In this week’s bulletin episode, we welcome back former podcast guest Jimmy Palahey and current British Dental Association (BDA) English council chair Hannah Wodrough.
The pair are both standing as candidates in the BDA’s Principal Executive Committee (PEC) by-election. Hannah and Jimmy explain why they are standing and set out their vision for the committee.
They also talk about why this year’s by-election could be one of the most significant in the BDA’s history.
To find out more about PEC candidates and read statements by each, visit www.bda.org/elections.
If you are a BDA member, you will have had the stuff through the post with everybody’s statements on it. If you’ve thrown out, you will still be able to read those on the website, and then you need to find somebody that shares your values who can fight your corner if you don’t want to do it yourself. – Hannah Woolnough
Watch the video of the interview here:
In This Episode
00.17 – Hannah’s backstory
07.18 – Jimmy’s backstory
09.47 – Navigating organisations
14.02 – Jimmy and Hannah’s burning issues
18.23 – COVID and the NHS
30.48 – Vicarious liability and indemnity
38.46 – Prison dentistry
44.31 – Mending the cracks in dentistry
48.43 – Engaging the profession
56.13 – Other professional organisations
01.03.19 – Closing comments
About Jimmy Palahey and Hannah Woolnough
Jimmy qualified at Leeds’ Dental Institute in 2004 and spent time in practice around the West Midlands. He is the clinical director of the JDSP group of clinics, which provided urgent care throughout the COVID pandemic. Jimmy is chairman of the Nottingham Local Dental Committee.
Hannah Woolnough works in general practice in Suffolk. She has spent time in community roles, including as a prison dentist.
She is a passionate advocate of reducing inequalities in access to dental care.
[00:00:00] This is Dental Leaders podcast, where you get to go one on one with emerging leaders and dentists, treat your hosts Payman, Langroudi and Prav Solanki.
[00:00:17] It’s my pleasure to introduce the new episode of the Dental Leaders Bulletin in time for the PTA elections. What is the media pick? Why should you be interested in it and who’s standing? Well, there’s nine candidates today I thought would be useful and a bit different to get two of the younger candidates who are deciding to throw that in the ring, I guess, to provide an alternative to to what we’ve seen so far. I’ll let them speak for themselves on that subject. We’ve got Jemmy Pallay, who actually has been on our podcast before you wet fingered. You heard his story with the new season and many practises, mixed practises that he’s running, as well as the LDC work that he’s done. And we’ve had a woman who’s an associate and again, refreshing to have an associate lady who’s so involved politically. Let’s start with this. Do you want to just introduce yourself to tell us how you got here, OK?
[00:01:29] Oh, it’s quite a convoluted story. And so practise wise, I started off I did my job search, went on to get an NHS associate job, as most of us do, and didn’t really like it because it was kind of hectic and not particularly rewarding and very treadmill. So within a year, I decided to broaden my horizons. I went and got a job working a couple of days a week and community a couple of days a week and mixed private and NHS practise and then ended up working in the prison service for a year, which was brilliant. My favourite job ever working for the out of hours as well. So I just did lots of different jobs for a few years just to find out what I actually enjoyed doing and then settled working as a predominantly NHS associate and good practise really enjoyed. It was a training practise, so I applied to be an FDA trainer, did that for a couple of years and then one of our local TPD jobs came up. So I did that, which I love. That was such a brilliant job working with new graduates all the time. I did that for about six years, ended up doing some work with the PLB Abe Fortas Foundation, but experience stuff as well for the local area in the last year or so of that job and left out a couple of years ago. And now I’m just working in private practise and also doing some Botox clinics, a physiotherapy practise, just to occasionally work somewhere where I’m a dentist, which is really quite nice.
[00:03:02] So that’s my kind of personal clinical background. But while I was working in H-E, so first as a trainer and then as a TPD, these jobs kind of snowballed a little bit. So you end up going to the LDC because you kind of have to because they need to know what’s going on with H.E. and then you end up being sucked into the LDN. And because the big you had multiple Elden’s, I ended up as LDC chair. I then got involved with the BDA stuff because it’s always the same people that do everything. So we ended up chairing and being the treasurer for the Suffolk section of the BDI, the treasurer for the local branch branch president a couple of years ago. And now I’m treasurer and secretary for Branch. And these things just sort of go hand in hand and national media stuff. I was elected for GDP six point six six years ago or something like that, and did a TransAm as a GDP representative, the east of England. And that was really, really interesting. And I got to know what happened at the Beadie. I was going down to the head office where I could see the G20 meetings, meeting people, talking to people, finding out what they were doing. I mean, it’s just fascinating and it just gets you out with your day job. So, yeah, I got very sucked into it. End of that triennium. I stood to be the English Council representative for the east of England and was elected and then subsequently elected as chair of that committee, which is the position I’ve held for the last now three and a half years would normally be three years.
[00:04:42] But because I’ve covered all the elections for pushbacks, I don’t much like three and a half years, which involved a year is being the UK council chair. And for those that were unfamiliar with the structure of the British Dental Association, you’ve got the board of directors, the PAC, what the current election is for 15 seats. And those people run the business, we then have the cross committees and things like general practise, community community services, hospitals, armed forces, and they deal with the issues specific to those crafts under the umbrella of PTA. And then we have the country councils. And what they do is they basically try and feed into the media to make sure the media are doing the right things for the members. So we sort of hold the board of directors to account with regard to what they’re doing with their business day in, day out to make sure that it’s meeting the needs of the membership. So that’s that’s the job of the last three and a half years. And because I work quite a lot in head office and I work quite a lot with the pack and I kind of I know what it’s about and it really interests me. I thought, yeah, we’ll go for it. We’ll put our hat in the ring
[00:05:51] Before I come to Jemmy. What time frame between starting the first thing in politics and now how long is that?
[00:05:59] I think so. I graduated. So it looks like I’m really, really grateful for that. But we just some of the talking and I so I graduated in 2006, so it’s 15 years since I graduated. And I think I first started going to things like ABC meetings I’m getting involved with actually about 10 years ago. So and it started off quite gradually know just attending the board meeting. As I say, these things tend to snowball, especially if you live in rural areas where we find it really difficult to recruit somebody to come and do a job at the LDC. No one wants to hold a chequebook. So if you’re willing to get involved in any way, you sort of end up getting sucked into it and just being given more and more responsibility. Because, you know, if you’re interested, I mean, it’s interesting. It’s not lumbered with jobs that you don’t want to do. It is interesting stuff. It’s just finding people that have the capacity to deal with that. And I think in our profession, there are lots of people who are really, really worn out with everything they’re doing. And the thought of asking them to go to a meeting at the end of an evening of full clinic day and talk about dentistry even more, that that can be quite an ask. Well, it’s
[00:07:11] It’s really cool that energises you. I like that. Jemmy, how about you give us give us a summary.
[00:07:18] Well, thanks for having me on Payman. And you know about me anyway and did a podcast in the past. So I’m not going to rehash old old footage I qualified in 2004. So again, I’m no spring chicken either to be honest. But yeah, basically what more in general practise I would say associate FDA trainer when it was when it was called after trying to eat after the beep trainer. But you know, after training hours. Yes. So did that it take a bit more into the TPD role, much like kind of for a period of time I started chairing the LDC in Nottingham in about 2016. And then from there sort of I’ve done various positions at quite rightly said, you know, you get sucked into various roles. So, you know, quite a rich job chairing the LDC. Quite, quite a lot to do. Also worked and it NHS England again doing Pardeep. So performace. This decision panel now disciplines specific practitioner for NHS England. So, you know, a lot of pastoral care, a lot of working with young dentists, lots of kind of developing dentists and and working with them fitness wise. I’m clinical director of the Group of Practises Small Group with my wife.
[00:08:40] So kind of embedded in that sort of GDP world, you know, like family deal with about probably about 30 or so associates working with us. And so, you know, really kind of well aware of all the foibles and the issues that they’re having on the day to day basis. Quite, quite obviously, you know, I can see first hand the impact of the decisions that trickle down from that from the BDA on the sort of boots on the ground really not so embedded in the b’day. I think my motivation is to really expand a lot of the regional work I’ve been doing on more of a national platform. I think I’m used to dealing with multiple work streams and sort of, you know, lots of lots of eggs in lots of baskets and, you know, having to juggle all those different ideas and organise time and et cetera, et cetera. And I think that that sort of skill set, I feel that I could extrapolate that to on a more of a national platform, hopefully for the betterment of my fellow colleagues, various places. I suppose in a nutshell,
[00:09:47] Do you guys, you know, I guess maybe how do you have a lot of experience of this working with the different committees? But you’ve got an idea, let’s say. And then and then you’ve got. Navigating that massive organisation and trying to get that idea through that organisation, you know, what are the chances, let’s say Jemmy here had a fantastic idea with the chances of getting that idea onto a strategy of the media, even if he did get elected. How do you know how to navigate that system or.
[00:10:25] I mean, to be honest, if if he were elected as one of the 15 board members of the media pack and he had a good idea that he wanted to bring three and the media were capable of doing, I think this is the thing that we’ve really got to remember with the limitations of this job. This is what the media can do. And sometimes it gets confused with what we can do with their negotiations with the Department of Health about the contract or the work that happens with the CDO, about meetings or if it’s an idea that is something about the way the PDA functions as an organisation to support members from one of the board of directors comes up with the idea and brings it up at a board meeting. Absolutely. If it’s a good idea and everybody thinks it’s a good idea, crackle with it. You know, they are the people that set the strategy. It’s not sensible and it’s helpful. I mean, obviously, it’s a weird idea when the rest scratching their heads and going, well, that’s not really going to work, then it is going to get anywhere. But, you know, if it’s within the remit of what they can achieve as an organisation, then absolutely, you know, the world is you and you are one of the biggest voices in quite a small room at that point when you’re part of the pack.
[00:11:42] So, you know, if you can get your other pack members on board with your idea when it makes business sense, I mean, that’s the key. The critical thing. You have a responsibility for the media as a board member. You are running a business. You cannot do something that is going to put the business at risk of failure. You have to make sure that it’s financially viable. So as long as your ideas aren’t completely wacky and actually they would benefit the organisation, then having people coming onto the pack with ideas of how to change things for the future is what I feel really needs right now. Somebody driving forward. I think it’s very easy to get into a bit of a rut with the way things have been done a certain way, like things a certain way. And, you know, these are real primary membership categories that we need to be and all this sort of stuff. But, you know, it could do that, but it could do the bit of shaking up. I think it could be going to watch this and think about.
[00:12:48] Jemmy Jemmy with you.
[00:12:53] Yeah, I would agree with you. I think that, you know, injecting a little bit of, you know, indisciplined to the actual committees. Definitely, you know, I’ve been going to LDC conferences and, you know, being in multiple committees over many years. And I think that, you know, you’re right, you can gain you can get, you know, somehow handle it with a passion. You know, at the end of the day, regardless of who gets that vote today, I think if you can vote some end that’s got that, you know, sort of drive to, you know, shake the tree a little bit, see what falls, I think that’s probably a very sensible move, you know. Well, you know, existing infrastructure and, you know, only repairing the ship a slight direction here or there is probably not as exciting, in my opinion.
[00:13:41] Well, then, OK, let’s talk. What are the what are the why is this particular election an important one? I mean, well, it goes without saying we’ve got all the things that have happened over the last 18 months. But what are the key issues that you guys would like to discuss and, you know, ideas that you want to bring to those issues? Jemmy.
[00:14:02] But I’m not going to use the word unprecedented again. Yeah, this is again, you know, they basically basically the you know, I can’t remember everyday life. I think on a tipping point here, I feel that we’re on a tipping point. You know, when you go into forums, when you speak to young Dentists’, you know, when you speak to even the other end of the spectrum, they’re kind of planning their retirements a little sooner than what they thought. You know, it’s a b’day basically saying that 28 percent of registrants haven’t gone back on the GDC. I would say the tipping point, a huge tipping point. And I think that steadying the ship at this particular period is going to be probably have a knock on effect for years and years to come. I’ve certainly not seen anything like this before. And I think that the whole I think industry is going to look completely different in the next four to five years. I can already see huge changes happening. And, you know, there are lots of push and pull factors going on in the background. And it’s almost like the whole thing is coalescing and morphing at the moment. And I think that, you know, this is that’s why I think it’s important. I think it’s probably the most important one I’ve seen so far.
[00:15:09] Yeah. Yeah, I think it’s inevitable. You know, it’s not just dentistry. The society has changed the expectations of a population with regard to their safety, the everyday behaviours that work, life balance, everything has fundamentally changed. And I think we need to be respectful of what we need to be responsive to that one thing that really and this isn’t a new issue. This is always kind of got to me a bit over 80 percent of registered dentists or associates. That is not the reflected characteristic on the board of the BDA directors by a very significant margin. So I worry, looking at the media pack, that they’re safe members who pay the bills, who pay for the staff, who pay for everything, all the designers, the people that are running the business, the practise owners. And there’s a potential for it to be. And I mean, I am privy to the workings of the media in that I see it from the roles that I have within it. And I know that they’re trying not to be, but I think we need significantly greater associate focussed membership support because I can see increasing I mean, that’s been a huge increase in the number of people that are setting up squats. And I think that’s a really interesting development for dentistry. I’m really interested to see what happens without people leaving a licenced practise left, right and centre and either going just in private practise or setting up. We are seeing a real change in it. But also one thing that we’re definitely going to continue to see is the high level of associates, nonpracticing individuals who have no intention of owning a practise.
[00:17:01] You know, it’s not that we’re talking about young people at the beginning of their careers. There are plenty of people like myself. You don’t want to own a practise who want to develop other skills, who want to invest in themselves as individuals, who don’t want the responsibilities of running. A day to day business premises, and those people equally need support and they have had, I think, a pretty tough time in the last 18 months. I think there’s a lot of them questioning whether or not the jobs that they’re in are right for them, but they feel quite stuck. And I feel that as a union and as a as a professional body to be, they could be doing a lot more to help those individuals make those decisions, be it negotiating better contracts as an associate or setting up a school practise or going into a partnership or whatever they want to do with their careers. But I worry that because of the diversity with regard to profession or professional status, with regard to job role on the pay is so off kilter before we even get involved in personal characteristics like gender and ethnicity and everything else. That’s my major concern, really, the change in the last particularly the last 20 years. I said, you know, we’ve seen it a seismic shift and I don’t think it’s going to completely turn around. I think we need to be focussing more on these issues.
[00:18:23] Well, I mean, you’re right. Is play a massive, you know, percentage role in in the workforce. But, you know you know how that thing where we say, you know, look after dentists and dentists will look after patients, you know, that that idea. So are we now seeing that looking after US principles doesn’t mean that you’re going to be looking after associates. And I know it’s a it’s a divisive question because, you know, we like to sort of pit principals against associates, private against the NHS or whatever. But Jemmy, sitting here with 30 associates. Yeah. You know, what’s good for his associates is good for him and vice versa, because they’ve got multiple relationships outside of. I know there’s been abuse. Yeah, I know that we all that we all heard those stories and we’re going to have some of those people on, you know, then, you know, of course, that’s an issue. But Jemmy, is there a more pressing issue, in your opinion?
[00:19:24] Well, that is a very pressing issue. I mean, there was obviously this associate principal, you know, widening of the chasm, shall we say, between between the two parties over the covid period. But fundamentally, that was because everything was written so quickly. And when it was, you know, when when this wording and, you know, and you could arguably say it was a b’day responsibility to a certain extent. But some of the wording when challenged legally was difficult to actually, you know, you know, to to, you know, utilise or interpret that in a very sort of fair way between the two parties. And I think that was part of the issue. You know, in that role, the hopefully going forward, there’ll be a bit more to do, a bit more time and a bit more due diligence on that sort of wording. You know, hopefully they can come up with a solution that’s beneficial and that’s better for anyone. As Payman said, what’s good for an associates, good principal and vice versa? I strongly believe that. I think, you know, ultimately we have to work together in that respect. I mean, there are other pressing issues. I mean, the big issue is PPA. And, you know, what’s going to be the fallout ultimately, you know, we know something has to stick after the seismic events.
[00:20:39] It always does. You know, mad cow disease, whatever, prions in something have to stick. You know, we had companies already tying themselves up for single use, you know, high speed and et cetera, et cetera. They were making the packaging even before we knew anything about it. You know, lots of things go on in the background and, you know, some bits stuck in some bits didn’t say postdebate. You know, some parts will stick. So let’s hope the ventilation is actually beneficial. I’ve got some window surgery and I’m quite like the ventilation systems. They work quite well. It’s a much a pressure experience for everyone. But I don’t want my paper to stick for another day if I can help, you know. You know, that’s basically getting people down, getting it. I mean, that’s probably part of the reason why this 28 per cent of people are leaving the register because they’re stuck in these feet. You know, dentistry is a communicative profession. You’re basically communicating with people. That’s a different thing. You would get in a complaint and not most of the time. And actually, if you stuck behind at 53, especially if the evidence base is not that strong, it’s more of an insurance based issue or a kind of, you know, indemnity based issue rather than, you know, you’re not following the science.
[00:21:43] Basically following we’re running scared of the lawyers and the insurance. You know, that’s always the case, isn’t it? And I think that’s what’s. Yeah. So I’d say that’s probably a pressing issue. Boots on the ground type issue. I certainly want him to associate him. We want to get out. Now, that time is one thing that, you know, this is really sort of fucking us down. So I think there’s some immediate sort of, you know, pressing issue that need to be dealt with as quickly as possible. And then obviously some more medium term issues like, for example, societ the FSA issue and also. You know, you touched on the private nature issue as well. I mean, let’s face it, the private sector is going to grow and grow. As we can see, it may be a bubble. It may be just because the energy demand is so low. You know, I know a lot of people are setting up spot practises and we hear that a lot of daily fees and we speak to other practitioners as well. But, you know, is it the right time? Who knows, really? You know, is it just a bubble? Would you normally take a business decision in such an uncertain period? You know? This is all questions that would, you know, are worth exploring, definitely worth the media having some input on that and maybe giving a fair and balanced viewpoint on what people are making these quite sort big decisions in their lives and things like that.
[00:22:54] So definitely worth inputting there. But that sort of balance between private and I think will change fundamentally. I think, you know, the attitude, the aptitude to do need to undergo NHS care to work in the NHS. I mean, I’m a big fan of the NHS. I favourite you know, I worked in the NHS, were privately, you know, been around the block, really. And I think that, you know, they’ve got to be an NHS system. I fundamentally believe whether it should look like it does. Now, that’s the question, isn’t it? And I think, you know, it will all be kind of touched on. It’s all about the budget, isn’t it? All about the money that’s available. It’s all about how they want to spend it and what the priorities are. But I think that’s also a huge sort of medium to long term issue that needs to be addressed, the nature of the NHS contract, the balance between private and NHS and also how the associates and the principles fit into that.
[00:23:47] I mean, I have to absolutely. I think what’s going on at the moment with the is a response to cultivate is he’s going to have a huge impact on what happens long term with conjunctural effectively what we’ve seen over the last 18 months is the NHS becoming an urgent cancer. It’s the remit of the NHS has been enormously reducing the majority of areas to the majority of patients to something that deals with basic, urgent Dental need and not an exhaustive service that covers the whole population. Not that it ever really managed to achieve that despite its best intentions. So we are now in a really good position to be able to come back and say, look, if we need more money to be able to provide a better service to more people, there is absolutely no doubt about that. And it is really put the squeeze on the funding that’s available to be able to provide that care. And there’s no part of the country that has escaped that at all. So that’s utterly crucial that this is really pushed through at this point.
[00:24:58] Sorry to interrupt more money. I mean, do we seriously believe that more money is going to come into dentistry?
[00:25:04] No, I mean, I, I, I have always been of the opinion that we should have a core NHS service that is funded sufficiently to provide basic service for everyone. As we all know, the government currently only provide sufficient contracting needs to cover just over 50 percent of the population. So even if everybody wanted a Dental something simple, that’s just not the funding. That one thing that’s always really upset me is the fact that we would go to these LDN meetings. We’re talking about commissioning for advanced services and our millions are getting all geared up and we’re doing X, Y and Z to improve the services for things like, you know, especially since downticks. Yeah, 40 miles away, we’ve got patients queuing up outside an access centre, you can’t get a tooth taken out. Not to me. You know, we’ve got a finite pot of money. You need to be careful with how you spend it. Yes, we all want to live in a world where we can commission specialist services for everybody, regardless of their financial position. But until we’ve addressed the fact that we’ve got people walking around with swollen faces, it can’t have their teeth taken out because the access isn’t available.
[00:26:26] We’ve got a fundamental problem with our Dental contract. So I, I, you know, I think we need to readdress it. I think we need to fundamentally shake it up. I think we maybe need to stop worrying about some of the more advanced services and focus on the basic care of the people in our society who don’t have the option. You know, and yeah, there’s been a boom in private Prav, but that’s what people that have an option. There are plenty of places in the country where we don’t have and I, I think it’s I think we need a real shake down of the entire system, which is a controversial view, because I know there are plenty of people out there that will say to me that you absolutely should be able to have your office having retreated the NHS, although I think, well, patients should have an old D.C. meeting about it. And she felt very strongly about it to me.
[00:27:19] If you were the king of the NHS, what would you do? What you know, the budget let’s imagine the budget isn’t increasing. Is that two and a half percent of health care budget or whatever it is, how would you allocate it?
[00:27:33] Well, the king of the NHS and I care. I’m okay. The health secretary. I think you know the OK, so I agree with that. I think that I’m not I know people say I mean, I don’t think I agree with, of course, over so much. I think that it just has to be a defined offer. At the moment. All the risk is on the shoulders of the associates and involvement in the service. So if you’re a get, you have to be the gatekeeper at this present time and all the rest of you all. And and I think that is not and that’s not a favourable position if a tenable position, you know, the government likes to shift because the risk is on you and not them. And, you know, they continue and everything takes over. But but it got to be an NHS offer. It’s something that’s been, you know, a defined NHS. But this is what you can have on the NHS and this is what you can’t I don’t think I would go so much into whether I think it should be core or advanced, but really, it should be this is what you can have and this is what you call them at the moment. It’s a great it’s just a grey area.
[00:28:39] And that really does need to be addressed in have a future commissioning occurs. I think once you’ve addressed that and obviously we’re clever, people will work around whatever whatever is on the table. I agree that, you know, we know that the Dental budget is only suitable for of population. You know, in the last LDC conference, you know, sorry. And he was pressed on that, you know, and she didn’t answer the question, quite frankly, because, you know, it’s a difficult thing to admit that really their only budget in the country is not politically palatable. You know, that’s our position, but that’s what’s going on. So, yeah, I possibly a bit less on everybody, but I don’t know. You know, you have to be clever bit of research. It needs to be done to work out what’s most suitable for people. You know, with that with that part, essentially, I think that, you know, part of the issue with what Hannah said in terms of, you know, there’s lots of people with fat faces and and giving up for, you know, urgent dental care. And we see that it’s urgent that we run UDC. But one of the major issues is workforce, isn’t it? I mean, you’ve got to find the associates that want to do that work.
[00:29:49] Quite frankly, everybody wants to just put biotoxins in people’s teeth and that’s what they aspire to. They don’t want to sit there and do the, you know, take people’s teeth out, you know, the people that run around the block. I think that’s a problem. I think that’s not an ideal situation to be in. But, you know, there’s a lot of people with, you know, a vested interest, the kind of a cohort of new graduates are coming through. And that’s what they want to do, is to beautify teeth and beautify the population, you know, and yeah, there will be a finite amount of work available. Yes. But there are if there’s a fundamental need for, you know, for patients to be seen and people that are disadvantaged, we’ve got to be responsible. And actually, you know, also explain that the need for population have to. And that should be something that people aspire to also, because I think that, you know, if you present it in the right way, there will be people that will aspire to that sort of thing and to really make that difference. So the media should be pushing that as well. You know, make the counternarrative to some of that, some of the ideas
[00:30:48] You talked you talked about risk there. And, you know, we’ve got. What just happened with the court case, that vicarious liability with the associates, how does that make you feel as a principal to me? And how does it make you feel as an associate, Hanna? Because on the face of it, you might think, well, that’s great. I’m no longer responsible. You know, all the blame with the principal. But as someone someone who was I was an associate myself for a few years. The last thing I wanted was my principal sticking his nose into my treatment plans and hassling me about the clinical side. So I expect that would increase if the principal felt like they had the legal weight of the world on their shoulders. How do you feel?
[00:31:34] Yeah, I mean, absolutely. I think I can completely see why the vicarious liability element of indemnity is increasingly important. The case we’ve had, particularly since the Brexit, we’ve had quite a lot of overseas dentists leave the UK. Now, I have to say, if I left the UK and was signing it up in Argentina, I would not be answering any letters from the Dental partnership. And so I have say, you know, if I don’t eat or, you know, anything else has happened and I just wasn’t responding, I think it is important the patients do have somewhere that they can still go. And I think having a vicarious liability element to indemnity is increasing. But, you know, it’s only recently this has become apparent. This is going to be a thing. And I think it is important if you were practising that you have that because otherwise you can be stung for some hefty payout. And it’s on you is a practise that, you know, not through your indemnity. So absolutely. I mean, the bidet included a standard when they launch their indemnity products, they included that standard. And at the time I thought, you know, you could do it as a bolt of I think now everybody’s going to be doing the same thing. And that is, you know, it’s just part of the professional environment that we work in. You know, if you’re also associate disabilities, you need as a practise owner a way of managing that situation as an associate. I have no intention of leaving the country. I have no intention of stopping working as a dentist. So I’m still going to need my my indemnity. My indemnity is going to rebuild on as much as it ever was because I cannot foresee a situation unless I did die that my previous practise owner would be asked to fight that battle for me.
[00:33:28] I just can’t foresee it. So as a UK living, no intention of ever leaving associate, it’s made no difference to the way that I view my own indemnity. As you quite rightly pointed out, you could make every difference to the way that I actually work in practise day to day if I have principals who are concerned about the vicarious liability aspect. One thing I love about my job is that I have complete political freedom. I can turn to what I can do my job. I can see the patients that I want to see, the way that I want to see them, sort of the patients I want to see, the patients that want to see me. I treat them the way that I want to treat them. We develop that relationship. We do what’s best for them and me is a professional relationship going forward. And that’s why they see me, is because they like me and they like the way that I do my job. And I feel like that would be seriously compromised if everything that I did was justified all the time. And if that was the way that it became, then actually I probably wouldn’t have any option other than to set myself up. So either to go into a partnership or to start a school to do whatever I needed to do, because I can’t I mean, I am not good at being an employee or an opinionated individual, so I think I’d struggle with it. Having been autonomous for so long, I don’t think I would. I don’t think it would sit well with me.
[00:35:00] Jemmy. Jemmy, how does it make you feel? Thirty associates. Now you have to worry about each of them.
[00:35:05] Yeah. I mean, obviously it can be you know, this case is a very interesting one. I think some of the more cynical, probably a little bit, to be honest. But it was just testing a position, wasn’t it, to see what the outcome would be, much like this associate principal malarky that’s gone on over covid. You know, the fact of the matter is it’s poorly written. And when it was scrutinised, it was torn apart and they couldn’t go any further with it. And this is a test case that they put the wording in the tested that b’day contract. And, you know, some and some of the outcome has been quite damning on that on that particular contract set up. So so. So, yeah, it is concerning. I think that we have an idea we Payman why don’t we give Crown indemnity to NHS practitioners? If you want people to stay in the NHS, if you want to incentivise NHS to work to be done, if you want these cases to be seen, why not give associates and principals Crown Indemnity much like their GP colleagues, so that we can be treating the faces and the other part of the week they could be doing all the beautification, you know, give them some incentive to stay in the NHS? It is a no brainer in my mind. So so, you know, for something, you know, that should be what Dental NHS Dental should strive for. And then if should have a top up privately owned private practise, most of the and most of it by a GP background indemnity.
[00:36:22] They do need to top it off. Quite frankly, it’s not sufficient for most of the work that they do. But why not have the same support? Why not push it out? I think I would feel strongly about that. The other thing is the outcome of this is not the vicarious liability issue because we cannot ensure our selves about this. I think what I think when needed to sort of employ stated the NHMRC taken up the final word on this. If the outcome from the HMRC, it doesn’t make a difference whether it be dental or partnership, have found this waiting to be flawed or etc, etc. and then we all have to suddenly high koppa indemnity in order to cover all sorts of like areas. Ultimately, HMRC are going to determine where their associates are self-employed or employed and that will be the biggest concern for both parties, because then you’re going to have to rewrite the rulebook, you know, between principles and associates. If you think that the covid, you know, widening of the gap, you know, you ain’t seen nothing yet. If everyone starts to have to become employed, it’s fundamentally going to shift. And so, you know, that said, you know, I said, yeah, we’re we’re at a crossroads. You know, lots of things are coming together. I think, you know, it will be interesting to see what comes out the other end. Yeah.
[00:37:32] Can I just I think I absolutely 100 percent agree with the Crown indemnity for the NHS work, and I think it was thrown out in the past. They looked across the border into the GPS and they decided it was too complicated because GP’s were quite separate. NHS and private work that they do, they tend to run an NHS clinic or private clinic. And obviously with dentists, it’s more complicated than that. But I think there was to be honest, I feel like it’s a bit of a copout. It’s too complicated. So we’re not going to bother. And I think absolutely, if we’re doing particularly things like access, we should have Crown indemnity for that. You know, I’ve known people that have been dragged to the GDC because they took a cheap for a patient with a massive face, really neglected dentition, didn’t talk to them about the option of an implant before they took the teeth out as an emergency appointment and then got drawn to the GDC for not informing the patient that an implant could cost that much. You know, we need somebody to to provide that to to give a little bit of support to people so they can quite comfortably go in. And you know what? These guys were great. I’m going to do with this coming back to the whole beach vacation thing. As I said at the beginning, the favourite job I’ve ever had ever was working in the prison. And all I did there all day was twenty four. It was a great job,
[00:38:56] Also good about it.
[00:38:57] And I was helping people who were in genuine agony. You know, prisons are a horrible place to be. You get shipped from place to place to place. And the waiting list is so long for any medical care that you’re just about the top of the list and then they’ll leave you with no notice and then you go back to the bottom of the list. So the people that I was seeing have been in agony for months, years, really neglected dentition. Most people that I saw had drug, alcohol, mental health. Really, really severe problems. And it was as simple as taking the teeth out and then they were not in pain for the first time in two minutes, and that’s a brilliant job. I was working in Clwyd through community at the time, so I had the support of an organisation. You know, it worked well. And because it was the prison, there was a danger money. So I had a slightly inflated pay for the day that I gave. I was a little bit nervous the first few days, but you got used to it. So it was well paid. I was well supported and I was doing something that I genuinely thought it was valuable to a population of people who were genuinely grateful for the help that I was boarding.
[00:40:12] And I would do not all day, every day, rather than put Botox in people, if it were appropriate, even didn’t support it. And that’s the problem. I look at it now, you know, it’s more than 10 years since I did that job. I can guarantee to any prison job going at the moment is on less money with less support than it was when I was doing it. And therefore, it’s you know, it’s not peeling is not going to be drawing in those new graduates. I went in as quite an early dentist. I’ve probably only been working for about two, three years. I’m good at taking teeth out. And the reason I’m taking teeth out is because I spent 18 months working in a prison and there’s no one to help you. And if you refer them to the surgery, the waiting list is six months. So you pretty much figure out how to get it out. I learnt so much from that job, but it comes down to having a job that is appropriately supported and appropriately funded so that people can really just get on with.
[00:41:16] Yeah, I mean, it’s what you will be outside of the Dental, what was your your feeling on prisons overall? I mean, give me that’s a big question. Yeah, but can you give me 10 seconds on it?
[00:41:30] Since I was really nervous about going in first time, to be honest, they were really, really short staffed and they kind of asked me what I know, but I was OK. So I probably went in when I was about twenty five and I, you know, classic pretty Frenchwomen, pretty privileged white girls with nice, nice home and nice, you know, well brought up and didn’t really know what I’m going to meet in that. I was a bit, you know, very, very out of my comfort zone. And the thing that fundamentally struck me is that the majority of the people that have been that are really, really young. And they’re basically just kids that are caught up in stuff that we should never be grew up in and we’d see their rap sheet. So if you were firing somebody out of the hospital, when they’d go off to the hospital, they’d have all of their information, their medical information, all of that criminal information, and goes with the guards that are going with them to the hospital appointment. And you’d skim through it. And you’ve got these guys are in there who are 19 years old and they’re from a rough bit of London. They’ve been in a gang. Their rap sheet is carrying a weapon, carrying drugs, driving without insurance, driving under the influence of drugs, you know, driving the age of 15. Well, if you’re 14, 15 years old and everybody, you know, carries a weapon, pretty much everybody takes drugs.
[00:42:55] Nobody has insurance. Everybody drinks and drives and you get caught doing all the right things, which is completely normal for you. How are you not going to get in trouble? So it really opened my eyes to the absolute disparity in in our society. You know, we have gulfs between different communities in this country. And, you know, it really does show you again then why we have such a see dentistry. You know, you can walk two miles down a road and you will walk past a beautiful private practise of really lovely things. And then you walk two miles on the road and you will be in an area where there is massive deprivation, huge health inequalities, just literally nothing there. But the statistics show that 10 miles away, there’s an indigenous dental practise. It’s full. It’s always been full. It never will have taken any of these people. And we have these issues scattered throughout society with regard to, you know, basically it’s demographics and there are things that we can do to help within dentistry. You know, inevitably, there are things that we can be doing that can make things better for some people. But, you know, it’s I think everybody needs to go and work in these places. They need to work in acceptance or in a prison or in a homeless centre or or something just to give them a little bit of an idea as to what our situation is like in this country.
[00:44:31] Look, it’s a it’s a feature of the UK that we’ve got the very best of staff and the very worst and the middle sort of not so well serviced, you know, we have the best universities in the world and then we’ve got those who never make it to university. We’ve got the best restaurants in the world and then we’ve got some pretty crappy food places. And then, you know, how do you address that? You tax people more and then again and again and again, people vote not to have that. You know, this division Jimmi division, I’m reading your manifesto. Anything to mend the cracks in our profession. I can do that in the end. That’s going to take ideas. I mean, you know, you said Crown Indemnity. That’s going to cost money, right. So where’s that money going to come from? From patient care, for instance. It’s always a bit more complicated, isn’t it, than you think. But tell me some of the things you’ve done in your LTC job where you feel like you’ve done you know, you said you you want to you want to do on the national level what you’ve been doing on a local level. There were some clues. How are you going to try and mend all this?
[00:45:45] We hit the nail on the head of funding the you in terms of, you know, ultimately, you know, I’ve written business cases before for the NHS, managed to get funding into the region, you know, for projects, for dentistry, you know, fighting in the corner to sort of I think we want to want to manage this fundamentally. We need if they were taking a huge clawback, huge amount of clawback, you know, money. And I think that, you know, staggering about 19 million pounds don’t quote me on that bit of something similar to that kind of figure and year on year to be getting that money back. So in our region, I think they were I think there were eight million short or something like that in our region. And we managed to sort of negotiate, not meet personally. But, you know, by putting pressure and by saying that we need these services and working with the NHS, really working with the infrastructure, managed to get three million pounds back, you know, from from from that amount. So to actually redistribute back into our increased access in the region. So I do I’m a way to do it, to actually make a business case, really crunch those numbers and actually explain the fact that it’s actually not it’s a false economy sometimes to save money.
[00:46:52] And actually you’ve got to spend the money to save a bit money in the long term. So you’re right. If you just say we want to bang the drum and bang the table and say we want grant indemnity, that’s going to go in one ear and out the other. But if you say, look, we want indemnity because it’s costing the NHS this much money to basically defend these cases and, you know, apologise to these patients, this much manpower is being wasted trawling through, you know, hours and hours and hours of complaints that, you know, it’s probably worth your while just to cover up a little bit, just throw these things out. I mean, we saw it recently with the complaints. I think there’s a form that we send out. Again, don’t quote me on the name Chayo something or other Cayo on AIDS or something. And, you know, during the pandemic period, they basically told us not to send them. And I thought that’s ah, you know, declaration of all the complaints we’ve had that you, you know, doing Pandemic said don’t bother us anything, you know, and I know they don’t have the manpower to actually look through that plethora of stuff that’s pouring through as a result of it, you know, so there are means and ways to make an argument.
[00:47:51] I think that’s probably what I’ve been doing through the LDC and the LDN because about the funding as well over the years, you know, asking us what do you want to spend the excess money on and off? And there’ll be a case where, you know, they say we’ve got this much money, there’s 100000 pounds or something like that. If we don’t spend it in the next month, it’ll go and we’ll never see again. So then you’d have to think of a business case very quickly to spend. They’ll say, you know, maybe spread it out there, peer review, CPD, you know, a project in a care home, etc, etc.. So, you know, I think, you know, I think that’s the approach that you would need to take in this situation. And I’m sure the media well versed on, you know, you know, these negotiations. But definitely that would be the way that it would mend the cracks. You’d have to you’d have to have quite a compelling argument to actually, you know, attempt to attempt to loosen the purse strings, I think.
[00:48:43] Guys, you know, we were discussing before I started recording that there’s not massive engagement with this media process and, you know, the were voter out there that had come out and vote that the members don’t come out and vote for it as it is to younger members of the profession. And I mean, listening to you guys and you’re so well versed on these issues, you know, from from the outside, you’ve got to remember, you know, just just the acronyms are confusing. You know, the for you guys, you’re so in it. How are you going to engage the younger generation? Being I know, I know you are saying you’re no spring chicken, but you’re certainly not at the end of your careers. How are we going to do that? It’s important and I’m guilty of it myself. I’ve never voted in a in a PTA election. I have voted that. But generally with the election, I’ve never thought to vote. But then I thought about it and I thought, you know, I’ve been a critic of the PTA enough. Yeah, it’s a vocal critic sometimes and sometimes on this platform, sometimes on social media particularly. I wasn’t very happy with their communication strategy during covid. But what’s the point of being a critic of it if you don’t even vote, let alone stand like you guys do? What are the ideas for engaging the professional?
[00:50:14] So my my fundamental issue with. With the way that sports represented the way that the communications run is that you’re not going to engage with something if it doesn’t look like you. You know, you can’t get people to get excited about a conversation a bunch of people are having, if you cannot see yourself ever being involved in that conversation and the way that you need to see that is because you can see people like you who share your vision and share your experiences, who are involved in that conversation, and they are engaged with it, you know, so with myself or with Jemmy, you know, if we were then part of that conversation. We do have people younger than even myself on the pack ready for this one. But it is a case of having those people that having that conversation in a forum that other people can see, the other people that can potentially engage with, you know, doing things like this, your viewers who normally potentially wouldn’t be involved in everyday stuff, who wouldn’t normally be interested me something. Oh, actually, you know what they’re talking about something that does annoy me. Maybe I’ll read what the media are doing about it. You know, having this conversation, this debate, you will then increase interest. And that’s what we need to do. You just need to increase the interest and then make the information readily available and then it’s there. If somebody is actually to know, I am a bit interested. I would like to know a little bit more about that as long as it’s readily accessible. It looks like you then it’s something you’ll get involved in.
[00:51:59] And I take issue with it looks like you a little bit. Yeah. Because I of course understand what you mean. Of course I understand that. But, you know, not much of the country looks like Boris Johnson, but he managed he he he managed to pull it off. Right. He might pull it off in a big way. OK, you know, there was a little this disorganise and all of that. But, you know, you don’t necessarily have to look like the person you’re voting for. Jemmy, sorry.
[00:52:30] Yeah, I mean, I agree. I mean, obviously reaching out to, you know, people like yourself, you know, ultimately you’ve got a big reach. There are other people in the Dental industry who have a big reach. And you can imagine that most of your audience is the younger end of the spectrum, people engaging in social media. We see how hot all of these forums are. We don’t see any of this stuff really pouring into the forums. And I think if people really understood that, you know, the gravitas of the conversations are being had at that level, you know, every facet of their working life to a certain extent is going to be influenced, whether they’re private or energy to a certain extent, by some of the decisions made in those boardrooms. So I think you’re only going to get some proportion of people that are going to be fundamentally interested in the politics side of it. They are. They just buy why it that way. But I think if the general populace or the younger a younger colleague, if they were basically aware of the mechanics and the fact that those mechanics affect their day to day, when the patient sits in the mouth with the head back and open their mouth and what their work experience is like, that kind of talking about leaving prison at work.
[00:53:30] But basically it’s just not feasible anymore. It’s not feasible because of some of the decisions that maybe could be influenced in that boardroom. So, you know, if you really want to make that change and you’ve got to be engaged in the process, I think also we have a very niche market. You know, sometimes we just get absorbed in ourselves. But, you know, we’re a tiny market, you know, really. And so these decisions can be quite close to home. You know, we’re not the government. It’s not like, you know, voting in a general election. You know, your vote yes will have an effect. But he has to go through layers and layers and layers of pogson, you know, to have any you probably won’t see the ramifications of your vote, you know, immediately. But in dentistry, it’s a pretty niche. You know, I think that you if you actually put your vote in, I think you will see some effect that will affect you quite quickly.
[00:54:20] You know,
[00:54:21] Having cesta these elections before I can tell you, it comes down to a handful. So five people watch this tomorrow and vote. That will change the outcome of the election, though, right? Yeah. So the numbers are tiny and it is just about you don’t have to do it yourself. You don’t have to want to be on the pack. You don’t want to have to go to the ABC. You don’t want to. Yeah, it’s costumey. Says you just need to have an awareness of the fact that these things do impact you. And regardless of where you’re from, what you do, where you are in your career, what your aspirations are, having your vote is your fundamental rights. To influence the way that things are going to turn out, so my absolute message would be if you were a member, you will have had the stuff through the post with everybody statements in it. If you’ve thrown out, you will still be able to read the news on the website and then you need to find somebody that shares your values. You can fight your corner if you don’t want to do it yourself, invite them.
[00:55:26] Your PDA to org slash elections is where you can find that. Um. Well, it’s, I think it’s been really fascinating. Really has. And you know, I wish we had others on here as well, but it was very short notice for most. And I want to thank you guys for for coming on and giving that fresh sort of angle on what could be the future for our profession and for the younger audiences that we were talking about. And then just generally, I mean, the actually before we close it down, let’s talk about, you know, your purely private Narnia. All right. Yeah. Jimi, I know you’ve got all sorts of private and NHS things going on with these new organisations that have come along during covid the baptism of those other independent groups. Do you think I mean, I thought there was there was a good reason for those to come along, but trying to sort of do it in six weeks was taken 60 years or 100 years of the b’day. You know, it’s not going to happen. So are we going to get a more inclusive, private focussed angle from the media or is the media, not the organisation? And and these other organisations should grow and take that space?
[00:56:53] I think I think the media does a huge amount behind closed doors for everybody. And I think people that are vocal critics of the media, I mean, we often find people that are vocally critical of the media aren’t members, you know, so they don’t know what’s going on. And I think one of the biggest issues is that it does not blow its own trumpet anywhere near enough. And if we went back 15 years and we had lived the last 15 years without the constant negotiations of the media, with all of the various powers that be and all of the influence that it has and all the good that it’s done, you know, yeah, we’ve got a terrible contract. But can you imagine how awful it would be if the BDA didn’t exist? That’s that’s the issue. And you’ve got these new organisations who are saying, well, we need this, we need this, we need this now. Well, yeah, but we tried to do that already. And these are the 10 years worth the various battles that have been fought on various fronts to achieve this. And we’ve realised that, you know, things are more complicated than they initially appear. And I think this is the is very easy as an outsider to go, well, they’re just not doing the job properly. They’re just not doing it well enough with that because you don’t know each single one of those staff members is doing day in, day out in their full time job to protect us as a profession because they don’t tell you unless you ask. But, yeah, I mean, you can rest assured without the work that the BDI does, the profession would not be in the place that it is right now.
[00:58:32] It would be significantly worse off. And I know that sometimes seems hard to believe. And we can all have a bit of a woe is me moment about how terrible things are. But trust me, it would be worse. I’ve seen some of the bullets that have been dodged because of the work of the work that goes on at the V.A. and we need to be grateful to those colleagues. And it’s not necessarily the pack. It’s the staff that are incredibly hard working. A lot of the positions that are held within the media, the craft committees, you know, they don’t pay for these jobs. You know, everybody’s probably heard of Charlotte Waite’s, who’s the chair of the Community Centre Services Committee, and she’s regularly in parliament and she’s doing all sorts of things, promoting dentistry for marginalised groups like Community. She’s paid to do that job. The PTA support her as a professional to be able to make these big, big impacts on the profession. And, you know, a lot of the people that are involved in the PTA do it voluntarily. They do it because they love the profession and they are doing a good job. It just doesn’t always necessarily publicly appear to be that way. I’d like to help them improve their public image, because I know that they’re doing great job, so I read some of the stuff that’s going on is amazing to me.
[01:00:02] I kind of had to be honest. You know, the media has to be everything to everyone, really. To be honest, it is representing the whole profession. So, I mean, Simon is not going to mind me saying I’m a doctor who is my sister, my oldest sister, not going to mind meeting me, saying, you know, during the open period, I think there was a lot of a lot of people that felt quite helpless, a lot of Dental helpless. Alfer. And quite sort of in the way that we’re wired. And I think that we felt quite helpless, you know, people shouting or practises or telling us we can do this or that. We might send you to a Nightingale hospital, etc., etc.. And as you said, you know, we. And that’s a natural reaction, isn’t it? You band together. We need to form some kind of power base. And so all of these organisations pop up to come for you know, some of it comes from a sort of business element, from a monetary element. I think it’s important to keep those ones out. And a lot of them have got some good, you know, you know, some good contribution to make. So I don’t think you can immediately say they’re sort of not relevant in the space, but I think fundamentally happened because of that sort of crisis situation and people felt underrepresented.
[01:01:15] And I think that social media gives a lot of people and I a chance to be a keyboard warrior. You see a lot of the same people popping up on social media, you know, voicing their opinions. And then when you have a look at something like Valpak or you look fat in the Aldiss and, you know, the actual established infrastructure, these people are nowhere to be seen. So it’s very easy to say in front of a, you know, in front of the keyboard and just punch away your opinion and you see in all spheres of life then you. But actually, you know, sometimes I kind of say you don’t have to blow by blow your own trumpet. You’ve got to be judged on your results. And actually, you know, you don’t have to sit there screaming. You can just be judged on your results and people should just judge them on the results. If you don’t think the results are good enough, then be a vocal critic, but really do sort of understand that it’s quite a large infrastructure and there’s a lot of cogs in the machine.
[01:02:07] You know, the there’s one thing getting involved and just voting, whole other thing standing and getting involved with all of these, I mean, and both of you, you know, Jimi, you’ve got is it four or five practises? You could be focussing on your next four or five practises. But, you know, you’re spending your time in these committees. And Hannah, I’m sure you can find many things to do as well in your spare time. So, you know, the degree of service is admirable. I think I think we should point out there are other candidates, apart from Hannah and Jim, there are seven other candidates, Marc Newsome, Sarah Campbell and Jillian Cottam atop the car, Marion English as the category, and Chris Morris, the other candidates for completeness. I think that that we should say that it’s been lovely having you guys and it’s really piqued my interest. And I say that for it and certainly try and have more on this on this platform. And I wish you both the very best and really lovely to see to see people like you guys so engaged in the process. Thanks a lot for taking the time to discuss.
[01:03:19] Can I just ask one really quickly before we go, though? The BDA runs elections every three years for GBC Aldergrove Committee so that the country councils JPC, which is a general dentist, can use Dental services. If you in any way even vaguely interested in getting involved, just put yourself forward because we struggle to get people wanting to just do it. So you don’t feel like you’re not experienced enough or you’ve not got the right background or you don’t know the right people. Just put your name forward because that is the only way that you’re going to get involved in it and you would be welcomed with open arms, trust me.
[01:03:57] Paula, any closing comments for you, Jemmy,
[01:04:01] What you’re saying, just engage with the process? I think that’s the key. Just to gauge, you know, for the sake of you’ve only got a couple of days now to get your votes. And I think you should really, you know, get on the computer, punch, punch it in, and then basically have a look at the statements and get a vote and just get something in and hopefully Payman your supporters over the years, because I’m sure this will crop up again and again. It has been over many years. You can get more even if it’s just a win at this time. And we can engage on the next you know, the next election, for example. At least you’re starting the process.
[01:04:30] Yeah, absolutely. All right, guys. Well, thanks a lot for taking the time and good luck to both of you. Voting ends on the 30th at noon. It is opposed to vote. You would have been sent your your postal ballot at wherever you could receive your BTG. Thanks. Thanks a lot for taking the time.
[01:04:50] Thank you. This is Dental Leaders, the podcast where you get to go one on one with emerging Leaders Dental Street. Your hosts, Payman, Langroudi and Prav Solanki.