Chamber
Plenary, 25 Oct 2000
25 Oct 2000 · S1 · Plenary
Item of business
Primary Dental Care
No one would disagree that oral health is important, that we do not want our children to have fillings or extractions, and that all of us should retain a healthy mouthful of teeth and gums throughout our lives. Unfortunately, we are a long way short of achieving that. It is important to set out how we can get from where we are to where we want to be; in that context, the action plan is to be welcomed.
Let us begin at the beginning, with prevention. The first-line tools that are available are information and education. People can deliver those in a variety of public and private sector arenas, and the budget for health education has been boosted. I do not want to say much more about prevention, except that I welcome especially the proposed action on local co-ordinated community programmes, which I regard as one of the best ways forward. They will form a long, slow process but they are possibly the only truly effective long-term answer. There is a necessity to change people's behaviour, and achieving that will require sustained personal contact over a long period.
The next line of defence—or attack, depending on how one looks at it—is intervention. That covers such measures as fissure sealings, the supply of fluoridated milk and the fluoridation of water. The partnership agreement proposes widespread consultation on whether water supplies should be fluoridated. Dental professionals regard fluoridation as an effective way of achieving dental health improvement, and it is superficially attractive in its efficacy. It is a fairly draconian measure, and evidence and general acceptance that it is an appropriate way forward must be secured. I do not support Robin Harper's amendment, which would eliminate the option of fluoridation without due public examination.
One of the most important elements in the whole equation is the general dental practitioner. The ideal would be for everyone to be registered with a dentist and to have regular dental check-ups. That is easier said than done, not least because there are not enough dentists. Not every airt and pairt of Scotland has an accessible dental practitioner.
About 20 years ago, the powers that were decided that dental health was improving, so three dental schools were closed; two in England and one in Scotland. With hindsight, that was probably a mistake.
Let us begin at the beginning, with prevention. The first-line tools that are available are information and education. People can deliver those in a variety of public and private sector arenas, and the budget for health education has been boosted. I do not want to say much more about prevention, except that I welcome especially the proposed action on local co-ordinated community programmes, which I regard as one of the best ways forward. They will form a long, slow process but they are possibly the only truly effective long-term answer. There is a necessity to change people's behaviour, and achieving that will require sustained personal contact over a long period.
The next line of defence—or attack, depending on how one looks at it—is intervention. That covers such measures as fissure sealings, the supply of fluoridated milk and the fluoridation of water. The partnership agreement proposes widespread consultation on whether water supplies should be fluoridated. Dental professionals regard fluoridation as an effective way of achieving dental health improvement, and it is superficially attractive in its efficacy. It is a fairly draconian measure, and evidence and general acceptance that it is an appropriate way forward must be secured. I do not support Robin Harper's amendment, which would eliminate the option of fluoridation without due public examination.
One of the most important elements in the whole equation is the general dental practitioner. The ideal would be for everyone to be registered with a dentist and to have regular dental check-ups. That is easier said than done, not least because there are not enough dentists. Not every airt and pairt of Scotland has an accessible dental practitioner.
About 20 years ago, the powers that were decided that dental health was improving, so three dental schools were closed; two in England and one in Scotland. With hindsight, that was probably a mistake.
In the same item of business
The Presiding Officer (Sir David Steel):
NPA
The main business of the afternoon is the debate on motion S1M-1271, in the name of Susan Deacon, on primary dental care services. I have selected two amendm...
The Deputy Minister for Community Care (Iain Gray):
Lab
In the debate on public health on 5 October, Susan Deacon made it clear that oral and dental health are priorities for the Executive. In that debate, several...
Mrs Margaret Ewing (Moray) (SNP):
SNP
Is it not also the case that the York study indicated that further research had to be done on fluoridation?
Iain Gray:
Lab
That is the case, and the study commented on the methodologies of the studies that it considered. However, if Mrs Ewing will bear with me, I will say somethi...
Phil Gallie (South of Scotland) (Con):
Con
Is the minister aware of the proposal, made by dentists in Ayrshire, to establish an emergency call-out system in line with the extremely successful out-of-h...
Iain Gray:
Lab
We are aware of the initiative and we will pursue an interest in that. The action plan that I referred to includes, in the long term, an examination of how w...
Elaine Smith (Coatbridge and Chryston) (Lab):
Lab
Where does the funding for those dentists come from? Do health boards have to find the funding?
Iain Gray:
Lab
The funding comes through the health board and the approval to appoint a salaried dentist is given by Scottish ministers, but of course health boards have fu...
Dorothy-Grace Elder (Glasgow) (SNP):
SNP
Can I take it that the minister does not approve of the installation of confectionery and soft-drink vending machines in school halls, which seems to oppose ...
Iain Gray:
Lab
I want to move on to talk about effects on health, on which there has been some debate. I think that Dorothy-Grace Elder is thinking in particular about the ...
Mr Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
So far, the minister has not mentioned that one of the main ways to improve dental health would be to increase the number of dental graduates. He referred to...
Iain Gray:
Lab
If Mr Rumbles will bear with me, the next section of my speech will address some of the issues that he raises.We need our general dental practitioners to pla...
Nicola Sturgeon (Glasgow) (SNP):
SNP
I welcome today's debate and the fact that the improvement of dental and oral health is being prioritised by the Scottish Executive. As the minister has outl...
Mr Brian Monteith (Mid Scotland and Fife) (Con):
Con
I admit that it is a long time since I was at school, but when I was there I ran the tuck shop, which sold Mars bars—
Mr Rumbles:
LD
We can see that.
Mr Monteith:
Con
We sold Mars bars, Polos and crisps, and the financial benefits went to buy snooker tables, books and so on for pupils. Does Nicola Sturgeon advocate that th...
Nicola Sturgeon:
SNP
I advocate implementation of a national strategy—as there is—to encourage good dental health among young people and to encourage them to consume low-sugar pr...
Iain Gray:
Lab
Is the member aware that dental fees are set by a body that is independent of the Government and that it recommends each year the percentage increase in fees?
Nicola Sturgeon:
SNP
I am fully aware of that fact, but if MSPs are to have a reasoned and rational debate on the future of dental services in Scotland, we cannot ignore the real...
The Deputy Presiding Officer (Mr George Reid):
SNP
Before I call Robin Harper, I advise members of a purely editorial change in the last line of his amendment—S1M-1271.2. The phrase "NHS Centre for Research a...
Robin Harper (Lothians) (Green):
Green
I am pleased that the workings of the Scottish Parliament have allowed a small party to contribute to the debate through an amendment.I have no problem with ...
Phil Gallie:
Con
I understand that fluoride exists naturally in some water supplies. If Mr Harper is really concerned about the harmful effects, does he believe that those su...
Robin Harper:
Green
Mr Gallie is talking about one small area of Scotland, around Burghead. It would be nice to have good-quality research on that area. I have tried to find som...
Mary Scanlon (Highlands and Islands) (Con):
Con
I, too, welcome the opportunity to debate the important subject of primary dental care services, including the plans for early registration schemes, fissure ...
Nora Radcliffe (Gordon) (LD):
LD
No one would disagree that oral health is important, that we do not want our children to have fillings or extractions, and that all of us should retain a hea...
Nicola Sturgeon:
SNP
Will the Liberal Democrats vote in line with last year's manifesto commitment?
Nora Radcliffe:
LD
I will deal with that when I come to it. I will not duck the question.Nicola Sturgeon has made me lose my place.Three dental schools were closed. It is right...
Mary Scanlon:
Con
The recommended number of dental graduates each year in Scotland is 120; Glasgow produces 70 graduates and Dundee produces 50. Dundee is allowed to fund 59 g...
Nora Radcliffe:
LD
Whether or not we are training enough dentists, we do not seem to have enough on the ground. That points up the fact that we need more. We also need more anc...
The Deputy Presiding Officer:
SNP
We will have speakers from the floor until 4.29 pm. I suspect that more members want to speak than time will allow, but if members keep speeches to four minu...