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US Futures, Global Stocks Hit Fresh All Time High

US Futures, Global Stocks Hit Fresh All Time High

US equity futures and global stocks rose to new record highs and oil climbed after strong U.S. and Chinese economic data bolstered expectations of a solid global recovery from the covid pandem

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US Futures, Global Stocks Hit Fresh All Time High

US equity futures and global stocks rose to new record highs and oil climbed after strong U.S. and Chinese economic data bolstered expectations of a solid global recovery from the covid pandemic. At 7:00 a.m. ET, Dow e-minis were up 34 points, or 0.1%, S&P 500 e-minis were up 5 points, or 0.11% to a new all time high of 4,167, and Nasdaq 100 e-minis erased a decline of as much as 0.4% to trade little changed as of 7:20am in New York.

The benchmark S&P 500 and the blue-chip Dow are on course for their fourth straight week of gains, while the Nasdaq is less than a percent below its own all-time peak despite some turbulence last month. With the first-quarter corporate earnings season under way, focus will be on results from Morgan Stanley after bumper earnings earlier this week from JPMorgan, Goldman and Bank of America that reinforced hopes of a swift economic rebound. Oil companies, mainly Chevron Corp, Marathon Petroleum, Exxon Mobil Corp and Occidental Petroleum, gained between 0.3% and 1.1% as oil prices rose.

“As the economic reopening accelerates in the coming months, we believe the bull market remains on a solid footing,” said Mark Haefele, chief investment officer at UBS Global Wealth Management. “We maintain a cyclical bias and prefer U.S. consumer discretionary, energy, financials and industrials.”

In the U.S., Thursday’s retail sales and weekly jobless claims data signaled an accelerating recovery in the world’s biggest economy. Investors will look for further confirmation as the reporting season picks up pace next week, with around 80 S&P 500 members and more than 50 Stoxx 600 firms announcing.

Looking at global markets, MSCI’s broadest gauge of world stocks edged higher in early European trade, up 0.2% to a record high. Europe’s top indexes all opened higher, led by Britain’s FTSE 100, up 0.5% and passing 7,000 points for the first time since February 2020.

“As the global recovery becomes more entrenched, fuelled by continued fiscal stimulus and ultra-loose monetary policy, we think this should translate into continued positive UK equity market performance,” said Nick Peters, multi asset portfolio manager, Fidelity International.

The Stoxx Europe 600 Index was poised for a seventh week of advances, its longest streak since May 2018, as investors continued to boost cyclicals such as carmakers and banks, while defensive sectors lagged. The Stoxx 600 benchmark index rose 0.6%, pushing further into record-high territory, with economically sensitive sectors leading gains. European cyclicals outperformed while all 20 sector groups positive: Automotives +2.2%, banks +1.6%, industrials +0.9%; consumer products & services, health care sectors up by less than 0.1%

Here are some of the biggest European movers today:

  • Bank of Ireland Group shares jump as much as 7.9%. KBC signed a memo with Bank of Ireland agreeing to “explore a route” to sell “substantially all of KBC Bank Ireland’s performing loan assets and liabilities,” the pair said in a joint statement Friday.
  • Kesko shares rise as much as 6.6% after upgrading its 2021 guidance late on Thursday. Inderes raised its recommendation on the Finnish retailer to accumulate, saying the company is “rewriting records once again.”
  • WH Smith shares gain as much as 5.3% as RBC upgraded the stock to outperform and increased the price target. The broker said in a note that the retailer’s international businesses are providing an encouraging precedent for a recovery in U.K. travel demand.
  • HelloFresh shares surge as much as 8.4% with Deutsche Bank saying the meal-kit maker’s 1Q results were a “massive beat” after the firm raised its FY guidance.
  • CD Projekt shares decline as much as 4.2% after preliminary earnings unexpectedly released late on Thursday and indicated lower-than-consensus estimate sales for Cyberpunk 2077. Patria said investors will be worried about weak preliminary sales and net income numbers.
  • L’Oreal shares slipped as much as 3.2% as the French beauty-products maker’s 10% beat in its 1Q organic-sales growth wasn’t enough to propel higher a stock trading around record levels.
  • Evolution shares drop as much as 2.6% after being downgraded to hold at DNB. While the company faces an “impressive” 1Q, near-term catalysts seem mostly priced in, the broker said in a note.

The latest data from Beijing which saw China's GDP rise by a record 18.3%  (although the growth rate slowed substantially Q/Q) to Thursday’s string of positive economic figures out of the U.S., boosting futures on the small-cap Russell 2000 and Dow Jones Industrial Average indexes.

Overnight, Asian stocks tracked a path similar to Europe’s. MSCI’s broadest index of Asia-Pacific shares outside Japan was last up 0.5%, with Shanghai shares adding 0.8% and Japan’s Nikkei up 0.1%. Driving the move was Chinese data showing record 18.3% growth in the first quarter, though the reading slightly undershot expectations. Retail sales were the only real-time print that beat expectations (see more here).

Asian stocks reversed an earlier loss, as data showing that China’s economy expanded by a record in the first quarter boosted investor sentiment. Hong Kong-listed Tencent and Meituan were the biggest boosts to the MSCI Asia Pacific Index, which was on track for a weekly gain of 1.1%, its biggest in about two months. TSMC was the biggest drag as analysts pointed to profit-margin pressure from its increased spending plan. The tech sector could be active next week, with events including Apple’s first product unveiling of the year as well as earnings from Intel and Japanese electronic components maker Nidec. Stocks in Hong Kong and China turned higher after China’s GDP data, helping the CSI 300 Index close just above its 200-day moving average. The economy grew 18.3% in the first quarter from a year earlier, largely in line with estimates. The nation’s retail sales beat expectations while industrial output moderated. Equity benchmarks in the Philippines and Vietnam fell, while those in India and Japan were sluggish amid renewed surges in coronavirus infections.

Chinese stocks rose on the strength of liquor producers and car manufacturers, after government figures showed consumer spending strengthened in the first quarter to make economic recovery more balanced. The benchmark CSI 300 Index closed 0.4% higher after sliding earlier in the session. Baijiu distillers including Kweichow Moutai and Wuliangye Yibin were the biggest contributors to the gauge while Changan Auto and Guangzhou Auto were the top performers. The Hang Seng Index ended 0.6% stronger. The National Bureau of Statistics announced that China’s gross domestic product climbed 18.3% year on year in the first quarter, compared with consensus of 18.5%. Retail sales beat expectations while industrial output moderated. Consumption of auto products surged 65.6% in the period from a year ago, out-pacing a 33.9% jump in overall retail sales. Investors beefed up buying in afternoon trading via the stock connect programs between the mainland and Hong Kong, said Daniel So, a CMB International strategist. “One of the reading into the economic data is that the central bank may slow down its pace to tighten the liquidity in the market, after the growth came in slightly below estimates.”  Net purchase of mainland stocks via the trading links exceeded 7.1 billion yuan on Friday, the second biggest in almost four weeks. That took the weekly total to the most since Feb. 5, according to Bloomberg-compiled data. The CSI 300 Index declined 1.4% for the week. It still held above its 200-day moving average, a key support level.

“We remain focused on a China-led rebound steadily helping the Asia-Pacific region,” said Sebastien Galy, senior macro strategist at Nordea Asset Management. “As the U.S. economy and then European economies open up, it should further help Asian exports. This should support Emerging Market and APAC equities as well as China equities and fixed income.”

In rates, Treasuries held onto Thursday’s gain, with traders suggesting foreign buying and geopolitical risks may have contributed to the advance. The 10-year U.S. Treasuries yield was last at 1.55%. Long-end yields are richer by 3bp on the day, flattening the curve. Treasuries faced pressure during Asia session from double block sale in 5-and 10-year futures; bunds and gilts underperform. The curve flattened from belly out to long-end, 2s10s by less than 1bp, 5s30s by ~1bp; 10-year yield around 1.57% is ~1bp lower on the day, outperforming bunds by ~2bp, gilts by ~3bp. Dollar issuance slate empty so far; nearly $24b was priced Thursday, including biggest-ever bank offering by JPMorgan ($13b 5-part), as well as by Goldman Sachs ($6b) and Tencent ($4.15b)

“As the economic reopening accelerates in the coming months, we believe the bull market remains on a solid footing,” said Mark Haefele, chief investment officer at UBS Global Wealth Management. “We maintain a cyclical bias and prefer U.S. consumer discretionary, energy, financials and industrials.”

In FX, the Bloomberg Dollar Spot Index was little changed, after falling for four consecutive days, and the greenback traded mixed against its G-10 peers; Treasuries outperformed European government bonds. The euro approached $1.20 before paring gains as it gravitated toward the 55-DMA. The pound hit its weakest against the euro since February, unwinding the premium from the U.K.’s speedy vaccination program earlier this year. The yen edged lower for the first time in five sessions as traders adjusted their positions ahead of the meeting between President Joe Biden and Prime Minister Yoshihide Suga. Australian and New Zealand dollars eased against the greenback as short-term accounts trimmed existing longs; the currencies are poised for their biggest weekly gains since November, buoyed by rising commodity prices and a falling Treasury yields.

In commodities, oil hit a one-month highs thanks to the economic data and higher demand forecasts from the International Energy Agency (IEA) and OPEC, Oil headed for the biggest weekly gain since early March on optimism the recovery in demand from the Covid-19 pandemic is improving. Brent futures were last flat at $66.94 per barrel. U.S. crude was down 0.1% at $63.4 per barrel, both on course for their first substantial weekly gains in six.

Elsewhere, copper remained on course for the best week in about two months. Bitcoin slipped.

Bitcoin tumbled after Turkey banned the cryptocurrency.

Looking at the day ahead now, the data highlights include US housing starts and building permits for March, along with the preliminary University of Michigan consumer sentiment index for April. Meanwhile in Europe, there’s the new EU car registrations for March and the final Euro Area CPI reading for that month as well. Otherwise, central bank speakers include Dallas Fed President Kaplan and BoE Deputy Governor Cunliffe, and earnings releases include Morgan Stanley and BNY Mellon.

Market Snapshot

  • S&P 500 futures +0.1% at 4,167.75
  • MXAP up 0.3% to 208.61
  • MXAPJ up 0.5% to 695.84
  • Nikkei up 0.1% to 29,683.37
  • Topix little changed at 1,960.87
  • Hang Seng Index up 0.6% to 28,969.71
  • Shanghai Composite up 0.8% to 3,426.62
  • Sensex up 0.1% to 48,873.01
  • Australia S&P/ASX 200 little changed at 7,063.45
  • Kospi up 0.1% to 3,198.62
  • Brent Futures up 0.3% to $67.12/bbl
  • Gold spot up 0.2% to $1,767.31
  • STOXX Europe 600 up 0.3% to 439.92
  • German 10Y yield rose 2.3 bps to -0.268%
  • Euro up 0.1% to $1.1975
  • U.S. Dollar Index little changed at 91.626

Top Overnight News from Bloomberg

  • Hedge funds have been a major player in this year’s Treasury selloff, offloading more than $100 billion of the securities since the start of January, according to holdings data
  • Brevan Howard Asset Management is preparing to start investing in digital assets, becoming the latest money manager seeking to exploit the cryptocurrency boom
  • China’s economy soared in the first quarter as consumer spending strengthened, suggesting a more balanced recovery after an investment and export-fueled rebound from last year’s coronavirus lockdowns. GDP climbed a record 18.3% in the first quarter from a year earlier, largely in line with the 18.5% predicted in a Bloomberg survey of economists
  • Man Group Plc assets hit yet another record as investors kept pouring money into its funds, signaling a pickup in its business and the wider hedge fund industry. The world’s largest publicly-traded hedge fund firm raked in $600 million of cash in the first quarter that lifted assets under management to $127 billion, the company said in a statement Friday
  • The EU “most probably” won’t renew its coronavirus vaccine contracts with AstraZeneca and Johnson & Johnson, French Industry Minister Agnes Pannier-Runacher said on BFM TV on Friday

A quick look at global markets courtesy of Newsquawk

Asian equity markets traded cautiously after the mild tailwinds from US, where most major indices notched fresh record highs and tech outperformed amid a decline in yields and surge in Retail Sales, gradually dissipated as the region digested a miss on Chinese GDP and Industrial Production data. ASX 200 (Unch.) was subdued after the disappointing data from Australia’s largest trading partner with sentiment also dampened by underperformance in energy and the top-weighted financials sector, while Nikkei 225 (+0.1%) was indecisive with concerns of widening COVID-19 measures counterbalanced by a more favourable currency. Hang Seng (+0.6%) and Shanghai Comp. (+0.8%) were choppy following the latest economic growth and activity data from China in which GDP and Industrial Production disappointed although still showed a double-digit percentage surge Y/Y and Retail Sales surpassed estimates to suggest a strong domestic consumer profile, while the stats bureau also suggested the economy got off to a good start with continued improvement to production and demand. Finally, 10yr JGBs retraced some of yesterday’s after hours gains as the recent bull flattening and short-covering in USTs lost steam, while the indecisive risk tone and lack of purchases by the BoJ in the market today also constrained price action. PBoC injected CNY 10bln via 7-day reverse repos with the rate at 2.20% for a net neutral daily position.

Top Asian News

  • Normal Monsoon in India May Spur Growth of Virus-Ravaged Economy
  • Singapore Air to Stop Flying Transit Passengers to Hong Kong
  • Final Fantasy Maker Jumps on Report It May Be Acquisition Target
  • Distressed Firm Sritex Is Said to Pause Dollar Loan Payments

European equities trade somewhat mixed with an upside bias as the core bourses edge higher in early European trade (Euro Stoxx 50 +0.5%) following somewhat of a lukewarm cash open, with newsflow again on the lighter side. Stateside, US equity futures see sideways trade as participants look ahead to another wave of earnings, with Morgan Stanley among the bunch. Back to Europe, The FTSE 100 (+0.5%) was initially the leader amid favourable Sterling dynamics, but Germany’s DAX (+0.7%) now outpaces peers as Daimler (+2.5%) leads the gains following a significant beat in Q1 EBIT - led by favourable sales momentum by all major regions and particularly in China. Separately, Co. unveiled the electric version of its Mercedes-Benz S-Class sedan poised for sale from August and billed as a competitor to Tesla. This, alongside an almost 90% Y/Y increase in EZ New Car Registrations, sees the Auto sector as the clear outperformer closely followed by financials amid the higher yield environment. The other end of the spectrum sees Consumer Staples, Healthcare and Tech. Overall, sectors are mixed with no clear overarching theme. In terms of individual movers, L’Oreal (-2.0%) shares are pressure post-earnings amid a Q1 revenue miss.

Top European News

  • Merkel Pleads for More Control to Break Third Pandemic Wave
  • U.K. Lobbying Scandal Deepens as Hancock Accused of ‘Cronyism’
  • Stirling Square Is Said to Weigh IPO of Sweden’s Byggfakta Group
  • Hungary Regulator Suspends OTT-One Shares After Auditor Resigns

In FX, sterling has pared some losses, but remains under pressure amidst the ongoing dispute between the UK and EU over NI protocol compliance, with some progress made at a meeting between Frost and Sefcovic, but difficult issues still to be resolved according to the former. Meanwhile, Cable succumbed to sell orders when a key pivot point was breached at 1.3760 and more following the loss of 1.3750 before finding some underlying bids ahead of 1.3700 and Eur/Gbp climbed to a fresh April peak after crossing 0.8700 and is now eyeing a late February apex at 0.8731 vs 0.8719, thus far.

  • USD - Aside from Pound weakness, the Dollar has regained some yield attraction, though not across the board by any means as the DXY straddles its own former technical axis around 91.740 within a 91.813-574 range against the backdrop of buoyant risk sentiment that has seen certain EU stock indices emulate their Wall Street peers to trade at record levels, like the Dax. Ahead, US housing data and another regional survey, but this time in the form of prelim Michigan sentiment.
  • CHF/CAD/EUR - The Franc is outperforming through 0.9200 vs the Greenback and closer to 1.1000 against the Euro than 1.1050 in wake of Swiss producer/import price data showing a 0.6% m/m rise that pushed the y/y rate up to -0.2% from -1.1% previously, while the Loonie seems to be latching on to mostly firmer oil prices following yesterday’s weaker than expected Canadian manufacturing sales as it rebounds from sub-1.2550 lows towards 1.2500 in the run up to securities purchases and wholesale trade. Elsewhere, the Euro continues to hold above 1.1950 and stay capped beneath 1.2000 where bids and offers presumably lie in decent size, though without anything of note in terms of option expiries today.
  • JPY/AUD/NZD - All softer vs their US counterpart, or handing back some gains to be more precise with the Yen now nearer 109.00 following a 2nd unsuccessful attempt to pierce 108.60, Aussie back below 0.7750 after even more efforts to break above and Kiwi hovering just over 0.7150 vs a circa double top around 0.7180. Note, Aud/Usd failed to derive momentum from a raft of Chinese data as GDP and IP missed admittedly lofty expectations in contrast to retail sales, while Nzd/Usd also gleaned little lasting benefit from an acceleration in NZ’s manufacturing PMI and Usd/Jpy shrugged off strength in Reuters’ Japanese Tankan Manufacturing Index.
  • EM - A seemingly conciliatory tone from US President Biden in the context of strained relations with Russia and Brent peering over Usd 67/brl has helped the ravaged Rub recover losses to 75.3340 at one stage from 76.4800+, but the Try remains beneath 8.0000 irrespective of Turkey raising corporate tax to 25% from 20% and the Cnh is flat on the day around 6.5200, though not far from w-t-d highs on the back of a firmer PBoC Cny midpoint fix overnight.

In commodities, WTI and Brent front month futures yet again experience a choppy European morning, as the contract fails to clinch onto a narrative amid slow news flow. Meanwhile, participants attempt to gauge the supply/demand scales as COVID cases remain elevated, some vaccines are halted, and the geopolitical landscape tense on several fronts. However, supportive omens have emanated from the bullish inventory data and constructive oil market reports throughout the week. WTI Jun around the 63.75/bbl mark (63.30-63.94 range) and its Brent counterpart just north of USD 67/bbl (66.75-67.36 range). Elsewhere, spot gold and silver were rangebound for a large part of the session amid after rising in unison with the recent drop in yields, although upside was seen in wake of reports that China has reportedly permitted banks to import large amounts of gold, around 150 tonnes of gold worth some USD 8.5bln in April and May, sources said, with spot gold around USD 1,770/oz and spot silver eyeing USD 26/oz to the upside. In terms of base metals, LME copper is waning off best levels with the miss in Chinese GDP and IP not supportive for sentiment surrounding the red metal, albeit prices reside comfortable north of USD 9,000/t. Meanwhile, the APAC session saw Dalian coking coal futures surge as safety inspections sparked supply concerns.

US Event Calendar

  • 8:30am: March Housing Starts est. 1.61m, prior 1.42m; MoM, est. 13.5%, prior -10.3%
  • 8:30am: March Building Permits, est. 1.75m, prior 1.68m, revised 1.72m; MoM, est. 1.7%, prior -10.8%, revised -8.8%
  • 10am: April U. of Mich. 1 Yr Inflation, est. 3.2%, prior 3.1%; 5-10 Yr Inflation, prior 2.8%
  • 10am: April U. of Mich. Current Conditions, est. 96.0, prior 93.0; Expectations, est. 85.0, prior 79.7; Sentiment, est. 89.0, prior 84.9

DB's Jim Reid concludes the overnight wrap

I feel truly blessed to be working today. The family are about to leave without me on a 2-hour trip to Thomas Land which is based on Thomas the Tank Engine. As with earlier this week it’s in a middle of a bigger Theme Park which looks even more frightening than the one I went to on Monday (around Peppa Pig World). So I will have Bronte curled up at my foot all day today while my wife curls up in a ball after too many rollercoasters.

Markets got back on the bullish train yesterday with both bond and equity markets performing as the decent data seemed to be already baked into bond markets (a bit like with CPI a couple of days back) whilst the strong data and strong earnings boosted equities. A Goldilocks day if ever there was one. The -5.6bps rally in 10 year US yields caught the eye with the benchmark now trading -12.5bps lower than its intra-day day high on Tuesday. Most of the bond rally came after the strong retail sales/claims report that maybe didn’t blow the lights out as much as it could have done in some people’s eyes. There were some larger whisper numbers being flagged in recent days. The other explanation for the recent rally in US bonds has been renewed demand from Japanese investors after government data showed Japanese investors bought $15.6 billion of foreign bonds last week. This comes after insurers and banks in Japan contributed to a good deal of selling in February. Geopolitical risk rising was also cited. More on the retail data below but to quickly recap other key variables, the S&P 500 (+1.11%) advanced to its 7th all-time high so far this month, while the VIX index of volatility (-0.42pts) reached a new post-pandemic low, and the NYFANG index (+1.65%) saw its 13th increase in the last 14 days.

Running through the headlines from those US data releases, retail sales rose by a stronger-than-expected +9.8% in March (vs. +5.8% expected) as they marked their fastest monthly growth since last May. The gains were aided by the stimulus checks as well as a recovery from February’s bad weather, and February’s contraction was revised to show a smaller -2.7% decline (vs. -3.0% previously). There was also good news from the weekly initial jobless claims for the week through April 10, one of the timeliest indicators we get, which showed them falling to a post-pandemic low of 576k (vs. 700k expected), a number that was beneath every estimate on Bloomberg. Survey data from April was positive too, with the NY Fed’s Empire State manufacturing survey seeing the general business conditions index rise to 26.3 (vs. 20.0 expected), in the best reading since 2017. On the inflation front, notably the prices paid index rose to its highest level since 2008, and the prices received index hit a record high. Elsewhere the Philadelphia Fed’s Manufacturing Business Outlook Survey rose to 50.3, which was its highest level since April 1973. March Industrial production was the main disappointment and only rose by +1.4% (vs. +2.5% expected). Separately, the NAHB’s housing market index for March rose by 1 point to 83 as expected.

Global equities reacted very strongly to the data tailwind and with lower yields at their backs, and as mentioned the S&P 500 soared to a fresh record in a broad-based advance that saw more than 75% of the index move higher on the day. The Dow Jones (+.90%) similarly hit a fresh record, and at one point in trading breached the 34,000 mark for the first time. 22 of 24 S&P 500 industry groups were higher on the day, with the only laggards being two of the cyclical industries that outperformed in the first quarter of the year, namely energy (-0.88%) and banks (-0.88%). Health care equipment (+2.21%) and semiconductors (+2.27%) were at the other end of the spectrum, leading the S&P higher. The outperformance of technology stocks led the NASDAQ composite to gain +1.31% yesterday, taking the index to within half a per cent of its record close.

Meanwhile Europe’s STOXX 600 (+0.55%) and the German DAX (+0.30%) both climbed to their own all-time highs. The moves in 10yr Treasuries saw the lowest yield close in over a month, with real yields (-6.1bps) driving the decline though inflation expectations (-0.8bps) fell back a touch on as well. The moves were somewhat replicated in Europe, where yields on 10yr bunds (-3.2bps), OATs (-3.4bps) and BTPs (-6.3bps) all fell. Italian bond yields fell the most since March 11 after €15b of redemptions paid Thursday and are said to be prioritising borrowing plans rather than the country’s budget deficit. 10yr gilt yields fell back -6.7 bps to 0.74%, similarly marking the biggest drop since early-March.

Overnight in Asia, we have seen China‘s economic data dump for March with Q1 2021 GDP printing largely in line with expectations at +18.3% yoy (vs. +18.5% yoy expected). In terms of quarterly growth the latest print came at +0.6% qoq as against an upwardly revised reading of +3.2% qoq (prior reading +2.6% qoq) in the previous quarter. The GDP growth was supported by a strong rebound in industrial output and robust exports even as consumer spending continued to lag. Besides this we also saw March industrial production which printed at +14.1% yoy as against expectations of +18.0% yoy while retail sales came in strong at +34.2% yoy (vs. +28.0% expected). Meanwhile, YtD March fixed asset investments ex rural stood at +25.6% yoy (vs. +26.0% yoy expected) and the surveyed jobless rate for March printed at +5.3% yoy vs. +5.4% yoy expected.

Against the backdrop of a relatively strong Chinese data, Asian markets are mostly trading up with the Shanghai Comp (+0.46%) leading the gains while the Nikkei (+0.09%), Hang Seng (+0.11%) and Kospi (+0.14%) are also up. Elsewhere, futures on the S&P 500 are down -0.10% and those on the Nasdaq are down a larger -0.20%. US 10y treasury yields are trading flattish this morning.

Another major story yesterday was the imposition of new US sanctions on Russia, which saw the Ruble decline against all the other major currencies, including a -0.76% loss against the US dollar. The moves saw 10 Russian diplomats expelled from the US, sanctions placed on over 30 individuals and entities, along with restrictions placed on the Russian primary debt market from June 14 that would prevent US institutions participating in new debt issuance by the central bank, finance ministry and sovereign wealth fund. In a letter to Congress detailing the Executive Order, Biden said that Russia’s actions such as “efforts to undermine the conduct of free and fair democratic elections”, constituted “an unusual and extraordinary threat to the national security, foreign policy, and economy of the United States.”

Over in Germany, the race to be the CDU/CSU chancellor candidate is still ongoing ahead of September’s federal election, with both the CDU’s Armin Laschet and the CSU’s Markus Soeder remaining in the running. As mentioned earlier in the week, the issue is that normally the larger CDU decides the nominee, but their leader Laschet is less popular than the CSU’s Soeder, which has led to calls for him to be the candidate instead, particularly given their decline in the opinion polls over the last couple of months, with the party only a few points ahead of the second-placed Greens. Speaking of the Greens, they themselves will be presenting their chancellor candidate on Monday, and given they’re running at second-place in the polls, their choice could potentially become Chancellor following the election. According to our German economists (link here),they think that the odds appear slightly tilted towards Annalena Baerbock being chosen, who co-leads the party along with Robert Habeck. Given the current polls, the Greens would only move into the chancellery through a “traffic light” coalition with the SPD and the Liberals. However, that would require the Liberals to cross a number of red lines, and our economists’ baseline scenario sees the Conservatives regaining support later in the year, leading to a CDU/CSU-Green coalition where the Greens are the junior partner.

On the pandemic, Germany’s head of the Robert Koch Institute called on the country’s hospitals to “significantly reduce” elective procedures and move stable patients as the occupancy rate in intensive-care units rose to 88% on Wednesday. This comes as new cases yesterday was up to 31,117 – the most since mid-January. While the case counts grow, North Rhine-Westphalia Premier Laschet - featured above – ruled out negotiating a deal to acquire the Sputnik V Covid-19 vaccine, due to Russia not having provided enough data on the vaccine. This is also why the EMA has not yet recommended its use. He also did not want to start an “arms race” between states, relative to a cohesive German deal. There was some good news on the vaccine front with Airfinity, a London-based research company, who announced that 1 billion doses of Covid-19 vaccines have been made so far and are forecasting the world could produce another 1 billion doses of vaccines in the next month alone as production ramps up. While the US is among the world-leaders in vaccination rates, cases are still raising sharply in pockets around the country. Maine - the northeastern most state - announced their largest one-day increase since January driven by younger unvaccinated people, according to state health data. 20 to 30 year olds make up roughly a fifth of all new cases, compared with eight per cent at the start of the year. Elsewhere numbers continue to improve, NY state hospitalizations fell to their lowest level since December 1 and the weekly average rate of positive test results fell to 3.05%, which is the lowest since November 25.

To the day ahead now, and the data highlights include US housing starts and building permits for March, along with the preliminary University of Michigan consumer sentiment index for April. Meanwhile in Europe, there’s the new EU car registrations for March and the final Euro Area CPI reading for that month as well. Otherwise, central bank speakers include Dallas Fed President Kaplan and BoE Deputy Governor Cunliffe, and earnings releases include Morgan Stanley and BNY Mellon.

Tyler Durden Fri, 04/16/2021 - 07:46

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Rand Paul Teases Senate GOP Leader Run – Musk Says “I Would Support”

Rand Paul Teases Senate GOP Leader Run – Musk Says "I Would Support"

Republican Kentucky Senator Rand Paul on Friday hinted that he may jump…

Published

3 hours ago

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March 10, 2024

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Rand Paul Teases Senate GOP Leader Run - Musk Says "I Would Support"

Republican Kentucky Senator Rand Paul on Friday hinted that he may jump into the race to become the next Senate GOP leader, and Elon Musk was quick to support the idea. Republicans must find a successor for periodically malfunctioning Mitch McConnell, who recently announced he'll step down in November, though intending to keep his Senate seat until his term ends in January 2027, when he'd be within weeks of turning 86. 

So far, the announced field consists of two quintessential establishment types: John Cornyn of Texas and John Thune of South Dakota. While John Barrasso's name had been thrown around as one of "The Three Johns" considered top contenders, the Wyoming senator on Tuesday said he'll instead seek the number two slot as party whip. 

Paul used X to tease his potential bid for the position which -- if the GOP takes back the upper chamber in November -- could graduate from Minority Leader to Majority Leader. He started by telling his 5.1 million followers he'd had lots of people asking him about his interest in running...

...then followed up with a poll in which he predictably annihilated Cornyn and Thune, taking a 96% share as of Friday night, with the other two below 2% each. 

Elon Musk was quick to back the idea of Paul as GOP leader, while daring Cornyn and Thune to follow Paul's lead by throwing their names out for consideration by the Twitter-verse X-verse. 

Paul has been a stalwart opponent of security-state mass surveillance, foreign interventionism -- to include shoveling billions of dollars into the proxy war in Ukraine -- and out-of-control spending in general. He demonstrated the latter passion on the Senate floor this week as he ridiculed the latest kick-the-can spending package:   

In February, Paul used Senate rules to force his colleagues into a grueling Super Bowl weekend of votes, as he worked to derail a $95 billion foreign aid bill. "I think we should stay here as long as it takes,” said Paul. “If it takes a week or a month, I’ll force them to stay here to discuss why they think the border of Ukraine is more important than the US border.”

Don't expect a Majority Leader Paul to ditch the filibuster -- he's been a hardy user of the legislative delay tactic. In 2013, he spoke for 13 hours to fight the nomination of John Brennan as CIA director. In 2015, he orated for 10-and-a-half-hours to oppose extension of the Patriot Act. 

Rand Paul amid his 10 1/2 hour filibuster in 2015

Among the general public, Paul is probably best known as Capitol Hill's chief tormentor of Dr. Anthony Fauci, who was director of the National Institute of Allergy and Infectious Disease during the Covid-19 pandemic. Paul says the evidence indicates the virus emerged from China's Wuhan Institute of Virology. He's accused Fauci and other members of the US government public health apparatus of evading questions about their funding of the Chinese lab's "gain of function" research, which takes natural viruses and morphs them into something more dangerous. Paul has pointedly said that Fauci committed perjury in congressional hearings and that he belongs in jail "without question."   

Musk is neither the only nor the first noteworthy figure to back Paul for party leader. Just hours after McConnell announced his upcoming step-down from leadership, independent 2024 presidential candidate Robert F. Kennedy, Jr voiced his support: 

In a testament to the extent to which the establishment recoils at the libertarian-minded Paul, mainstream media outlets -- which have been quick to report on other developments in the majority leader race -- pretended not to notice that Paul had signaled his interest in the job. More than 24 hours after Paul's test-the-waters tweet-fest began, not a single major outlet had brought it to the attention of their audience. 

That may be his strongest endorsement yet. 

Tyler Durden Sun, 03/10/2024 - 20:25

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The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While “Waiting” For Deporation, Asylum

The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While "Waiting" For Deporation, Asylum

Over the past several…

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March 10, 2024

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The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While "Waiting" For Deporation, Asylum

Over the past several months we've pointed out that there has  been zero job creation for native-born workers since the summer of 2018...

... and that since Joe Biden was sworn into office, most of the post-pandemic job gains the administration continuously brags about have gone foreign-born (read immigrants, mostly illegal ones) workers.

And while the left might find this data almost as verboten as FBI crime statistics - as it directly supports the so-called "great replacement theory" we're not supposed to discuss - it also coincides with record numbers of illegal crossings into the United States under Biden.

In short, the Biden administration opened the floodgates, 10 million illegal immigrants poured into the country, and most of the post-pandemic "jobs recovery" went to foreign-born workers, of which illegal immigrants represent the largest chunk.

Asylum seekers from Venezuela await work permits on June 28, 2023 (via the Chicago Tribune)

'But Tyler, illegal immigrants can't possibly work in the United States whilst awaiting their asylum hearings,' one might hear from the peanut gallery. On the contrary: ever since Biden reversed a key aspect of Trump's labor policies, all illegal immigrants - even those awaiting deportation proceedings - have been given carte blanche to work while awaiting said proceedings for up to five years...

... something which even Elon Musk was shocked to learn.

Which leads us to another question: recall that the primary concern for the Biden admin for much of 2022 and 2023 was soaring prices, i.e., relentless inflation in general, and rising wages in particular, which in turn prompted even Goldman to admit two years ago that the diabolical wage-price spiral had been unleashed in the US (diabolical, because nothing absent a major economic shock, read recession or depression, can short-circuit it once it is in place).

Well, there is one other thing that can break the wage-price spiral loop: a flood of ultra-cheap illegal immigrant workers. But don't take our word for it: here is Fed Chair Jerome Powell himself during his February 60 Minutes interview:

PELLEY: Why was immigration important?

POWELL: Because, you know, immigrants come in, and they tend to work at a rate that is at or above that for non-immigrants. Immigrants who come to the country tend to be in the workforce at a slightly higher level than native Americans do. But that's largely because of the age difference. They tend to skew younger.

PELLEY: Why is immigration so important to the economy?

POWELL: Well, first of all, immigration policy is not the Fed's job. The immigration policy of the United States is really important and really much under discussion right now, and that's none of our business. We don't set immigration policy. We don't comment on it.

I will say, over time, though, the U.S. economy has benefited from immigration. And, frankly, just in the last, year a big part of the story of the labor market coming back into better balance is immigration returning to levels that were more typical of the pre-pandemic era.

PELLEY: The country needed the workers.

POWELL: It did. And so, that's what's been happening.

Translation: Immigrants work hard, and Americans are lazy. But much more importantly, since illegal immigrants will work for any pay, and since Biden's Department of Homeland Security, via its Citizenship and Immigration Services Agency, has made it so illegal immigrants can work in the US perfectly legally for up to 5 years (if not more), one can argue that the flood of illegals through the southern border has been the primary reason why inflation - or rather mostly wage inflation, that all too critical component of the wage-price spiral  - has moderated in in the past year, when the US labor market suddenly found itself flooded with millions of perfectly eligible workers, who just also happen to be illegal immigrants and thus have zero wage bargaining options.

None of this is to suggest that the relentless flood of immigrants into the US is not also driven by voting and census concerns - something Elon Musk has been pounding the table on in recent weeks, and has gone so far to call it "the biggest corruption of American democracy in the 21st century", but in retrospect, one can also argue that the only modest success the Biden admin has had in the past year - namely bringing inflation down from a torrid 9% annual rate to "only" 3% - has also been due to the millions of illegals he's imported into the country.

We would be remiss if we didn't also note that this so often carries catastrophic short-term consequences for the social fabric of the country (the Laken Riley fiasco being only the latest example), not to mention the far more dire long-term consequences for the future of the US - chief among them the trillions of dollars in debt the US will need to incur to pay for all those new illegal immigrants Democrat voters and low-paid workers. This is on top of the labor revolution that will kick in once AI leads to mass layoffs among high-paying, white-collar jobs, after which all those newly laid off native-born workers hoping to trade down to lower paying (if available) jobs will discover that hardened criminals from Honduras or Guatemala have already taken them, all thanks to Joe Biden.

Tyler Durden Sun, 03/10/2024 - 19:15

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‘I couldn’t stand the pain’: the Turkish holiday resort that’s become an emergency dental centre for Britons who can’t get treated at home

The crisis in NHS dentistry is driving increasing numbers abroad for treatment. Here are some of their stories.

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March 10, 2024

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This clinic in the Turkish resort of Antalya is the official 'dental sponsor' of the Miss England competition. Diana Ibanez-Tirado, Author provided

It’s a hot summer day in the Turkish city of Antalya, a Mediterranean resort with golden beaches, deep blue sea and vibrant nightlife. The pool area of the all-inclusive resort is crammed with British people on sun loungers – but they aren’t here for a holiday. This hotel is linked to a dental clinic that organises treatment packages, and most of these guests are here to see a dentist.

From Norwich, two women talk about gums and injections. A man from Wales holds a tissue close to his mouth and spits blood – he has just had two molars extracted.

The dental clinic organises everything for these dental “tourists” throughout their treatment, which typically lasts from three to 15 days. The stories I hear of what has caused them to travel to Turkey are strikingly similar: all have struggled to secure dental treatment at home on the NHS.

“The hotel is nice and some days I go to the beach,” says Susan*, a hairdresser in her mid-30s from Norwich. “But really, we aren’t tourists like in a proper holiday. We come here because we have no choice. I couldn’t stand the pain.”

Seaside beach resort with mountains in the distance
The Turkish Mediterranean resort of Antalya. Akimov Konstantin/Shutterstock

This is Susan’s second visit to Antalya. She explains that her ordeal started two years earlier:

I went to an NHS dentist who told me I had gum disease … She did some cleaning to my teeth and gums but it got worse. When I ate, my teeth were moving … the gums were bleeding and it was very painful. I called to say I was in pain but the clinic was not accepting NHS patients any more.

The only option the dentist offered Susan was to register as a private patient:

I asked how much. They said £50 for x-rays and then if the gum disease got worse, £300 or so for extraction. Four of them were moving – imagine: £1,200 for losing your teeth! Without teeth I’d lose my clients, but I didn’t have the money. I’m a single mum. I called my mum and cried.

Susan’s mother told her about a friend of hers who had been to Turkey for treatment, then together they found a suitable clinic:

The prices are so much cheaper! Tooth extraction, x-rays, consultations – it all comes included. The flight and hotel for seven days cost the same as losing four teeth in Norwich … I had my lower teeth removed here six months ago, now I’ve got implants … £2,800 for everything – hotel, transfer, treatments. I only paid the flights separately.

In the UK, roughly half the adult population suffers from periodontitis – inflammation of the gums caused by plaque bacteria that can lead to irreversible loss of gums, teeth, and bone. Regular reviews by a dentist or hygienist are required to manage this condition. But nine out of ten dental practices cannot offer NHS appointments to new adult patients, while eight in ten are not accepting new child patients.

Some UK dentists argue that Britons who travel abroad for treatment do so mainly for cosmetic procedures. They warn that dental tourism is dangerous, and that if their treatment goes wrong, dentists in the UK will be unable to help because they don’t want to be responsible for further damage. Susan shrugs this off:

Dentists in England say: ‘If you go to Turkey, we won’t touch you [afterwards].’ But I don’t worry because there are no appointments at home anyway. They couldn’t help in the first place, and this is why we are in Turkey.

‘How can we pay all this money?’

As a social anthropologist, I travelled to Turkey a number of times in 2023 to investigate the crisis of NHS dentistry, and the journeys abroad that UK patients are increasingly making as a result. I have relatives in Istanbul and have been researching migration and trading patterns in Turkey’s largest city since 2016.

In August 2023, I visited the resort in Antalya, nearly 400 miles south of Istanbul. As well as Susan, I met a group from a village in Wales who said there was no provision of NHS dentistry back home. They had organised a two-week trip to Turkey: the 12-strong group included a middle-aged couple with two sons in their early 20s, and two couples who were pensioners. By going together, Anya tells me, they could support each other through their different treatments:

I’ve had many cavities since I was little … Before, you could see a dentist regularly – you didn’t even think about it. If you had pain or wanted a regular visit, you phoned and you went … That was in the 1990s, when I went to the dentist maybe every year.

Anya says that once she had children, her family and work commitments meant she had no time to go to the dentist. Then, years later, she started having serious toothache:

Every time I chewed something, it hurt. I ate soups and soft food, and I also lost weight … Even drinking was painful – tea: pain, cold water: pain. I was taking paracetamol all the time! I went to the dentist to fix all this, but there were no appointments.

Anya was told she would have to wait months, or find a dentist elsewhere:

A private clinic gave me a list of things I needed done. Oh my God, almost £6,000. My husband went too – same story. How can we pay all this money? So we decided to come to Turkey. Some people we know had been here, and others in the village wanted to come too. We’ve brought our sons too – they also need to be checked and fixed. Our whole family could be fixed for less than £6,000.

By the time they travelled, Anya’s dental problems had turned into a dental emergency. She says she could not live with the pain anymore, and was relying on paracetamol.

In 2023, about 6 million adults in the UK experienced protracted pain (lasting more than two weeks) caused by toothache. Unintentional paracetamol overdose due to dental pain is a significant cause of admissions to acute medical units. If left untreated, tooth infections can spread to other parts of the body and cause life-threatening complications – and on rare occasions, death.

In February 2024, police were called to manage hundreds of people queuing outside a newly opened dental clinic in Bristol, all hoping to be registered or seen by an NHS dentist. One in ten Britons have admitted to performing “DIY dentistry”, of which 20% did so because they could not find a timely appointment. This includes people pulling out their teeth with pliers and using superglue to repair their teeth.

In the 1990s, dentistry was almost entirely provided through NHS services, with only around 500 solely private dentists registered. Today, NHS dentist numbers in England are at their lowest level in a decade, with 23,577 dentists registered to perform NHS work in 2022-23, down 695 on the previous year. Furthermore, the precise division of NHS and private work that each dentist provides is not measured.

The COVID pandemic created longer waiting lists for NHS treatment in an already stretched public service. In Bridlington, Yorkshire, people are now reportedly having to wait eight-to-nine years to get an NHS dental appointment with the only remaining NHS dentist in the town.

In his book Patients of the State (2012), Argentine sociologist Javier Auyero describes the “indignities of waiting”. It is the poor who are mostly forced to wait, he writes. Queues for state benefits and public services constitute a tangible form of power over the marginalised. There is an ethnic dimension to this story, too. Data suggests that in the UK, patients less likely to be effective in booking an NHS dental appointment are non-white ethnic groups and Gypsy or Irish travellers, and that it is particularly challenging for refugees and asylum-seekers to access dental care.

This article is part of Conversation Insights
The Insights team generates long-form journalism derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.

In 2022, I experienced my own dental emergency. An infected tooth was causing me debilitating pain, and needed root canal treatment. I was advised this would cost £71 on the NHS, plus £307 for a follow-up crown – but that I would have to wait months for an appointment. The pain became excruciating – I could not sleep, let alone wait for months. In the same clinic, privately, I was quoted £1,300 for the treatment (more than half my monthly income at the time), or £295 for a tooth extraction.

I did not want to lose my tooth because of lack of money. So I bought a flight to Istanbul immediately for the price of the extraction in the UK, and my tooth was treated with root canal therapy by a private dentist there for £80. Including the costs of travelling, the total was a third of what I was quoted to be treated privately in the UK. Two years on, my treated tooth hasn’t given me any more problems.

A better quality of life

Not everyone is in Antalya for emergency procedures. The pensioners from Wales had contacted numerous clinics they found on the internet, comparing prices, treatments and hotel packages at least a year in advance, in a carefully planned trip to get dental implants – artificial replacements for tooth roots that help support dentures, crowns and bridges.

Street view of a dental clinic in Antalya, Turkey
Dental clinic in Antalya, Turkey. Diana Ibanez-Tirado, CC BY-NC-ND

In Turkey, all the dentists I speak to (most of whom cater mainly for foreigners, including UK nationals) consider implants not a cosmetic or luxurious treatment, but a development in dentistry that gives patients who are able to have the procedure a much better quality of life. This procedure is not available on the NHS for most of the UK population, and the patients I meet in Turkey could not afford implants in private clinics back home.

Paul is in Antalya to replace his dentures, which have become uncomfortable and irritating to his gums, with implants. He says he couldn’t find an appointment to see an NHS dentist. His wife Sonia went through a similar procedure the year before and is very satisfied with the results, telling me: “Why have dentures that you need to put in a glass overnight, in the old style? If you can have implants, I say, you’re better off having them.”

Most of the dental tourists I meet in Antalya are white British: this city, known as the Turkish Riviera, has developed an entire economy catering to English-speaking tourists. In 2023, more than 1.3 million people visited the city from the UK, up almost 15% on the previous year.

Read more: NHS dentistry is in crisis – are overseas dentists the answer?

In contrast, the Britons I meet in Istanbul are predominantly from a non-white ethnic background. Omar, a pensioner of Pakistani origin in his early 70s, has come here after waiting “half a year” for an NHS appointment to fix the dental bridge that is causing him pain. Omar’s son had been previously for a hair transplant, and was offered a free dental checkup by the same clinic, so he suggested it to his father. Having worked as a driver for a manufacturing company for two decades in Birmingham, Omar says he feels disappointed to have contributed to the British economy for so long, only to be “let down” by the NHS:

At home, I must wait and wait and wait to get a bridge – and then I had many problems with it. I couldn’t eat because the bridge was uncomfortable and I was in pain, but there were no appointments on the NHS. I asked a private dentist and they recommended implants, but they are far too expensive [in the UK]. I started losing weight, which is not a bad thing at the beginning, but then I was worrying because I couldn’t chew and eat well and was losing more weight … Here in Istanbul, I got dental implants – US$500 each, problem solved! In England, each implant is maybe £2,000 or £3,000.

In the waiting area of another clinic in Istanbul, I meet Mariam, a British woman of Iraqi background in her late 40s, who is making her second visit to the dentist here. Initially, she needed root canal therapy after experiencing severe pain for weeks. Having been quoted £1,200 in a private clinic in outer London, Mariam decided to fly to Istanbul instead, where she was quoted £150 by a dentist she knew through her large family. Even considering the cost of the flight, Mariam says the decision was obvious:

Dentists in England are so expensive and NHS appointments so difficult to find. It’s awful there, isn’t it? Dentists there blamed me for my rotten teeth. They say it’s my fault: I don’t clean or I ate sugar, or this or that. I grew up in a village in Iraq and didn’t go to the dentist – we were very poor. Then we left because of war, so we didn’t go to a dentist … When I arrived in London more than 20 years ago, I didn’t speak English, so I still didn’t go to the dentist … I think when you move from one place to another, you don’t go to the dentist unless you are in real, real pain.

In Istanbul, Mariam has opted not only for the urgent root canal treatment but also a longer and more complex treatment suggested by her consultant, who she says is a renowned doctor from Syria. This will include several extractions and implants of back and front teeth, and when I ask what she thinks of achieving a “Hollywood smile”, Mariam says:

Who doesn’t want a nice smile? I didn’t come here to be a model. I came because I was in pain, but I know this doctor is the best for implants, and my front teeth were rotten anyway.

Dentists in the UK warn about the risks of “overtreatment” abroad, but Mariam appears confident that this is her opportunity to solve all her oral health problems. Two of her sisters have already been through a similar treatment, so they all trust this doctor.

Alt text
An Istanbul clinic founded by Afghan dentists has a message for its UK customers. Diana Ibanez-Tirado, CC BY-NC-ND

The UK’s ‘dental deserts’

To get a fuller understanding of the NHS dental crisis, I’ve also conducted 20 interviews in the UK with people who have travelled or were considering travelling abroad for dental treatment.

Joan, a 50-year-old woman from Exeter, tells me she considered going to Turkey and could have afforded it, but that her back and knee problems meant she could not brave the trip. She has lost all her lower front teeth due to gum disease and, when I meet her, has been waiting 13 months for an NHS dental appointment. Joan tells me she is living in “shame”, unable to smile.

In the UK, areas with extremely limited provision of NHS dental services – known as as “dental deserts” – include densely populated urban areas such as Portsmouth and Greater Manchester, as well as many rural and coastal areas.

In Felixstowe, the last dentist taking NHS patients went private in 2023, despite the efforts of the activist group Toothless in Suffolk to secure better access to NHS dentists in the area. It’s a similar story in Ripon, Yorkshire, and in Dumfries & Galloway, Scotland, where nearly 25,000 patients have been de-registered from NHS dentists since 2021.

Data shows that 2 million adults must travel at least 40 miles within the UK to access dental care. Branding travel for dental care as “tourism” carries the risk of disguising the elements of duress under which patients move to restore their oral health – nationally and internationally. It also hides the immobility of those who cannot undertake such journeys.

The 90-year-old woman in Dumfries & Galloway who now faces travelling for hours by bus to see an NHS dentist can hardly be considered “tourism” – nor the Ukrainian war refugees who travelled back from West Sussex and Norwich to Ukraine, rather than face the long wait to see an NHS dentist.

Many people I have spoken to cannot afford the cost of transport to attend dental appointments two hours away – or they have care responsibilities that make it impossible. Instead, they are forced to wait in pain, in the hope of one day securing an appointment closer to home.

Billboard advertising a dental clinic in Turkey
Dental clinics have mushroomed in recent years in Turkey, thanks to the influx of foreign patients seeking a wide range of treatments. Diana Ibanez-Tirado, CC BY-NC-ND

‘Your crisis is our business’

The indignities of waiting in the UK are having a big impact on the lives of some local and foreign dentists in Turkey. Some neighbourhoods are rapidly changing as dental and other health clinics, usually in luxurious multi-storey glass buildings, mushroom. In the office of one large Istanbul medical complex with sections for hair transplants and dentistry (plus one linked to a hospital for more extensive cosmetic surgery), its Turkish owner and main investor tells me:

Your crisis is our business, but this is a bazaar. There are good clinics and bad clinics, and unfortunately sometimes foreign patients do not know which one to choose. But for us, the business is very good.

This clinic only caters to foreign patients. The owner, an architect by profession who also developed medical clinics in Brazil, describes how COVID had a major impact on his business:

When in Europe you had COVID lockdowns, Turkey allowed foreigners to come. Many people came for ‘medical tourism’ – we had many patients for cosmetic surgery and hair transplants. And that was when the dental business started, because our patients couldn’t see a dentist in Germany or England. Then more and more patients started to come for dental treatments, especially from the UK and Ireland. For them, it’s very, very cheap here.

The reasons include the value of the Turkish lira relative to the British pound, the low cost of labour, the increasing competition among Turkish clinics, and the sheer motivation of dentists here. While most dentists catering to foreign patients are from Turkey, others have arrived seeking refuge from war and violence in Syria, Iraq, Afghanistan, Iran and beyond. They work diligently to rebuild their lives, careers and lost wealth.

Regardless of their origin, all dentists in Turkey must be registered and certified. Hamed, a Syrian dentist and co-owner of a new clinic in Istanbul catering to European and North American patients, tells me:

I know that you say ‘Syrian’ and people think ‘migrant’, ‘refugee’, and maybe think ‘how can this dentist be good?’ – but Syria, before the war, had very good doctors and dentists. Many of us came to Turkey and now I have a Turkish passport. I had to pass the exams to practise dentistry here – I study hard. The exams are in Turkish and they are difficult, so you cannot say that Syrian doctors are stupid.

Hamed talks excitedly about the latest technology that is coming to his profession: “There are always new materials and techniques, and we cannot stop learning.” He is about to travel to Paris to an international conference:

I can say my techniques are very advanced … I bet I put more implants and do more bone grafting and surgeries every week than any dentist you know in England. A good dentist is about practice and hand skills and experience. I work hard, very hard, because more and more patients are arriving to my clinic, because in England they don’t find dentists.

Dental equipment in a Turkish treatment room
Dentists in Turkey boast of using the latest technology. Diana Ibanez-Tirado, CC BY-NC-ND

While there is no official data about the number of people travelling from the UK to Turkey for dental treatment, investors and dentists I speak to consider that numbers are rocketing. From all over the world, Turkey received 1.2 million visitors for “medical tourism” in 2022, an increase of 308% on the previous year. Of these, about 250,000 patients went for dentistry. One of the most renowned dental clinics in Istanbul had only 15 British patients in 2019, but that number increased to 2,200 in 2023 and is expected to reach 5,500 in 2024.

Like all forms of medical care, dental treatments carry risks. Most clinics in Turkey offer a ten-year guarantee for treatments and a printed clinical history of procedures carried out, so patients can show this to their local dentists and continue their regular annual care in the UK. Dental treatments, checkups and maintaining a good oral health is a life-time process, not a one-off event.

Many UK patients, however, are caught between a rock and a hard place – criticised for going abroad, yet unable to get affordable dental care in the UK before and after their return. The British Dental Association has called for more action to inform these patients about the risks of getting treated overseas – and has warned UK dentists about the legal implications of treating these patients on their return. But this does not address the difficulties faced by British patients who are being forced to go abroad in search of affordable, often urgent dental care.

A global emergency

The World Health Organization states that the explosion of oral disease around the world is a result of the “negligent attitude” that governments, policymakers and insurance companies have towards including oral healthcare under the umbrella of universal healthcare. It as if the health of our teeth and mouth is optional; somehow less important than treatment to the rest of our body. Yet complications from untreated tooth decay can lead to hospitalisation.

The main causes of oral health diseases are untreated tooth decay, severe gum disease, toothlessness, and cancers of the lip and oral cavity. Cases grew during the pandemic, when little or no attention was paid to oral health. Meanwhile, the global cosmetic dentistry market is predicted to continue growing at an annual rate of 13% for the rest of this decade, confirming the strong relationship between socioeconomic status and access to oral healthcare.

In the UK since 2018, there have been more than 218,000 admissions to hospital for rotting teeth, of which more than 100,000 were children. Some 40% of children in the UK have not seen a dentist in the past 12 months. The role of dentists in prevention of tooth decay and its complications, and in the early detection of mouth cancer, is vital. While there is a 90% survival rate for mouth cancer if spotted early, the lack of access to dental appointments is causing cases to go undetected.

The reasons for the crisis in NHS dentistry are complex, but include: the real-term cuts in funding to NHS dentistry; the challenges of recruitment and retention of dentists in rural and coastal areas; pay inequalities facing dental nurses, most of them women, who are being badly hit by the cost of living crisis; and, in England, the 2006 Dental Contract that does not remunerate dentists in a way that encourages them to continue seeing NHS patients.

The UK is suffering a mass exodus of the public dentistry workforce, with workers leaving the profession entirely or shifting to the private sector, where payments and life-work balance are better, bureaucracy is reduced, and prospects for career development look much better. A survey of general dental practitioners found that around half have reduced their NHS work since the pandemic – with 43% saying they were likely to go fully private, and 42% considering a career change or taking early retirement.

Reversing the UK’s dental crisis requires more commitment to substantial reform and funding than the “recovery plan” announced by Victoria Atkins, the secretary of state for health and social care, on February 7.

The stories I have gathered show that people travelling abroad for dental treatment don’t see themselves as “tourists” or vanity-driven consumers of the “Hollywood smile”. Rather, they have been forced by the crisis in NHS dentistry to seek out a service 1,500 miles away in Turkey that should be a basic, affordable right for all, on their own doorstep.

*Names in this article have been changed to protect the anonymity of the interviewees.

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Diana Ibanez Tirado receives funding from the School of Global Studies, University of Sussex.

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