Chamber
Plenary, 05 Sep 2002
05 Sep 2002 · S1 · Plenary
Item of business
NHS Dental Services (Moray)
I thank everyone who signed the motion. I am glad to see such a huge interest in Moray. I particularly welcome Nora Radcliffe, because although Keith is not within the Moray constituency, it is within the Moray area and I know the problems that there have been in Keith. I would also like to thank members who have stayed behind for at least the opening of the debate.
When I lodged the motion, it was in the knowledge that there is also a general problem throughout Scotland in the context of national health service dentistry. Any of us who are interested in the subject must have seen the extremely useful research document by the Consumers Association entitled, "The gap in Scotland's dental care". No pun is intended. The research shows that access to NHS dental treatment has turned into a geographical lottery, with patients' ability to access treatment increasingly dependent on where they live. Nowhere are those problems more acute than in the Moray area.
In my parliamentary office, which I share with Angus Robertson MP, we have received well over 200 complaints from individual constituents. We have met and spoken with dental practitioners in the area and sent out a full questionnaire to all the practices in Moray. The dentists who have responded so far represent approximately 40,000 of my constituents. I have a couple of quotations from those dentists. The first said:
"I am currently resisting the move of my practice to private work but I am working longer hours with higher expenses for less income and will be forced to go private to maintain my standards or go out of business."
Another dentist said:
"My practice receives up to 30 calls per day from people wanting to join the NHS and private lists that closed over a year ago."
In some areas of Moray, waiting lists for both NHS and private patients have been closed for as long as four years. Not a single practice in Moray is taking on any new NHS patients. Additionally, it can take as long as three years to be given an appointment to see an orthodontist, never mind the length of time that might be involved in subsequent treatment.
The nearest place for registration with an NHS dentist is in Aberdeen. The most westerly tip of my constituency is Forres and surrounding areas. A trip from Forres station to Aberdeen costs up to £25.30 per adult and £12.75 per child. That is expensive for anyone on a basic income, not to mention the fact that a child would need to be taken out of school for a day and that an adult would lose a day's wages. Not everyone has a car. The monthly costs for private dental insurance for two adults and three children range from £17.62 to £78. Those are the basic facts about what is happening in Moray.
I am sure that the minister will point out that, last December, the coalition Executive allocated money for three additional salaried dental posts in the NHS in Moray. However, those posts were finally advertised in the British Dental Journal only in August this year. The closing date was 20 September. If we assume that the successful applicants might need to complete contracts elsewhere, it will be the end of this year before those dentists can possibly be in place.
I tried to find out from Grampian Primary Care NHS Trust why the appointments had taken so long. I know that the money is not time-barred, but given the fact that the crisis already exists and that the money is there, I wanted to find out why on earth the three dentists could not have been appointed earlier. The primary care trust claimed that the reason for the delay was the need to find accommodation at Dr Gray's hospital, where at least six months were required for the alteration of sewing rooms. It seems to me that, in the interim period, at least some of those who were interested in becoming dental practitioners in this beautiful part of the country could have been accommodated somewhere else in the area or even with the other existing practices. It seems to me and to my worried constituents that a whole year has been wasted.
The fact that the posts will be filled in the near future is of some comfort, but I wish to highlight the need to address the medium and long-term effects of the current situation. The report of the chairman of the local dental committee pointed out that, of the 21 local practising dentists, 11 were over 55 years of age.
The Scottish survey of general and community dental practitioners in 2000 highlighted areas of serious cause for concern for the future. Two thirds of dentists said that they planned to retire early at the age of 55. Half of that group planned to reduce their clinical hours in the years before retirement. Of those planning to retire early, 74 per cent said that they might stay on if the NHS system were to value quality rather than quantity of treatment.
When those three new dentists arrive, we will welcome them with open arms. They will have taken a wonderful choice to come and live in Moray, which is a marvellous community with great facilities. However, the problem will not stop just with those appointments. We need a medium and long-term strategy if we are to lose people through early retirement.
In April, the minister announced the concept of the golden hello as a step to help rural areas. Now that the graduation period is over, will the minister indicate whether there has been any interest in the golden hello? What has the take-up been?
I ask the Government to address the age levels of practising dentists throughout Scotland, to ensure that there will be a continuous supply of new graduates coming into the profession and that we do not end up with many practices having no newcomers while everyone else is retiring.
Those matters are vital and I appreciate the fact that members have stayed behind to listen to the debate. I hope that the positive way in which I have explained the issues will meet with a positive response from the minister.
When I lodged the motion, it was in the knowledge that there is also a general problem throughout Scotland in the context of national health service dentistry. Any of us who are interested in the subject must have seen the extremely useful research document by the Consumers Association entitled, "The gap in Scotland's dental care". No pun is intended. The research shows that access to NHS dental treatment has turned into a geographical lottery, with patients' ability to access treatment increasingly dependent on where they live. Nowhere are those problems more acute than in the Moray area.
In my parliamentary office, which I share with Angus Robertson MP, we have received well over 200 complaints from individual constituents. We have met and spoken with dental practitioners in the area and sent out a full questionnaire to all the practices in Moray. The dentists who have responded so far represent approximately 40,000 of my constituents. I have a couple of quotations from those dentists. The first said:
"I am currently resisting the move of my practice to private work but I am working longer hours with higher expenses for less income and will be forced to go private to maintain my standards or go out of business."
Another dentist said:
"My practice receives up to 30 calls per day from people wanting to join the NHS and private lists that closed over a year ago."
In some areas of Moray, waiting lists for both NHS and private patients have been closed for as long as four years. Not a single practice in Moray is taking on any new NHS patients. Additionally, it can take as long as three years to be given an appointment to see an orthodontist, never mind the length of time that might be involved in subsequent treatment.
The nearest place for registration with an NHS dentist is in Aberdeen. The most westerly tip of my constituency is Forres and surrounding areas. A trip from Forres station to Aberdeen costs up to £25.30 per adult and £12.75 per child. That is expensive for anyone on a basic income, not to mention the fact that a child would need to be taken out of school for a day and that an adult would lose a day's wages. Not everyone has a car. The monthly costs for private dental insurance for two adults and three children range from £17.62 to £78. Those are the basic facts about what is happening in Moray.
I am sure that the minister will point out that, last December, the coalition Executive allocated money for three additional salaried dental posts in the NHS in Moray. However, those posts were finally advertised in the British Dental Journal only in August this year. The closing date was 20 September. If we assume that the successful applicants might need to complete contracts elsewhere, it will be the end of this year before those dentists can possibly be in place.
I tried to find out from Grampian Primary Care NHS Trust why the appointments had taken so long. I know that the money is not time-barred, but given the fact that the crisis already exists and that the money is there, I wanted to find out why on earth the three dentists could not have been appointed earlier. The primary care trust claimed that the reason for the delay was the need to find accommodation at Dr Gray's hospital, where at least six months were required for the alteration of sewing rooms. It seems to me that, in the interim period, at least some of those who were interested in becoming dental practitioners in this beautiful part of the country could have been accommodated somewhere else in the area or even with the other existing practices. It seems to me and to my worried constituents that a whole year has been wasted.
The fact that the posts will be filled in the near future is of some comfort, but I wish to highlight the need to address the medium and long-term effects of the current situation. The report of the chairman of the local dental committee pointed out that, of the 21 local practising dentists, 11 were over 55 years of age.
The Scottish survey of general and community dental practitioners in 2000 highlighted areas of serious cause for concern for the future. Two thirds of dentists said that they planned to retire early at the age of 55. Half of that group planned to reduce their clinical hours in the years before retirement. Of those planning to retire early, 74 per cent said that they might stay on if the NHS system were to value quality rather than quantity of treatment.
When those three new dentists arrive, we will welcome them with open arms. They will have taken a wonderful choice to come and live in Moray, which is a marvellous community with great facilities. However, the problem will not stop just with those appointments. We need a medium and long-term strategy if we are to lose people through early retirement.
In April, the minister announced the concept of the golden hello as a step to help rural areas. Now that the graduation period is over, will the minister indicate whether there has been any interest in the golden hello? What has the take-up been?
I ask the Government to address the age levels of practising dentists throughout Scotland, to ensure that there will be a continuous supply of new graduates coming into the profession and that we do not end up with many practices having no newcomers while everyone else is retiring.
Those matters are vital and I appreciate the fact that members have stayed behind to listen to the debate. I hope that the positive way in which I have explained the issues will meet with a positive response from the minister.
In the same item of business
The Deputy Presiding Officer (Mr George Reid):
SNP
I ask members to move along and clear the chamber. I also remind those who wish to speak in the debate that they should press their request-to-speak buttons ...
Motion debated,
That the Parliament recognises that the provision of NHS dental services in Moray has reached crisis point; finds it unacceptable that residents of Moray now...
Mrs Margaret Ewing (Moray) (SNP):
SNP
I thank everyone who signed the motion. I am glad to see such a huge interest in Moray. I particularly welcome Nora Radcliffe, because although Keith is not ...
The Deputy Presiding Officer:
SNP
I remind members that the debate is specific to Moray, so I will be listening for some geographic or service links to Moray in members' speeches.
Nora Radcliffe (Gordon) (LD):
LD
Part of my constituency lies in Moray, but the problems of a lack of dental services, or a lack of access to dental services, are acute throughout the north-...
Mary Scanlon (Highlands and Islands) (Con):
Con
I, too, am delighted to see Margaret Ewing back. If I may say so, Margaret looks very well. It is nice to see her back in her stride, as feisty as usual, for...
Maureen Macmillan (Highlands and Islands) (Lab):
Lab
I, too, welcome Margaret Ewing back to the chamber. I am pleased that she had the first question of question time and opened today's members' business debate...
The Deputy Presiding Officer:
SNP
As of now I would be grateful if the speeches were kept to under three minutes.
Stewart Stevenson (Banff and Buchan) (SNP):
SNP
I say very well done to Margaret Ewing for securing a debate on this important topic. It is good to be able to add my welcome back to her. It is also good to...
Mr Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
I congratulate Margaret Ewing on keeping the subject of access to NHS dental care on the agenda.We have heard a lot of statistics and I want to throw in a fe...
Mr Andrew Welsh (Angus) (SNP):
SNP
I congratulate my colleague Margaret Ewing on her initiative in leading this important debate. I hope that the minister will address the problems in Moray as...
Richard Lochhead (North-East Scotland) (SNP):
SNP
I congratulate Margaret Ewing on securing this important debate. I welcome her back to the Parliament—she is back with a bang. SNP parliamentary group meetin...
Fergus Ewing (Inverness East, Nairn and Lochaber) (SNP):
SNP
In an entirely impartial and unbiased way, I warmly congratulate Margaret Ewing on her excellent exposition of the topic. I will address some of the deeper i...
The Deputy Minister for Health and Community Care (Mrs Mary Mulligan):
Lab
I, too, join members in welcoming Margaret Ewing back to the chamber. It is great to see her and I look forward to debating many other issues with her. Howev...
Mr Rumbles:
LD
Two years ago, in the initial debate on the matter, I said that the target of 120 dentists in the dental action plan was not a great one to achieve. In fact,...
Mrs Mulligan:
Lab
One hundred and twenty dentists is an achievable target. Instead of simply increasing that number, we need to find out how to retain those people in Scotland...
Maureen Macmillan:
Lab
Will the minister consider giving more support to training practices in the Highlands? More training practices being in receipt of support would attract new ...
Mrs Mulligan:
Lab
I will come back to that point in a moment.We are also able to offer postgraduate vocational training places for all Scottish graduate dentists. Moreover, to...
Mary Scanlon:
Con
Does the minister acknowledge that Mike Rumbles's suggestion that there should be a new dental school in Aberdeen would be extremely difficult to implement, ...
Mrs Mulligan:
Lab
As I said, we must consider what we have at the moment and decide how we can use it in the best possible way. By ensuring that students leave the dental hosp...
Meeting closed at 17:56.