In 2021 UK qualified new registrant dentists with the General Dental Council (GDC) formed 61% – the remaining 39% of new registrants coming from EEA countries or other overseas routes to registration[1]. Dentists with overseas qualifications now make up nearly 30% of all dentists on the register. Even if the Government was prepared to invest in a significant number of additional new UK dental student places, and the education facilities to undertake their qualifications as desired by MPs in some parts of England, (we support a new dental school in the East of England) they will not be entering the workforce for at least another 6 years. For this reason alone the UK will remain dependent on overseas clinicians to maintain the current workforce.
The recruitment of overseas professionals from countries outside the EEA halted in March 2020 as the examination they are required to take to register (the Overseas Registration Examination, commonly known as “ORE”) was suspended during the pandemic period. The ORE is administered by the GDC and widely acknowledged to be no longer fit for purpose. The GDC themselves describe the ORE as a “flawed system made worse by the pandemic.”[2]. This flawed system is now a major contribution to the access crisis in NHS dentistry.
Recognising this the Government brought forward legislation last year to reform the ORE. This legislation was one of the ADG’s “Six to Fix” to solve the access crisis and enjoyed cross party support in Parliament as MPs believed it would quickly enable the recruitment of more overseas clinicians into the NHS workforce.
Since the beginning of the year, we have been urging the GDC to work “at pace” however six months on, the GDC has yet to start its own consultation on reform of international registration, meaning we will see little in the way of changes until late 2024.
Although it is welcome that the number of sittings for Part 1 of the ORE has been expanded to 600 it appears from Freedom of Information data we have seen that candidates are currently waiting up to 471 days to even be told they are eligible to sit the examination, and it is taking an applicant more than 3 years to go from applying to sit the ORE to actually sitting it. With a backlog of 2,725 clinicians waiting for their application to be assessed this is a clear bottleneck that needs to be addressed by the GDC to ease the current workforce crisis. The most immediate step is to allocate more budgetary resources into this area to clear the backlog and speed up the process. This is not about expanding overseas recruitment but ensuring a functioning pathway continues to exist to maintain the current workforce.
It is clearly not desirable for the ORE to be the sole route to registration in the UK for overseas applications and new mutual recognition process can now be agreed with countries where the GDC as regulator believes that standards meet ours . We believe that the GDC should now scope out further opportunities for mutual recognition globally with Commonwealth countries such as India. Before 2001 the GDC had a number of bilateral agreements with Commonwealth countries including Australia, Singapore, Hong Kong and South Africa whose qualifications met UK standards and potential agreements can be explored again.
There is already a recruitment crisis in NHS dentistry – driven by the failing NHS contract workforce numbers are now at their lowest for nearly a decade. A contracting workforce is not best placed to recover the huge backlog of care which is why we cannot afford to see the routes to registration for overseas dentists stuck in a bottleneck at the GDC. Talented clinicians will look elsewhere for more attractive offers in the global marketplace.
Neil Carmichael is the former Conservative MP for Stroud 2010 – 2017 and the Executive Chair of the Association of Dental Groups, the trade association representing dental groups whose members are delivering NHS and private dentistry across the United Kingdom.
[1] Registration statistical report 2021 (gdc-uk.org)
[2] The ORE: a flawed system made worse by the pandemic with further challenges ahead (gdc-uk.org)