq, we made money.

Simon Thackeray: By.

Payman Langroudi: Doing that. Yeah.

Simon Thackeray: Oh yeah. [00:33:25] Wars that we’ve always made money out of wars. I mean, the or.

Payman Langroudi: Afghanistan [00:33:30] or whatever. Yeah. Now part of that is now those people are having to get up and come. Yeah. [00:33:35] So the net net result of the amount of money we made by BP now having all those [00:33:40] contracts or whatever.

Simon Thackeray: They’ve kept it.

Payman Langroudi: And, and and now the issue of these people, these poor people [00:33:45] having to come here. And I understand what you’re saying about resource, but from a European [00:33:50] perspective, we’re not taking anywhere near as many as all the other European countries. No.

Simon Thackeray: But the [00:33:55] other thing is, they’re those countries that have those companies that have made the money, have kept the money. [00:34:00]

Payman Langroudi: That’s going back to the system, not.

Simon Thackeray: Gone into go back to the top heavy.

Payman Langroudi: Bottom heavy. [00:34:05]

Simon Thackeray: System. I mean, you you’ve broadened it there almost into [00:34:10] the fact that there’s the the class system within companies and that you’ve got these [00:34:15] ultra, ultra wealthy companies like you had the ultra wealthy families. Yeah, [00:34:20] yeah. Um, and, you know, it’s all pervasive. It’s across everything. You look at [00:34:25] Amazon. I mean, Amazon came from nowhere, somebody’s garage. And [00:34:30] then in the last sort of, what, 30 years? It’s turned into the biggest company on [00:34:35] the planet. And listen.

Payman Langroudi: I’m not saying I don’t understand, I fully understand. I did [00:34:40] my jobs in Kent. Right. And I recently went back to Kent. [00:34:45] And I couldn’t believe the demographic change here. I mean, back then, [00:34:50] you hardly saw a foreign face in the town that I, you know, Whitstable or wherever I [00:34:55] was. And now there’s loads and loads of foreign faces. And I can understand the population [00:35:00] getting a bit nervous when, when the doctor can’t, can’t give them an appointment and they fully [00:35:05] get it. And by the way, back when we had the race riots thing. Yeah, my, my my [00:35:10] biggest thing was what is the actual concern of [00:35:15] these people? Rather than saying, oh, these are bigots. Yeah, yeah. The actual concern of those [00:35:20] people is, let’s face it. I mean, you as a family, you’ve managed to progress. [00:35:25] Yeah. Um, as a person, you know, you’re you’re you’re a linchpin of society in Mansfield [00:35:30] or now and hopefully in dentistry. Right. But there’s a there’s a huge number of people [00:35:35] I don’t know the number, but let’s call it 10% of the population who got nothing out [00:35:40] of globalism. Yeah. Nothing out of being part [00:35:45] of the European Union. Yeah. Who? That. That population needs that that concern [00:35:50] needs to be addressed. The one where the guy goes out in the street and starts firebombing [00:35:55] some hotel. Rather than saying he’s a bigot. Yeah. We understand. What is [00:36:00] it? Why this this guy hasn’t been able to progress and come back to that whole thing about [00:36:05] the bottom layer not getting the opportunities in this country.

Simon Thackeray: You’re [00:36:10] probably right, but I don’t know how you would solve something like that because you’re talking, you know, [00:36:15] and you’re also talking about the, the it’s very [00:36:20] difficult to say it without being derogatory, but often those people are not as [00:36:25] intelligent and able to look at the bigger picture, where we can take that picture apart [00:36:30] and we can analyse it.

Payman Langroudi: It’s very easy for me and you when we’re benefiting from it, right? But when [00:36:35] you’re not benefiting, but.

Simon Thackeray: We’ve benefited from it right from the beginning [00:36:40] of our education, because the way that we’ve been exposed to education, I had a state education. [00:36:45] Um, and, you know, I wouldn’t have said I was [00:36:50] particularly outstanding in, in anything, but I listened and I learnt [00:36:55] and I wanted to although you didn’t think of it at the time, you wanted to [00:37:00] learn And I do think that the chances I was given is because I wanted to learn, not [00:37:05] because of any other reason other than me. I’ve not been pushed into anything, and [00:37:10] I think there are some people who are maybe not pushed in the same way, maybe because their [00:37:15] parents have not had the chances. But then my dad didn’t necessarily [00:37:20] have the chances, but he made me, I suppose, have the chances [00:37:25] by, you know, preparing me mentally for [00:37:30] learning. And but I think when you’ve got a very simplistic view of the [00:37:35] world and you can’t see the intricacies and the subtleties of how everything interacts, you do [00:37:40] have a very basic view of it and that it can be then, [00:37:45] you know, down to that person’s taking my job. That person is taking [00:37:50] more than they’re putting in. We shouldn’t allow them to do that. And it’s [00:37:55] it’s massively oversimplistic, but it’s possibly the most that that person can understand [00:38:00] the world. That’s their view of the world. And I think [00:38:05] the problem is it’s not just restricted to that level of, of of if you like the.

Payman Langroudi: Old enough [00:38:10] like me to remember. Do you remember single mums?

Simon Thackeray: Yeah.

Payman Langroudi: Single mums. It’s them.

Simon Thackeray: It [00:38:15] was their fault. It was. I’ve lost count of the number of people’s fault that the, the [00:38:20] crisis in, in, you know, society has been blamed on.

Payman Langroudi: But constantly looking [00:38:25] down here at someone less fortunate. Yeah. Whereas as you say Amazon doesn’t pay tax. [00:38:30] Right. Or you know, if you look it up there’s plenty of abuse going on that isn’t highlighted. Yeah. [00:38:35] Because it’s much easier to sort of. It is.

Simon Thackeray: Yeah. Because they can’t always fight back. Yeah. [00:38:40] And that’s it. And they can’t put themselves together in a way that allows [00:38:45] them to then present a concerted, concerted effort. [00:38:50] But I think that’s how society changes. And, you know, this is is this [00:38:55] any different to the 1920s when you had the ultra rich [00:39:00] families, you had the the middle section families and those [00:39:05] who were devastatingly poor and were wracked with disease. Now we’ve probably got rid [00:39:10] of the wracked with disease part of it. But actually, if you look at the the spread of that, that [00:39:15] money, it’s probably in exactly the same way. You’re probably right. It’s probably, you [00:39:20] know, society probably finds a way. And is that down to just the fact that [00:39:25] fundamentally we’re just animals and that we have these basic instincts and that [00:39:30] everything is based around the sort.

Payman Langroudi: Of the competitive nature of.

Simon Thackeray: Existing.

Payman Langroudi: On this planet. [00:39:35] The one plant outgrowing the other one?

Simon Thackeray: Yeah. You do wonder. And then and then you [00:39:40] have, you know, the predatory species that comes along and but then not all predators last [00:39:45] all the time. True. You know people well, not people, but extinction [00:39:50] occurs and changes occur. But you’re still then get a new [00:39:55] order. I don’t think we’ve ever had. I don’t know if the world can exist [00:40:00] as a, you know, a biological structure if everything [00:40:05] was equal. It has those balances. It has the predators that destroy something [00:40:10] it will always have. I mean, I, I used to say probably when I was younger, what [00:40:15] would be interesting is if you redistributed every penny [00:40:20] that everybody earned to every person [00:40:25] in the country.

Payman Langroudi: True socialism, like.

Simon Thackeray: Absolute.

Payman Langroudi: Proper communism.

Simon Thackeray: And proper [00:40:30] communism. And then just let the system [00:40:35] see what happened. And I think you would have at the end of maybe [00:40:40] 2 or 3 generations, with a few exceptions, [00:40:45] the people that had the money originally would probably have got it back. The people who didn’t have it [00:40:50] still wouldn’t have any, but then you’d have some in the middle who would have had the chance to do [00:40:55] something different and taken that chance and grasped it and made [00:41:00] something different of themselves. But I think fundamentally, the balance probably wouldn’t change [00:41:05] all that much, and that the rich would still be rich, the poor would still be poor, and those in the middle still be complaining [00:41:10] about paying too much tax.

Payman Langroudi: But then, look, if your worldview [00:41:15] is that things have always been this way, you wouldn’t be this cat who’s [00:41:20] involved in politics Dental politics. You know, like you, you know, it’s [00:41:25] important that, you know, we could just sit and talk like a talking shop or [00:41:30] whether we can actually make a difference. And I get it. I mean, I’m not involved [00:41:35] in Dental politics here, but I do get it that it’s frustrating to be involved in Dental politics. [00:41:40] Yeah, because of how slow things are to move. Now, where did [00:41:45] that start for you? I mean, you were, I’m guessing just a regular dentist like the rest of us. At what point [00:41:50] did you start getting involved in, you know, how do we do things? And how can I talk up on this? [00:41:55]

Simon Thackeray: I’d always been involved with the BDA. Since when? As a member, since qualifying.

Payman Langroudi: As [00:42:00] a member.

Simon Thackeray: So I’d been a member there and I did a little bit of teaching [00:42:05] in Sheffield back in the the late 90s.

Payman Langroudi: And the university at the university.

Simon Thackeray: Yeah. Um, [00:42:10] and my boss there, a guy called Keith. [00:42:15] Figures. Um, he said, why don’t you come to one of the BDA committee meetings? [00:42:20] Council meetings? Because, you know, it would probably be good for you to to understand a [00:42:25] bit about what was going on. And I just thought, yeah, I’ll go along. And that sort of started it. [00:42:30] The next thing was I ended up standing for the representative body as it was [00:42:35] then, and that’s when I started getting a little bit more interested in the [00:42:40] politics side of it. But one of the things that made [00:42:45] me try to get involved was for a while, I sat on the outside. [00:42:50] Prodding at people like [00:42:55] Eddie, Eddie Crouch, who was a fantastic guy, but I would product him [00:43:00] on things like GDP, UK. And he turned around to me one day and [00:43:05] he said, well, why don’t you just get involved? He said, because it’s all right. Sitting on the outside moaning. [00:43:10] Try and do something about it. So you do, [00:43:15] you get involved and then you realise just how bloody difficult it is. And you know, [00:43:20] sometimes when we criticise our Dental politicians, you need to spend [00:43:25] a little bit of time banging your head against the same brick walls as we’re banging our heads against [00:43:30] it to elicit change, because a lot of these things, they don’t want to change. [00:43:35] A lot of these things they can’t change. And then a [00:43:40] lot of the things other people want to change them in a different way, and you’ve got to come up with some [00:43:45] kind of of consensus. And I mean, as you know, as a dentist, put [00:43:50] a treatment plan in front of ten dentists and you’re going to get 45 [00:43:55] different treatment plans, aren’t you? There’s almost.

Payman Langroudi: I was going to say 11, but 11. Yeah, but [00:44:00] there’s.

Simon Thackeray: Almost as many ways of solving the dental problems in this country. Yeah. So when you [00:44:05] then try to put that over, there’s all these different opinions. So they all [00:44:10] have to be matched. You’ve then got the fact that it’s okay as an organisation [00:44:15] agreeing what a policy would be. You’ve then got to sell that [00:44:20] to the Department of Health who are not actually in charge, because [00:44:25] the Treasury are the ones who tell them whether they’ve got the money or not. Actually.

Payman Langroudi: Yeah.

Simon Thackeray: So, [00:44:30] you know, sometimes you’re dealing with you’re not actually dealing with the people who can make any difference. [00:44:35] And I think a lot of the, a lot of the dental politics, [00:44:40] when you get on a round table meeting, there’s a lot of agreement, [00:44:45] there’s an awful lot of agreement. And we agree on more than we disagree on. But [00:44:50] is the right person sat at the head of the table who can do something about it and actually [00:44:55] press the button and say, right, that’s going to change. And that’s not always the easiest [00:45:00] thing to do, because sometimes it’s trying to find that person who is the person who has control of it. [00:45:05] And often it’s the, um, you know, it’ll be the Treasury, but with [00:45:10] things like the GDC, if you wanted to get the GDC to change the GDC in [00:45:15] lots of respects would be happy to change, I think, because [00:45:20] they see their legislation as outdated. Who do you speak to and how much [00:45:25] of a priority is it for them when they’ve got other things on their, you know, in their portfolio [00:45:30] as ministers that, you know, they’re currently dealing with, you know, whatever other health problem [00:45:35] there is in that respect or any other treasury problem. So there’s so many things [00:45:40] vying for so many different people’s time.

Payman Langroudi: In my little world [00:45:45] of illegal teeth whitening. Sir Paul Beresford was very important. He was? Yeah, [00:45:50] he was very important in us as a profession, as a as a as a bleaching sector, [00:45:55] understanding how to affect change. Um, but, you know, it was coincidentally, [00:46:00] he was a dentist and an MP. Yeah. I mean, if we didn’t [00:46:05] have access to to someone who was a dentist, who was an MP, who would.

Simon Thackeray: Have taken that.

Payman Langroudi: On. I mean, [00:46:10] we got nowhere for years and years until he got interested in it. Yeah.

Simon Thackeray: And even then, it hasn’t [00:46:15] gone quickly because although you maybe not seeing as many illegal whiteners [00:46:20] they’re still out there, they’re still misleading people.

Payman Langroudi: No, no, it was illegal for dentists to do whitening, [00:46:25] if you remember.

Simon Thackeray: Yeah. I was going to say, I mean, the pressure that was put on for us to be able to do [00:46:30] it. Yeah. And the fact that, you know, it’s an accepted form of, [00:46:35] of treatment everywhere else in the world apart from here. Come on. You [00:46:40] know, but again, that just shows you the fact that we didn’t get a change particularly. Or [00:46:45] did we get a it was a statutory instrument adjustment to the dentist Act that allowed it I think [00:46:50] in 20 1212.

Payman Langroudi: Whereas if you remember the UpToDate case was 2001.

Simon Thackeray: Yeah, [00:46:55] it was 12 years. It was it was ridiculous.

Payman Langroudi: Um, and as you say, I mean, we’ve [00:47:00] got the leftover of illegal whitening. Yeah. That the GDC isn’t dealing with. Well, trying, but not [00:47:05] very well.

Simon Thackeray: Yeah. I mean, the problem you have there is you’ll often have dentists that are saying, [00:47:10] you know, the a, r, f is a certain amount and it’ll go up if [00:47:15] they try and chase some of these illegal whiteners. And it’s actually difficult for them to [00:47:20] to hold a case sometimes because there’s got to have been a complaint. Is it an [00:47:25] appropriate use of registrant’s funds? I personally think it is. I think there’s a lot of things that the [00:47:30] GDC should do to put themselves in better light, to show us [00:47:35] as a profession that they’re protecting the the population and protecting patients.

Payman Langroudi: I mean, [00:47:40] I’ve not I’ve not come across it in the UK, but in I happened in Italy. [00:47:45] There’s a major problem with non dentists doing actual dentistry really drilling. [00:47:50] And you know the question should you know it should come up. What would happen if people [00:47:55] started. I don’t know technicians or or non-qualified non-UK you know qualified [00:48:00] just coming in and just going in and starting drilling. Yeah. You’d imagine the GDC would have an interest in that. [00:48:05] You know, they would but but difficult to know for sure right. Well how how they [00:48:10] would. Yeah.

Simon Thackeray: Until it happens.

Payman Langroudi: Yeah. I mean do they have resource let’s say thousands [00:48:15] of these places started opening up. Um, it’s it’s a funny [00:48:20] situation we’re in. Let’s let’s get back to teeth. I mean, I didn’t realise our conversation was gonna go so far. [00:48:25] I was gonna say it did go off on a tangent.

Simon Thackeray: Though, didn’t it?

Payman Langroudi: Your first job.

Simon Thackeray: First [00:48:30] job was as a vocational trainee as it was then in Sheffield. Um, [00:48:35] in a, um, a practice just next to the [00:48:40] roughest council estate in Sheffield, so I learned a lot. [00:48:45] Um, and I think the practice is still there. Um, it was a [00:48:50] group of, of 4 or 5 partners, and I think the partners eventually went their separate ways. [00:48:55] That taught me a lot. Um, and but you.

Payman Langroudi: Knew the population, right? You’d [00:49:00] grown up in Sheffield. You’d studied dentistry in Sheffield. Yeah. You knew what you were kind of up against.

Simon Thackeray: I know [00:49:05] I was letting myself in for. Yeah. Uh, it was, it was quite interesting, I think, in my first [00:49:10] week. Um, a lad came in who [00:49:15] couldn’t speak, and I [00:49:20] asked my nurse and she said, didn’t you read the papers? And [00:49:25] I was like, what do you mean? He said he was the guy who he’d got himself as, as was the [00:49:30] thing in this particular council estate. There’d be a pool bike, [00:49:35] like a done up motorcycle that one of the scallies [00:49:40] had got from somewhere, and this guy apparently was racing it around one of the fields, [00:49:45] and the police couldn’t stop him. So the locals [00:49:50] strung up a wire between two trees and and it took [00:49:55] his nearly took his head off. Oh, God. Um, so that was the kind of place [00:50:00] that I, you know, started working in. Um, and [00:50:05] I knew that it was going to be like that, but I thought, you know, it’s going to be a good example of it’s going to be a good experience [00:50:10] for me to get my teeth into to dentistry. Um, but I, I [00:50:15] think I’d probably got ideas there that they [00:50:20] weren’t necessarily, you know, I’m, I’m reasonably outspoken and I think [00:50:25] I was reasonably outspoken then and they didn’t necessarily my, my, [00:50:30] I should have kept my mouth shut a bit more often, I think. Um, so I moved on from there [00:50:35] to another practice in Chesterfield. Um, but that it [00:50:40] never really turned into the job that I thought it was going to turn into because I was taking over [00:50:45] from, um, I was doing maternity cover, basically. Yeah. Um, [00:50:50] so I didn’t have a patient list. So then I moved to another practice. Just local. [00:50:55]

Payman Langroudi: Nhs.

Simon Thackeray: Practice. These are all NHS practices that I did. Virtually no private dentistry [00:51:00] at all. What year?

Payman Langroudi: What year did you qualify?

Simon Thackeray: I qualified in 91. So this was 92, 93, [00:51:05] 94. I then I moved to a practice in Staveley and that’s where I met my wife. [00:51:10] She’s a was a dental nurse. Um, and again I stayed in that [00:51:15] practice. It taught me an awful lot. I’m still in contact with the the guy who [00:51:20] was there, but I was I think my problem was I was always looking [00:51:25] for something that none of the practices could offer me, but I didn’t [00:51:30] know what it was. And it wasn’t money, but it was something, [00:51:35] and it was an intangible thing. And [00:51:40] I think now it was actually to be my own boss, because I [00:51:45] moved to another practice in, in Doncaster and didn’t enjoy working in Doncaster because [00:51:50] I didn’t enjoy the people in Doncaster. There was a different demographic again [00:51:55] to what I was used to in Sheffield, and at the same time this, the practice [00:52:00] that I eventually bought came up for sale and I looked at it and I was going to buy a different practice, [00:52:05] but the figures were somewhat, um, which [00:52:10] was embellished would have been the best way of describing it. Um, [00:52:15] so I bought this practice. Um, basically it was my wife who [00:52:20] saw the potential in it. Claire. My wife. And she said, NHS.

Payman Langroudi: When you bought it, it was.

Simon Thackeray: Entirely NHS. [00:52:25] Oh, really? Um, literally. Well, the figures showed it was entirely [00:52:30] NHS. Um, but I didn’t get all the figures, I don’t think. Um, and [00:52:35] there were lots of things that happened in the first year that were a massive learning curve. Most of the patient records [00:52:40] went missing because there was a technician who worked in the practice as well. [00:52:45] And there was some strange relationship between the boss [00:52:50] and the technician such that the technician was then he then left [00:52:55] as the boss retired. Um, and a lot of the clinical records went missing. [00:53:00] Wow. We’re not sure what ever happened to them. Um, but that was quite difficult. [00:53:05] Um, but I realised then that there was a lot of potential in this practice. Um, because it was big [00:53:10] enough, it got three of.

Payman Langroudi: When you say potential, do you mean as in building [00:53:15] potential, like building building more rooms, or were you already thinking private?

Simon Thackeray: I wasn’t [00:53:20] thinking private at all, but potential. It was potential to just do more NHS dentistry. As [00:53:25] in build it out as in build it out. There were. There were three surgeries in there. Um, but [00:53:30] they weren’t they weren’t well equipped. And one of the intentions was that this, this [00:53:35] room that this technician had was by far and away the biggest room in the practice. So I said, I’m going to have that [00:53:40] as a brand new surgery. I’ll have that, I’ll have that. So I put a brand new surgery in. And [00:53:45] then the plan was within three years to have refurbished all the other [00:53:50] surgeries and get them looking more modern because it was very, very outdated, proper [00:53:55] 1970s decor and equipment. Um, [00:54:00] and within the first nine months I’d had to do [00:54:05] all the refurbishment because everything was just breaking left, right and [00:54:10] centre. Um, and I got a couple of friends from university to work with me part time. [00:54:15] And I went from, you know, one full time dentist to [00:54:20] two and a half full time dentists within a year. And of course, that was the time where [00:54:25] you didn’t have to negotiate. Negotiate. You just open the doors. I’m going to take on some more [00:54:30] patients. And it flourished and it stayed like that.

Simon Thackeray: And [00:54:35] I never really had any intention of going private until [00:54:40] the new contract. And I saw what was in the new contract and which new contract. This [00:54:45] was the 2006, the 2008, 2000, the UDA contract. And I looked at it. I’m like, [00:54:50] I can’t sign that. I’m not going to do that. Yeah. So I made the decision to move patients. [00:54:55] Adult patients. Um, private. All adult [00:55:00] patients, including exempt. I didn’t want to be accused of having a two tier system [00:55:05] within my own practice. Yeah. But we kept kids on. Um, and [00:55:10] that worked quite well. That worked really well. One of the associates didn’t have [00:55:15] as good a conversion because he didn’t speak to the patients. But I’d spent six months [00:55:20] looking at what was going on. This is when GDP UK was was the big thing. Yeah. And you’d see all these [00:55:25] and yes, there were some naysayers and some doom merchants. But actually it really advised [00:55:30] me very, very well what could happen. And [00:55:35] I think the pessimist in me took the negative side. The optimist in [00:55:40] me sort of said, it can’t be as bad as that. And I ended up somewhere in the middle. And so I [00:55:45] did the conversion.

Payman Langroudi: So I was an associate in a place that did a conversion in [00:55:50] 97.

Simon Thackeray: Right.

Payman Langroudi: And I remember then plan [00:55:55] being critical, critical to that as they literally had a plan [00:56:00] for what to do. When was it then planned?

Simon Thackeray: It was I went with practice plan.

Payman Langroudi: So so [00:56:05] did they. Were they kind of holding your hand saying, send this letter now have that conversation?

Simon Thackeray: Yeah, absolutely. [00:56:10]

Payman Langroudi: So what would you say is the critical. I mean, some people will be doing that. Now. What would you say is the critical [00:56:15] point of it? Because my recollection having the team onside.

Simon Thackeray: Absolutely [00:56:20] was.

Payman Langroudi: The key thing.

Simon Thackeray: Absolutely. If you haven’t got your team 100% on [00:56:25] board with why you’re doing it. Yeah. Forget it. Yeah. And I had [00:56:30] I had one receptionist who had said, if you ever go private, I would [00:56:35] leave. And she’s the godfather. God, Godfather. She’s the godmother to our [00:56:40] son. Um, and we just had our son. Prior to doing this conversion. [00:56:45] And so that would have been a big loss. And she was a big character in the practice. All the patients [00:56:50] knew her. She knew everybody. She would be able to make appointments while she was doing her shopping [00:56:55] in Tesco on a Friday night. And how did.

Payman Langroudi: You manage her?

Simon Thackeray: She understood why I [00:57:00] needed to do it.

Payman Langroudi: Ah, you explained.

Simon Thackeray: It to her. I explained it and I made sure that it was. [00:57:05] The thing is, the patients have always known and the staff have always known. It’s not about [00:57:10] the money for me. It’s about the values that come with looking for another human, looking after another human [00:57:15] being, doing the right thing and doing what I was trying to do. And then hopefully some money will [00:57:20] come as a result of that, but not the other way around. So they [00:57:25] knew that the reason I was going private and that prices would change significantly. [00:57:30] They knew it wasn’t because I was wanting to earn more. They knew it was because I wanted [00:57:35] to do the dentistry that I’d been trained to do. And once you’ve got your staff knowing [00:57:40] that it’s going to be better for everybody, not just you, but [00:57:45] they’re going to get the benefit from it. And the patients particularly are going to get the benefit.

Payman Langroudi: Tricky [00:57:50] financial situation, psychological situation, because the team will be thinking, [00:57:55] this is a place that serves me and my family. Yeah. And then suddenly the thought [00:58:00] process might be, this place isn’t for me and my family anymore.

Simon Thackeray: Absolutely.

Payman Langroudi: And so it’s a it’s a it’s [00:58:05] a negotiation that needs to be taken very seriously.

Simon Thackeray: It was very difficult because, [00:58:10] you know, part of your I would say anybody thinking of doing it has got to have a plan B. And part [00:58:15] of that plan B is you get smaller, you actually contract in order to expand again. [00:58:20] And that might mean that you lose members of your team because you can’t support them financially. So [00:58:25] you’ve got to be prepared yourself to have those conversations [00:58:30] and you’ve got to stare it down. You know, you really do have to. There’s a degree [00:58:35] of you’re not playing chicken, but you are staring at that train rolling towards [00:58:40] you. Yeah. And I think it.

Payman Langroudi: Was was there any degree of nastiness? There must have been some right [00:58:45] from patients saying.

Simon Thackeray: No.

Payman Langroudi: Because. Selfish.

Simon Thackeray: We had a little bit. We had more [00:58:50] when we did a children’s conversion in 2021. Um, [00:58:55] but we had a little bit of nastiness. But what actually helped [00:59:00] us was as soon as we told the, uh, [00:59:05] Primary Care Trust or the local area team it was primary care trust, then, um, they’d [00:59:10] already got in the back ground another practice that was going to open as a squat. [00:59:15] So they’d got somewhere to send the patients. And that benefited [00:59:20] these two young guys who had set up this practice, which then went private Anyway, [00:59:25] um, but there was a, there was a, a relief valve, [00:59:30] if you like. So the patients would, they could badmouthed us a little bit and there [00:59:35] was a, there was a little bit. You’re only doing this for the money and most people will, you [00:59:40] know, realise why we’re doing it. Because they’d been seeing me for 6 or 7 years, but not as long as, [00:59:45] you know, I did it relatively early into my ownership of the practice, probably six years in. So I’d not [00:59:50] got as good a relationship as I would have said as I have now, but [00:59:55] they sort of accepted the fact that we can see this coming. I was the first practice [01:00:00] in the area to really do it. Oh, really? Yeah, because Mansfield, Mansfield’s a strange [01:00:05] place. I’ve been there. It’s, um. It’s one of those places that.

Payman Langroudi: Ex-mining. [01:00:10]

Simon Thackeray: Town. It’s an ex-mining town. People are very salt of the earth.

Payman Langroudi: Yeah, they. [01:00:15]

Simon Thackeray: Tell you like it is, but it seems to be about 20 years behind everything [01:00:20] that happens in the rest of the world. And I say that in a nice way, Because Mansfield’s been good to me. It’s given me a good career. [01:00:25] But if you look at the peaks and troughs of things like recessions or anything that happens [01:00:30] in world events, Mansfield doesn’t get the peaks and troughs. It gets a ripple, it gets [01:00:35] a little blip, and it’s like boom, boom. And then you carry on again. And [01:00:40] I never realised. But I think that’s what got me through various [01:00:45] recessions and things like Covid because it hasn’t been [01:00:50] that massive, you know. Yes, I might have had a massive peak of success, [01:00:55] but then I would have had a massive drop if if I’d have put all my eggs in one basket. But I’ve never [01:01:00] had that. It’s just been this slow undulation, if you like. Yeah. Um, [01:01:05] and would you.

Payman Langroudi: Say the majority of your patients stayed or a good, good majority?

Simon Thackeray: I couldn’t [01:01:10] keep the majority. Um, I did have good numbers. Stay. Um, I [01:01:15] originally had, I think the practice when I bought it had about 2500 patients.

Payman Langroudi: Give me. [01:01:20] Give me the spiel. What was the spill? What did you say to them?

Simon Thackeray: Oh, God. I’ve got to remember now. I [01:01:25] think when I’d made the decision, it was along the lines of, look, you’ve [01:01:30] been with us long enough to realise now how we want to look after you. The way [01:01:35] things are looking with this new NHS contract, I don’t think I’m going to be able to [01:01:40] look after you and. And look after you in the way that you’ve become accustomed. So the only way [01:01:45] I’m going to be able to do that is to move out of the NHS and offer the treatment privately, [01:01:50] but unfortunately, it probably means I won’t have enough. I won’t have as much space [01:01:55] for as many people. Um, but you will know when I send you the letter, [01:02:00] what to do. And it wasn’t a case of me trying to pressure them into doing it and saying, you [01:02:05] know, you need to act fast. But it was it was truthful. It was, you know, I couldn’t see myself [01:02:10] making that contract work. There were going to be limited places. Over to you. [01:02:15] I’m not going to say to you, you’ve got to sign up. I’m not going to say, I would like you to continue to be [01:02:20] a patient. I’m just going to say, look, that’s the situation. You’ll get a you’ll get a [01:02:25] letter. It’s up to you to do what you do with it. And we had some leave. We had quite a lot leave because [01:02:30] we probably had to. But from a financial point of view, there was no [01:02:35] blip. It took over very much as the NHS dropped. The private [01:02:40] replaced it because we were on a monthly, uh, the monthly kind of plan. [01:02:45] But you were.

Payman Langroudi: Aware of the mixed model at the time?

Simon Thackeray: Yeah. I’d never.

Payman Langroudi: Used it. You [01:02:50] didn’t want to be in the mixed model.

Simon Thackeray: No, I, I think I’d got a [01:02:55] little bit, I’d probably say a bit anti private because I [01:03:00] prided myself on doing high quality work on the NHS and [01:03:05] almost sort of sticking two fingers up and saying, you can do [01:03:10] it on the NHS. You know, I had all digital x rays back then on the NHS, I’d [01:03:15] got intraoral cameras, I was fully We computerised. I’d got everything that [01:03:20] at the time a private practice would have wanted to, to have put in place to differentiate. [01:03:25] So I’d done all that. So part of me was thinking, God, I’m not going to make a success of this because I’ve [01:03:30] got nowhere to go now. And the only way I’ve got to go on this is to actually spend [01:03:35] more time with patients. And some of the patients don’t want you to spend more time because [01:03:40] they just want it over and done with as quick as possible. So I thought, oh, probably not making a good mistake, [01:03:45] a good decision here. This might not work, but it it did. [01:03:50] And I’ve never looked back. And of course I’ve now changed my opinion of that because I’ve realised [01:03:55] that if the system had stayed as it was, I would probably have stayed in it longer. [01:04:00] I would have probably found I was doing more private work, but [01:04:05] I probably wouldn’t have been happy doing it. In order to reduce a waiting list by saying, [01:04:10] well, you can have that on the NHS, but I’ll do it next week privately, but you’ll have to pay private. [01:04:15] I don’t think that would have sat very well with me because in honesty, would [01:04:20] I have done a higher quality? Job, or would they [01:04:25] have just had a different quality material? My crown prep. Would have been the same. My treatment would have been the [01:04:30] same. I only know how to do it one way, so I wouldn’t. Have you know, I’m not saying people [01:04:35] do, but my crown prep is the same. If it was an NHS crown or if it was a private crown. [01:04:40] So I never really saw the point in doing it different. Yeah.

Payman Langroudi: But you know, you couldn’t have done a one [01:04:45] hour examination.

Simon Thackeray: I have now.

Payman Langroudi: Yeah.

Simon Thackeray: But a lot [01:04:50] of that is, is the fact that you, you at first it [01:04:55] was, it was that it was that mindset change that I [01:05:00] needed to get in, that I do need to spend more time because I’ve got the patients. I’ve got to [01:05:05] justify the fact I am spending more time. Did I find anything more by [01:05:10] spending more time with them? Probably not an awful lot, But [01:05:15] the conversations allowed me to get more out of the patients and allowed me to develop a closer bond [01:05:20] with the patients, and I think that they appreciate that. But actually, it [01:05:25] took me a while before the actual time of which I spent on doing things [01:05:30] increased. And I think a lot of that came about with the change. [01:05:35] More from materials that you would use. Because obviously I did a bit of private. I’d be doing [01:05:40] the odd white filling here and there, but you’d be surprising how many patients. Then suddenly [01:05:45] when you’ve gone private, they actually think you’ve got a different qualification and they suddenly [01:05:50] go, oh, well, now we can do those, those things that I’d never spoken to you about before, but I’d like [01:05:55] all my front teeth, all my new crowns doing again, or my old crowns redoing. [01:06:00] And it’s like, because now you can do those. I was like, well, I could do them before. Why didn’t you say anything before? We didn’t want [01:06:05] to bother you. Well, okay. So I never ended up having to sell anything. It [01:06:10] sort of came in, but it was surprising how the patients thought you were differently qualified [01:06:15] and got you to do different things? I mean.

Payman Langroudi: The number of my users who they [01:06:20] get patients coming from practices saying, I’ve come for whitening, [01:06:25] I’m just assuming their own dentist doesn’t do whitening. Yeah, that’s [01:06:30] a common thing now. When you make that change for [01:06:35] me, for me, the thing about the NHS today, even back then, is [01:06:40] there’s the notion of a third party in between me and the patient. Yeah, they hate [01:06:45] it. They hate the whole idea that there is a third party. You know, there’s me, the patient, [01:06:50] the situation. I don’t want a rule book of any sort, you know, in [01:06:55] between us. Yeah, yeah. Of course. There’s that nice thing about. You don’t need to do marketing [01:07:00] because patients will just walk in there. Is that. Yeah. And, you know, when I, when I went to this, [01:07:05] um, dental groups meeting, ATG meeting, I noticed a lot of these groups have built [01:07:10] the whole business based on NHS next. You know, most of them.

Simon Thackeray: It’s one of the world’s most [01:07:15] recognised brands.

Payman Langroudi: Yeah, yeah, yeah. Um, but, you know, it’s a funny thing because it’s, it’s [01:07:20] almost the most commercial thing in the world. Yeah. Because you can go get loans. [01:07:25] You can sell goodwill based on it. Yeah. You know, it’s not supposed to [01:07:30] be. Right. It’s it’s a state funded system. Yeah. You know, when when you’re talking multi practice [01:07:35] owners, it’s that’s what they’re that’s what’s grown their practices.

Simon Thackeray: Yeah. [01:07:40] Yeah yeah.

Payman Langroudi: But but the question I was going to ask you was do you have sympathy with people like [01:07:45] young dentists now who definitely don’t want to touch the NHS at all.

Simon Thackeray: Sympathy. [01:07:50]

Payman Langroudi: What do you think of that.

Simon Thackeray: I [01:07:55] sympathy would be the wrong word. What would be the word, I think. Empathy. Empathy? [01:08:00] Yes. I think the, the desire to [01:08:05] do the dentistry that you were trained to do and not have a system dictate how [01:08:10] you do it. Yeah, that is a very desirable thing and is fundamentally [01:08:15] what I’ve done. So I can’t turn around and not support that when it’s exactly [01:08:20] how my career has turned out. And I actually feel [01:08:25] probably more sympathy to the people who find that they are stuck [01:08:30] in an NHS situation that they want to get out of. And again, [01:08:35] I’m not denigrating the NHS. It served me very, very well when I [01:08:40] was. I learnt my trade, I learnt my full mouth rehabs by doing big approval cases [01:08:45] and doing the dentistry that way. I don’t think that’s happening now. It should be [01:08:50] because fundamentally.

Payman Langroudi: Financial sense, but.

Simon Thackeray: It doesn’t make any financial sense. But [01:08:55] you know, I do I do [01:09:00] have a lot of sympathy for those who then feel trapped into that system and don’t know how to get [01:09:05] themselves out of it. Um, because again, you’ve almost come [01:09:10] right back to what we were saying earlier about those in society who can’t get themselves [01:09:15] out of that position.

Payman Langroudi: Yeah. I mean, I’ve got a friend. He’s not a young dentist. He’s [01:09:20] an old timer, but he’s an associate NHS guy. Right. And [01:09:25] he was telling me I’ve had enough. Um, I want to go private now. [01:09:30] Um, but he’s an absolute expert at [01:09:35] sort of executing NHS dentistry. And, [01:09:40] you know, the notion that the patient might actually have some aspirations of their own [01:09:45] and some ideas of their own and answer back and, you know, all of that stuff, you know, the, [01:09:50] the I mean, he’s, he’s got in his head part of the oh, it’s all about pushing things [01:09:55] on people they don’t need. Yeah. But but he knows he wants to move. But but it’s an interesting [01:10:00] question right. Being a really skilled, fully optimised NHS dentist [01:10:05] who isn’t used to talking to people and giving painless injections and all the nice [01:10:10] stuff. He’s probably in a better situation staying where he is compared to coming [01:10:15] and learning all of that in his 50s or whatever it is. Yeah. Um.

Simon Thackeray: It [01:10:20] would be a it would be a big.

Payman Langroudi: And by the.

Simon Thackeray: Way, step.

Payman Langroudi: By the [01:10:25] way, you wouldn’t manage in the UDA system as a dentist.

Simon Thackeray: No way. I, [01:10:30] I’ve said this. I mean, not least the fact that I’m virtually unemployable if I’m not [01:10:35] doing my own business. I mean, would you employ me? And that’s a question to anybody listening [01:10:40] to this. No you wouldn’t. And that’s probably the reason why I changed jobs so many times. But I [01:10:45] think, you know, there is a place for people like that. But the system has created him [01:10:50] in that respect, and he’s allowed that system to create it. And that’s not a wrong thing, [01:10:55] because he is probably providing a massively good service [01:11:00] to those to those patients and being optimised to [01:11:05] do that is is a fantastic thing and is probably at the peak of his abilities [01:11:10] in the same way that somebody, you know, who has always been private and [01:11:15] is now one of the finest dentists in the UK, is optimised to their own. And [01:11:20] it’s it’s each to their own. There’s got to be places for for every [01:11:25] aspect. It’s like you can go and have, you know, you can go and have your car serviced at the dealer [01:11:30] or you can go to an independent. You’ll pay different. The experience might [01:11:35] be different. Yeah. The the skill of the person might actually be the same. And this [01:11:40] guy probably is skilled enough to do all the other stuff, but [01:11:45] it’s almost like he’s forgotten those extra little bits. [01:11:50] But if he would you take the risk at this [01:11:55] point in your career of then saying, I’ll go for an associate job in a private practice, [01:12:00] would it stress him too much to then suddenly think, [01:12:05] actually, I can do that in 25 minutes.

Payman Langroudi: What about. What about the young dentists who I [01:12:10] was with at the weekend, who are finishing and saying, I want to go straight into private [01:12:15] without the baptism of fire that you had doing [01:12:20] those exempt cases and so on. I think look, I think it’s an interesting question there because [01:12:25] I don’t like it when people say, oh, I made my mistakes on the NHS. Like, [01:12:30] why is that kind of why is that okay? No.

Simon Thackeray: I made as many mistakes [01:12:35] on the.

Payman Langroudi: Privately as I’ve.

Simon Thackeray: Made on the NHS.

Payman Langroudi: Um, and so and so, you know, [01:12:40] without any experience going into private practice, you have to worry about that somewhat [01:12:45] as well. Yeah, I’d.

Simon Thackeray: Agree with that. And I think what you’ve got there is a different expectation from your [01:12:50] patients as well, because the patients will immediately bring in. I’m [01:12:55] paying for this. Yeah. If you’ve got a certain demographic of patients that you [01:13:00] know by, by nature of the fact everybody’s paying for the treatment in private than [01:13:05] they are paying for it. Within the NHS system you will get some of them are [01:13:10] paying for it, but it’s a reduced cost and they won’t necessarily appreciate [01:13:15] that. So they will say I am paying for this, but as soon as you introduce [01:13:20] that transaction, your patient potentially wants more [01:13:25] from that transaction. And sometimes [01:13:30] the younger practitioners are not as emotionally ready for that and not [01:13:35] as skilled. And I think we’ve got to be very careful.

Payman Langroudi: In in Australia, [01:13:40] in the US that’s what happens.

Simon Thackeray: It’s all private.

Payman Langroudi: That’s what happens. The guy is [01:13:45] one year out of university with a paying patient.

Simon Thackeray: That population is they [01:13:50] know that our population doesn’t our population probably [01:13:55] isn’t ready for that. And I think, you know, we’re getting into the realms of now our [01:14:00] litigious society, as it’s all too easy for somebody to make your life very uncomfortable by [01:14:05] trying to sue you. And I think a lot of the younger dentists are very, very wary of that. [01:14:10] When I’ve asked them, a lot of them, are you not.

Payman Langroudi: More likely to get sued in the high volume, [01:14:15] low quality stores?

Simon Thackeray: Personally, I think so. Yes, I think so. But I think [01:14:20] it’s perceived and in fact, I think the figures probably I don’t know them, but I think [01:14:25] they probably agree with that is I think you’re less likely to have a GDC [01:14:30] case, and I think you’re less likely to be sued in private practice than you are in the NHS because [01:14:35] of that volume.

Payman Langroudi: Not only the volume. You know, people who like people don’t sue them. Exactly. [01:14:40] And if you’ve got in private dentists, you can give a painless injection. You’ve got the time to become the guy’s friend, [01:14:45] understand and build rapport. You’re less likely to get sued by that patient than in NHS, [01:14:50] where you haven’t got time to say hello and you’re running, running around.

Simon Thackeray: I think [01:14:55] I would agree with that. I think the younger dentists going straight into private practice. I think [01:15:00] they’ve got to go in with their eyes wide open. They’ve got to know where their limitations are.

Payman Langroudi: Difficult. That’s [01:15:05] a difficult.

Simon Thackeray: One. That’s the.

Payman Langroudi: Difficult difficulty. Because how many times did you take on a procedure for the first [01:15:10] time and think, oh God, I’m going to muddle my way?

Simon Thackeray: I can remember having a textbook open behind [01:15:15] the patient. I you know, you wouldn’t you wouldn’t dream of doing that now in front of most patients. [01:15:20]

Payman Langroudi: But at the same time, you can’t not go ahead and drill your first.

Simon Thackeray: You’ve got [01:15:25] to learn somewhere.

Payman Langroudi: You’ve got to do it.

Simon Thackeray: Absolutely. I think there’s an honesty thing there that I [01:15:30] think if you get that conversation with the patients that you’ve got time to have and [01:15:35] you can say, look, I’ve not done many of these, I’d like to try it this way. How do you feel about that? That’s [01:15:40] one way of doing it.

Payman Langroudi: And I find I’ve got a mentor to be a wonderful thing to say [01:15:45] in that situation.

Simon Thackeray: That’s that’s it. Because I do the mentoring obviously in my practice. And [01:15:50] we do a lot of it, you know, by zoom, um, with my, you [01:15:55] know, newest dentist And I think it’s worked well. [01:16:00] What I don’t like is sometimes these ideas where people have said, well, if you see the [01:16:05] younger, less experienced dentist, then it’s almost like hairstylist. [01:16:10] You’re going to see the the the top hairstylist. You pay more for the top hairstylist, [01:16:15] you go for the junior one, you’re paying less. Not sure I like that idea [01:16:20] within dentistry. Why? Because I think if you’ve got a [01:16:25] a cost per hour per surgery, it’s going to be largely the same [01:16:30] for a newly qualified dentist as it is for a more experienced dentist. [01:16:35] So I think you’ve got to be prepared to underwrite that [01:16:40] cost more significantly, which might then not make it viable. [01:16:45] I’d prefer a situation like that to probably be a salaried position, and I [01:16:50] know people are working on that. And younger dentists are saying, right, let’s put you in a mentoring post, let’s give [01:16:55] you a salary. Stick with.

Payman Langroudi: Us for.

Simon Thackeray: Three years. Stick with us for three years. We’ll do this. We’ll sort out your training. [01:17:00] We may pay for it. Whatever. Or we’ll gain the access to that. Training will give [01:17:05] you a good exposure to the right people. And that should [01:17:10] set you up. I quite like that idea. And I think that’s that’s probably one of the ways that things will go forward, [01:17:15] because the other aspect will be, you know, we don’t really know what’s going to happen with employment worker and self-employed [01:17:20] status and Inland Revenue things in the future. So I can see things like that [01:17:25] actually maybe starting to become more formalised and having these formalised [01:17:30] agreements. And I think that’s probably a lot of the younger dentists would [01:17:35] probably like that. I mean, from what I’ve said, I’ve spoken to some of the younger [01:17:40] dentists at the Bapd. They like that idea because they do want to [01:17:45] get into private dentistry. This pathway to private dentistry that we’re doing as a, as a as [01:17:50] a webinar series I’ve never seen so much interest in [01:17:55] a webinar because I get all the emails and I, you know, I’m not [01:18:00] dealing with it, but I’m constantly, you know, there’s there’s hundreds. [01:18:05] So there’s there’s a massive I think the younger dentists don’t see their future in the NHS, and [01:18:10] they’re doing everything they can to prepare themselves.

Payman Langroudi: To. [01:18:15]

Simon Thackeray: To, to skill up.

Payman Langroudi: I mean, we run a course, a composite course, right. And, [01:18:20] you know, I’d say half the people who turn up turn up for their CV, you know, it’s [01:18:25] almost not not the composite bonding is actually, you know, composite veneers are actually [01:18:30] a very common thing in private practice, but they’re perceived to be yeah, they’re perceived to [01:18:35] be. And so people think you need to get that under your belt.

Simon Thackeray: I think they’ve got to.

Payman Langroudi: Remember the saline or whatever it is. [01:18:40]

Simon Thackeray: You’ve got to do the bread and butter dentistry because no matter, I think [01:18:45] no matter what happens in dentistry when you have these peaks and troughs of various fads, veneers, [01:18:50] Invisalign, whitening is a constant thing, but to a degree, [01:18:55] you could argue it’s a luxury purchase. In some.

Payman Langroudi: It’s discretionary.

Simon Thackeray: It’s a discretionary purchase. [01:19:00]

Payman Langroudi: I mean, when I spoke, I was speaking to people at BCD and at the private dental awards. Private [01:19:05] dentistry awards. And the only happy people. Dentists are the ones who [01:19:10] have the baby boomer demo. Yeah, the bread and butter ones. Everyone else is [01:19:15] is screaming pain my butt. But the baby Boomer demo, which basically [01:19:20] is bread and butter dentistry, that is it.

Simon Thackeray: You get good.

Payman Langroudi: At the bread and butter.

Simon Thackeray: Dentistry, even if it’s [01:19:25] that. If it’s just doing composites, Crown and bridge. It’s not all Invisalign [01:19:30] and composite bonding because eventually that market will [01:19:35] probably disappear or change in the way that the the ear to ear veneers back [01:19:40] in the the the 90s was a market that’s gone.

Payman Langroudi: But interestingly, [01:19:45] Simon, I find it very interesting that, you know, nowadays you’re just as likely for your waitress in [01:19:50] your in a restaurant to be wearing Invisalign. Oh, gosh. Yeah. Yeah. Back in the day, when we [01:19:55] used to talk about eating veneers, it was like rich people sport. Yeah. Yeah. And so cosmetic [01:20:00] dentistry is now gone. If you like. Downstream. Yeah. It’s [01:20:05] almost like something that anyone can aspire to.

Simon Thackeray: I think there’s a risk that it’s. [01:20:10] Dentistry has been too commoditized. Yeah. And that then people see that as [01:20:15] a, um, you know, the customer, the patient sees [01:20:20] it as a product.

Payman Langroudi: Yeah. As in saying give me composite veneers.

Simon Thackeray: Exactly. Give me Invisalign. [01:20:25] It’s a thing I need composite bonding. Yeah. You know, composite bonding is a thing. [01:20:30] It’s not. You’re going to a composite bond to a specific tooth. No. Composite bonding is a thing. [01:20:35] Um, and we’ve commoditized dentistry so much that sometimes [01:20:40] we then lose sight of what we actually do, which is a health based thing. And I’m all [01:20:45] for treating someone’s mental health and their esteem, but actually, [01:20:50] fundamentally, what I was taught to do was to look after their general health [01:20:55] via the medium of their teeth. And of course, we’re at risk, then, [01:21:00] of missing all the other bigger things that are occurring in dentistry, which is, you know, the incidence of [01:21:05] heart disease, things like diabetes. Should we be doing a lot of these big, heavy [01:21:10] duty, full mouth rehabilitations in an ageing population [01:21:15] who have got a higher percentage of, um, you know, institutionalisation as their older [01:21:20] not being able to look after it and certainly not able to look after their implants. I mean, these are massive ethical [01:21:25] conversations. So at one end of the scale, training people up and doing [01:21:30] Invisalign and composite bonding is great in the short term. In the long term, [01:21:35] we’ve got to look at the impact we have as a profession on people’s general health [01:21:40] and what we can do to, you know, to maintain and [01:21:45] solidify our position as healthcare workers and not just cosmeticians if that’s if [01:21:50] that’s a word.

Payman Langroudi: I mean, I think I think what’s crazy is if you go and talk to 100 people in the street, [01:21:55] they will know that brushing your teeth is important. They’ll know that not eating [01:22:00] sweets is important, but they won’t know that the frequency of the number of times you [01:22:05] know as a profession.

Simon Thackeray: How you eat those sweets.

Payman Langroudi: As a profession. We didn’t manage to get that [01:22:10] one piece of information. The key piece of information out. You had.

Simon Thackeray: One job.

Payman Langroudi: I’m. [01:22:15] I know we’re running out of time a little bit, so I want [01:22:20] to get to a really key question. Go on.

Simon Thackeray: Then.

Payman Langroudi: What grind your gear is the most about dentistry. What pisses you [01:22:25] off?

Simon Thackeray: What pisses me off about dentistry? I think most recently, [01:22:30] I don’t like the the [01:22:35] way that it’s becoming commoditized. And there’s, there’s, there’s a, there’s an attachment [01:22:40] to then avarice. It seems to be greed. It’s not about better. It’s [01:22:45] about more and more and more and having more and, [01:22:50] you know, I’m all for success and I’m all for.

Payman Langroudi: It’s not [01:22:55] very right wing. What you’re saying.

Simon Thackeray: No, it’s not is it not? Well, actually no, [01:23:00] you asked earlier. I’ve gone back the other way again. But I think, you know, I’m all [01:23:05] for I’m all for success. But not everybody can have that success. And I think you’ve got to be honest where that success [01:23:10] comes from. Um, I think some people [01:23:15] in the. And I don’t think this is a new thing. I think it’s always been the case, [01:23:20] but I think there is a degree of flexibility of ethics that allow [01:23:25] some people to do things and think they get in a way. They’ve got a they’ve got a cognitive dissonance [01:23:30] that they think they’re doing the right thing. But actually, if you’re really honest with yourself, [01:23:35] you’re possibly not.

Payman Langroudi: Let me tell you the most criminal thing I ever heard. [01:23:40]

Simon Thackeray: What’s that?

Payman Langroudi: This guy. There was a time where gold inlays were paid for by the NHS, if you remember. [01:23:45]

Simon Thackeray: Yes, this.

Payman Langroudi: Guy went to the Jewellery Quarter with a [01:23:50] giant, uh, cylindrical shaped, uh, burr and said, make [01:23:55] me a gold rod in this shape. Exactly this shape, a long gold rod. [01:24:00] And then he you can you know what? You know where I’m going. You know where I’m going with [01:24:05] this. Yeah. And then he put the gold rod in and cut it off. Gold inlay. And [01:24:10] he would pay and, you know, into all the, the foci.

Simon Thackeray: Of the book.

Payman Langroudi: Yeah, yeah, yeah. Because [01:24:15] I.

Simon Thackeray: Mean.

Payman Langroudi: You’ve got to buy the criminal, criminal, criminal [01:24:20] mind.

Simon Thackeray: They’re always gonna be someone who sees the way around that. But I think [01:24:25] what’s made it more visible is social media. And I think [01:24:30] social media is sometimes it’s a great tool in some respects [01:24:35] than in others. It’s very damaging. And it gives you a.

Payman Langroudi: Social media because social [01:24:40] media, you know, it’s everything, right? It is.

Simon Thackeray: It is everything. But it brings out. But it’s. [01:24:45]

Payman Langroudi: Everything.

Simon Thackeray: It puts it out there. It’s like.

Payman Langroudi: It’s like saying. It’s like saying there’s paedophiles on [01:24:50] social media. Well there.

Simon Thackeray: Is well, absolutely everything.

Payman Langroudi: Is on social.

Simon Thackeray: Media. Whether there are any more than there ever [01:24:55] have been or whether they we just know that there are more.

Payman Langroudi: I mean, maybe you’re saying, [01:25:00] correct me if I’m wrong. Maybe you’re saying some young dentist sees a line, bleach blonde only [01:25:05] coming out of some successful Ferrari driver and decides that’s all he wants to do? And is [01:25:10] that why is that bothering you?

Simon Thackeray: I think.

Payman Langroudi: Does that bother you? Because for me, it doesn’t really bother.

Simon Thackeray: Me that much. It doesn’t bother [01:25:15] me, but it’s not really what I wanted to do dentistry for. And it’s. [01:25:20]

Payman Langroudi: Not. What I’m saying is the next man is an endodontist. He only does Endo. Yeah, yeah, this guy only does this. [01:25:25] I’m fully focussed on hydrogen peroxide.

Simon Thackeray: Yeah, yeah I think I’m more [01:25:30] live and let live now. And I think since Covid certainly I’ve been [01:25:35] more live and let live. But I think I’d like our it’s [01:25:40] a bit of a Probably rose tinted spectacles kind of view. I would like [01:25:45] our profession to be fully professional in its [01:25:50] in the way it carries itself and what it does, because I think we can damage a lot [01:25:55] of the public’s perceptions.

Payman Langroudi: Yeah, but but look.

Simon Thackeray: By our actions. [01:26:00]

Payman Langroudi: Being a professional in the end I think is about what you do when no one’s looking. [01:26:05]

Simon Thackeray: Absolutely. Yeah. That’s integrity.

Payman Langroudi: I know what you mean about [01:26:10] the public’s perception. Yeah. But I’d say that that’s where our associations [01:26:15] and things have failed with, you know, the public’s perception is something where, you know, single dentists can’t make [01:26:20] a massive difference. No. Um, one more question. Go on then. We like mistakes on this [01:26:25] pod. What comes to mind when I say what was your biggest clinical mistake or your most [01:26:30] difficult patient?

Simon Thackeray: Most difficult patient? I’ve had lots of [01:26:35] difficult patients. Um, some of them. I [01:26:40] can’t always remember because I tend to try [01:26:45] and forget them. Biggest clinical mistake. I will actually freely admit this one. I had a [01:26:50] lovely patient who came in to see me for some orthodontics, [01:26:55] and she’s got two very buccally placed lower canines and a previous [01:27:00] associated aligned her upper teeth because she’d got two really buccally placed upper canines, [01:27:05] and he’d taken the upper canines out and she’d gone. Basically, he’d aligned [01:27:10] the upper teeth she now wanted the lower teeth doing. Yeah. Um. In [01:27:15] fact. Am I getting it right? Anyway, [01:27:20] it’s almost irrelevant. So I saw this patient [01:27:25] on behalf of one of my associates, and and I talked through the the treatment [01:27:30] plan, really thoroughly discussed the treatment plan. And in a [01:27:35] slightly unusual treatment, decided we’ll take out these massively buccally placed [01:27:40] lower canines and we’ll just align very simply, very quickly. [01:27:45] The rest of the teeth, because there wasn’t any space for these canines. But for [01:27:50] some reason I’d left on the clinical charting the extractions [01:27:55] on the fours, because that was the other option. We take the fours out [01:28:00] and retract the threes or we take the threes out. So on the clinical charting I’d left [01:28:05] the the so easy for that to happen.

Simon Thackeray: And but [01:28:10] massively in the nose it said lower threes everywhere. It said lower threes. And [01:28:15] she came in and my associate was was treating [01:28:20] her because I didn’t want to take these two threes out because they were horribly placed. And I [01:28:25] wouldn’t have been able to get them out. And and about five minutes later I get this [01:28:30] urgent knock on my office door. Um, the fours have been taken out [01:28:35] and the patient’s kicking off. She’s just realised. And [01:28:40] I basically said, right, that’s entirely down to me. I’ve got the highest charting, [01:28:45] I’ve conveyed the information incorrectly. Let’s deal with this and manage it, [01:28:50] because it’s at the time it was a never event. So first thing [01:28:55] I do is manage the patient there and then you’ve got a distressed patient, you’ve got a distressed [01:29:00] mother. And one of the reasons the mother was so distressed is she’d had a clinical [01:29:05] negligence at birth from one of the one of her sons. So she knew about [01:29:10] medical negligence. And it had gone horribly wrong with this birth of a son who was also a patient. [01:29:15] So the first thing I did was apologise. This is what’s happened. Had you known.

Payman Langroudi: Her for years or [01:29:20] was she kind of. Had you known.

Simon Thackeray: Her? She’s relatively new, but I’d known the son. I’d been treating the son [01:29:25] for quite a while. So there was a relationship there. Um. And the [01:29:30] first thing I did was like, we need to sort this out. I’m going to deal with this. I’m [01:29:35] accepting full responsibility. We will sort this out. There is no charge for this orthodontics. We’re going [01:29:40] to sort this quick phone call to the guy who taught me, [01:29:45] um, Jonathan Sandler explained the situation in full and [01:29:50] he said, you know, is your associate one of the good guys? I said, well, yes, [01:29:55] he’s in the you know, he’s in the staff room in tears. That’s, you [01:30:00] know, how hard it’s it’s hit. Uh, it says, right, send the patient down [01:30:05] now, send the patient down. We then managed everything [01:30:10] else, such as, you know, bunch of flowers apologising. There’s no chance of replanting these teeth. [01:30:15] Um, and sent the patient down to see Jonathan, and I [01:30:20] said, I will you tell me how much this is I’m paying for this. And [01:30:25] he said, don’t worry, we’ll sort it out. The same day [01:30:30] she’d got the fixed appliance on, he put the appliance on. He said [01:30:35] those threes, I can get them into position and I will do a better job than you would have done. [01:30:40] And I went, I know. But I knew you were going to say that. And [01:30:45] the upshot is the whole management of that what annoyed [01:30:50] me, I rang my indemnifies and said, this is my mistake. [01:30:55] I’ve basically put on that chart in and they said, no, it’s not. No, it’s not your mistake. It’s your [01:31:00] associate’s mistake. And I went, well, I’m going halves on this. Well, we won’t [01:31:05] support you on that. And that’s when I first realised that, you know, Indemnifies were not all they were [01:31:10] made out to be. But the upshot is, she ended up with this perfect smile [01:31:15] with these beautifully aligned lower canines. No legal [01:31:20] outcome from it. And she [01:31:25] she stayed a patient. She’s moved away from the area now. But a brother still [01:31:30] comes.

Payman Langroudi: It’s a good one and takes the.

Simon Thackeray: Mickey out of me for doing.

Payman Langroudi: It. It’s a [01:31:35] good one. There’s a learning point there of.

Simon Thackeray: Massively triple.

Payman Langroudi: Check everything. And if things go wrong, do [01:31:40] now. If things go wrong, manage it properly, admit it and manage it properly in [01:31:45] under normal circumstances, I wouldn’t accept that one because that one went too well. I kind of wanted one that went worse, [01:31:50] but it’s not normal because we’re running out of time. We’re running out of time. Unfortunately, you’ve [01:31:55] got a train to catch.

Simon Thackeray: I have, yeah.

Payman Langroudi: We’re gonna have to finish with the usual questions. [01:32:00] Okay. Um. Fantasy dinner party. Three guests, dead or alive. [01:32:05]

Simon Thackeray: Three guests, dead or alive. One of them is going to have to be John Bonham. Who’s that drummer [01:32:10] from LED Zeppelin? Oh, we.

Payman Langroudi: Didn’t even get into your drumming. Drumming? That would be like.

Simon Thackeray: The tuba [01:32:15] lights. Yeah, yeah, I would have to have John Bonham there. Yeah. Um, just to [01:32:20] basically wash his capacity for drink, probably. [01:32:25] Um, and then I think it’s probably a bit of an emotional [01:32:30] one. I’d probably want my dad there because he died a few years ago. Um, but if I could combine [01:32:35] my mum and dad as one. Sure, sure. I love my mum and dad as one. My mum died. No, my mum died, [01:32:40] um, just after I qualified. So I think I would like to them [01:32:45] to have seen my success, if you like, if you want to measure [01:32:50] it as that. And then, you know, my wife would probably say well me as well. That’s [01:32:55] a, that’s an aside. She’s going to be at the dinner party. So if I had somebody else. No.

Payman Langroudi: I’m [01:33:00] joking. Oh, God. No, I’m glad you said that. Joking me. Um.

Simon Thackeray: Another one. [01:33:05] Dead or alive? I think it would have to be [01:33:10] my maternal grandfather who [01:33:15] was the Royal Marine. Oh, because he died in 1952, [01:33:20] well before I was born. But the stories that he had, [01:33:25] he was arguably probably the most unlucky Royal Marine out because he [01:33:30] he was in Gallipoli at the landings in [01:33:35] the maelstrom of what happened. They’re told to get back on the boat. And the boat [01:33:40] took him to the Somme where he got blown up. So out of the frying pan into [01:33:45] the fire. But if he hadn’t got blown up at the Somme, he wouldn’t have met my grandma. So then I wouldn’t have been here. So. [01:33:50]

Payman Langroudi: And those family stories you want to hear firsthand? I want to hear.

Simon Thackeray: Them firsthand because I want to ask some.

Payman Langroudi: Deep. [01:33:55]

Simon Thackeray: Deep questions. So it’s not famous people other than John Bonham, but I don’t think [01:34:00] John Bonham would fit in with my mum and dad and granddad. That would just be, oh my God. [01:34:05] An eclectic mix. I like.

Payman Langroudi: That. The final question [01:34:10] is a deathbed question.

Simon Thackeray: Yeah.

Payman Langroudi: On your deathbed, surrounded by your [01:34:15] loved ones. Yeah. And you can give them three pieces of advice. What would they be?

Simon Thackeray: Don’t [01:34:20] get as stressed as I get about the little things. Look at [01:34:25] it. The worst that can happen hasn’t happened, although it probably is to me at the moment because I’m [01:34:30] on my deathbed. Um, but don’t you know I have [01:34:35] spent too long, too much of my life worrying about stuff that hasn’t happened and probably wouldn’t happen. [01:34:40] But that’s my character, so that’s the first one. Um, [01:34:45] the next word of advice. Follow [01:34:50] your dreams. Don’t let anybody try and put you off. I’m sure other people have said this, but it was [01:34:55] one thing that I, and possibly in this career, not because I followed [01:35:00] my own dreams, but because I did what the expectation [01:35:05] was from my family. If I’d have followed my dreams, I would have been a musician in the Royal Marines. But I wasn’t good enough. [01:35:10] But if I’d had known that I needed to be better, I would have probably spent more time doing that. [01:35:15]

[TRANSITION]: To a degree.

Payman Langroudi: Of regret on that. Oh, there’s a.

Simon Thackeray: Massive degree of regret, really, a huge degree. I [01:35:20] would I think I would have got out of that a lot more potentially. [01:35:25] Um, and then the final one. Honesty [01:35:30] and integrity. Just be the best person. [01:35:35] Do what’s right when nobody’s looking. And. And I think, you [01:35:40] know, if I’m having to say it on my deathbed, it’s probably too late. Uh, I’d like to think [01:35:45] that that is what I’ve brought my son up particularly, um, [01:35:50] to think, because we’ve only got the 111 child.

Payman Langroudi: Uh, did you want him to be a dentist?

Simon Thackeray: No, I didn’t. [01:35:55]

Payman Langroudi: You didn’t want him to be. I didn’t. You didn’t? No.

Simon Thackeray: Not specifically. I basically [01:36:00] said to him, you do what you want to do. I don’t have any preconceived ideas. And he’s. He doesn’t [01:36:05] like the scientific side of dentistry and dealing with blood and things like that. So he’s [01:36:10] doing an archaeology and ancient history degree with a view to joining the Navy as an officer. [01:36:15] So he’s going to get back into that military side of things. Is he a.

Payman Langroudi: Drummer as well?

Simon Thackeray: Yes he is. [01:36:20] And a and a saxophone player. And a bass guitar. He’s a far better musician than I’ll ever be. [01:36:25] Um, so. But it would be about doing the right thing. I love.

Payman Langroudi: That. [01:36:30] Thank you so much. It’s been a massive pleasure. I wish we could have kept going, but, [01:36:35] um, you’ve got a train to catch.

[TRANSITION]: I have, yes, I have.

Payman Langroudi: Thank you so.

[TRANSITION]: Much for coming. Thank you.

[VOICE]: This [01:36:40] is Dental. Leaders the podcast where [01:36:45] you get to go one on one with emerging leaders in dentistry. Your [01:36:50] hosts, Payman Langroudi and Prav Solanki. [01:36:55]

Prav Solanki: Thanks for listening, guys. If you got this far, you must have listened [01:37:00] to the whole thing. And just a huge thank you both from me and pay for actually sticking [01:37:05] through and listening to what we had to say and what our guest has had to say, because I’m assuming you got [01:37:10] some value out of it.

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