National Health Service Dentistry

– in the Scottish Parliament on 31 May 2023.

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Photo of Willie Rennie Willie Rennie Liberal Democrat

8. To ask the Scottish Government whether it will provide an update on what action it will take to reverse the reported decline of national health service dentistry. (S6O-02307)

Photo of Jenni Minto Jenni Minto Scottish National Party

The new policy prospectus, which the Government set out on 18 April, commits us to sustained and improved equitable national access to NHS dentistry by 2026. The previous Cabinet Secretary for Health and Social Care recently confirmed the continuation of the bridging payment to 31 October 2023, while we prepare for the implementation of payment reform. Payment reform will comprise a new, modernised system that will provide NHS dental teams with greater clinical discretion and transparency for NHS patients.

Photo of Willie Rennie Willie Rennie Liberal Democrat

Another month has passed and I am afraid that we still have no clarity about what the future fee payment system will be for dentists. Meanwhile, we hear from people such as Jim Fairlie that dentists are leaving the NHS system. When will the minister get a grip on the situation and bring forward the payment system so that we have more clarity and stop the rot in NHS dentistry?

Photo of Jenni Minto Jenni Minto Scottish National Party

I am sure that Willie Rennie will understand that our discussions with the British Dental Association need to remain confidential. However, I will update Parliament as soon as I can.

Photo of Sandesh Gulhane Sandesh Gulhane Conservative

The Scottish National Party-Green Government does not understand NHS dentistry. The minister has said that there is a low-bureaucracy model; well, if you are a qualified dentist who has been practising for many years abroad, or even in England, Wales or Northern Ireland, and you want to come to Scotland, you have to be recruited as a vocational training by equivalence—VTE—assistant, which means working under supervision for a year and not independently as a dentist. As a result, we have the frankly ludicrous scenario of highly qualified dentists, often with many years of experience, being required to work as trainees for a year if they wish to move to Scotland, which deters dentists from coming to the country.

Will the minister commit to removing that bureaucratic red tape so that we can attract qualified dentists to Scotland?

Photo of Jenni Minto Jenni Minto Scottish National Party

Sandesh Gulhane’s question refers to a United Kingdom-wide issue.

The Scottish Government is working closely with the other nations; I am, in fact, in the process of writing to them to see whether we can find a better process to ensure that we get the right dentists—

Photo of Sue Webber Sue Webber Conservative

That is factually incorrect—

The Deputy Presiding Officer:

Please resume your seat, minister. The question has been posed and the minister is responding. We do not need sedentary interventions; there are other routes.

Please continue, minister.

Photo of Jenni Minto Jenni Minto Scottish National Party

I am in the process of writing to the UK Government to work with it in a four-nation process to try to alleviate that situation.

Photo of Paul Sweeney Paul Sweeney Labour

With the accessibility of NHS dentistry declining, oral health inequalities are widening and access to dental care, particularly for vulnerable groups such as children and young people, is crucial.

What steps is the Government taking to support the recovery and future of oral health improvement programmes, such as the Labour legacy of Childsmile, caring for smiles and mouth matters?

Photo of Jenni Minto Jenni Minto Scottish National Party

I was going to reference Childsmile, too, because it is a fantastic project that really helps to educate young children about the importance of oral health. Over the longer term, we have seen significant improvements in child oral health. For example, the first year of the national dental inspection programme, in 2002-03, showed that 45 per cent of primary 1 children had no obvious decay experience. Despite the unique challenges of the pandemic, that figure has increased to 73 per cent.

As of 1 February last year, the Scottish Government introduced changes that permanently increased enhanced fees for examination appointments for both adults and children. For the first time, dentists would receive a fee for examinations for children.

Photo of Ivan McKee Ivan McKee Scottish National Party

What is the Scottish Government doing to proactively encourage the use of digital dentistry, particularly oral scanners, which offer significant time savings for dentists, thus increasing capacity; cost savings for the health service; economic development opportunities for Scotland’s live science sector; and which prevent Scotland from falling behind global best practice in that regard?

Photo of Jenni Minto Jenni Minto Scottish National Party

Ivan McKee raises a really important point. I remind the chamber that NHS dentistry is provided by independent contractors and that the use of digital technology is ultimately a business decision for them.

The use of digital technology in dentistry is becoming more commonplace, which I very much welcome. It affords dentists potential cost savings and provides improved patient experiences. I am confident that, through payment reform, we will enable dentists to make use of digital technology where they deem it appropriate—for example, by using digital scanners rather than taking physical impressions of teeth.

Photo of Colin Smyth Colin Smyth Labour

Does the minister accept that dentists are aware of all the policy initiatives that she talks about—the fact that payment is continuing until 31 October and that a new payments regime will come into place—but that they are still choosing to withdraw from NHS provision? More than 20,000 patients in Dumfries and Galloway alone have been deregistered from the NHS recently. Why does the minister think that that is happening, if the new regime is going to solve the problems?

Photo of Jenni Minto Jenni Minto Scottish National Party

Payment reform constitutes one of our national responses for dentistry. By putting in the framework of payment reform, it is our intention to lay the foundations to ensure further engagement with dentists to look at the points that the member has raised.