Retention versus recruitment
A Scottish Labour Party proposal has sparked a debate around the use of golden handcuffs
The corridors of our dental schools have always been filled with a palpable sense of ambition, but lately that ambition is tinged with a new kind of anxiety. As we navigate the early months of 2026, the Scottish dental landscape finds itself at a philosophical crossroads.
The Scottish Labour Party’s proposed Train Here, Stay Here initiative has moved from a campaign talking point to the centre of a fierce professional debate. The proposition is simple, yet provocative: in exchange for a funded Bachelor of Dental Surgery (BDS) place, graduates must commit to five years of NHS service or face the prospect of ‘buying out’ their degree.
On the surface, the logic is seductive. For a Scottish Government grappling with ‘dental deserts’ in the Highlands and an under-pressure NHS infrastructure in the Central Belt, a guaranteed pipeline of young clinicians feels like a silver bullet. It addresses the optics of recruitment; a metric that politicians love to cite. However, for those of who have spent decades in the surgery, it is well known that recruitment is merely the opening gambit. The real endgame is retention, and you cannot mandate loyalty.
If the Scottish Government wants to keep its graduates, it must make the NHS an environment where they can thrive
The ‘golden handcuffs’ strategy risks fundamentally altering the social contract between the state and the profession. Traditionally, that contract has been built on mutual investment; the state provides the education, and the professional provides the service because it is a viable, respected and sustainable career path. By shifting this to a mandatory ‘term of service’, we risk shifting the NHS from being
a choice to being a chore.
We must ask ourselves: what kind of workforce are we creating if the primary reason a young dentist stays in an NHS practice is to avoid the debt collector? A dentist who is ‘clocking in’ their five years while eyeing the door is a dentist at risk of burnout. They are also less likely to invest in the long-term community ties that are the bedrock of Scottish primary care. We do not just need bodies in surgeries; we need clinicians who are professionally and mentally engaged.
Furthermore, the timing of this proposal coincides with a 7% increase in BDS intake across the Glasgow, Dundee and Aberdeen hubs. While more graduates are welcome, the handcuff model ignores the ‘leaky bucket’ at the other end of the career spectrum. If we force 23-year-olds into a system that is currently driving 45-year-olds into early retirement or 100% private practice, we have not fixed the bucket, we have just turned the tap on harder.
The solution to our workforce crisis is not to be found in restrictive legislation, but in environmental reform. If the Scottish Government (of whatever political hue)wants to keep its graduates, it must make the NHS an environment where they can thrive. This means continuing to build on the payment reforms introduced in 2023 and, more recently, the change to prior approval this year.
Golden handcuffs might provide a temporary reprieve for the statistics, but it offers no long-term cure for the profession’s morale. We should be courting our graduates, not capturing them. We need to create a system so robust, so rewarding and so clinically fulfilling that the idea of leaving for the private sector feels like a loss, not an escape. As we look toward the next parliamentary session, there needs to be a shift in focus. Let us stop debating how to tether our young dentists to a – not so much sinking, but perhaps – listing ship and start discussing how to make the ship seaworthy again.
Recruitment gets them through the door; only a sustainable, respected career path will keep them in the room.
About the editor
Will Peakin is editor of Scottish Dental and Ireland’s Dental magazines, and education programme organiser for the Scotitsh Dental Show. If you have a question or comment for Will you can leave it below or email editor@sdmag.co.uk. Follow Scottish Dental on Instagram, Facebook and LinkedIn.