Chamber
Plenary, 05 Sep 2002
05 Sep 2002 · S1 · Plenary
Item of business
NHS Dental Services (Moray)
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 the people in Moray.
I picked up the following figures in the tea room about 10 minutes ago. I was actually quite shocked to see the fall in the number of registrations for general dental services. Since 1997, the registration of children has fallen by about 64,000 and the registration of adults has fallen by 197,464. When comparing health board areas, we see that the percentage of adult registrations in Highland is 38 per cent and in Grampian is 46 per cent, while in the Borders it is 58 per cent. The situation is mixed throughout Scotland.
We often talk about access to dental services and I have come across something that has surprised me. Will the minister confirm that there is no guarantee of access for patients to general dental services, unlike the case with general medical services?
As Margaret Ewing has outlined, the position in Moray is particularly critical. I, too, draw members' attention to the Consumers Association report, which notes that more than 50 per cent of dentists in Moray are over 55. Unless action is taken, the position is likely to get worse rather than better. In the same study, the Consumers Association pointed out that in Edinburgh, 40 per cent of dental practices were not taking on all NHS patients and in Aberdeen 80 per cent of dental practices were not taking on all NHS patients. That means that if Moray patients are seeking NHS dental treatment in Aberdeen, they will have to seek out the 20 per cent of practitioners who will welcome them as NHS patients.
The Consumers Association report also states that dentists had commented that it was not worth taking on NHS patients because of the low fees that dentists get from the NHS. In the Highlands and Islands, one practice had not taken on an NHS patient for five years and another practice quoted charges of £105 an hour. Several dentists in the Highlands said that NHS work did not pay enough to make it sustainable.
Like many members, I welcome the dental action plan, "An Action Plan for Dental Services in Scotland", which was introduced in August 2000. I know that we can all be quite carping and critical about the glossy brochures, but the action plan is excellent and two years later it is probably time to carry out a progress report and produce an update. If everything in the plan had been implemented, people in Moray would not face the problems that they do today.
The other point that has come to my attention in the Highlands is the statutory obligation on authorities to provide dental checks for schoolchildren three times throughout their education. It was confirmed quite recently at a meeting between MSPs and NHS Highland that NHS Highland does not meet that obligation.
Looking back at my file on dentistry, I found several letters from dental therapists, who were seeking to review the dental auxiliaries regulations under the National Health Service (Scotland) Act 1978. The regulations allow them to practise in the public health services but forbid them to work in general dental services. I understand that dental therapists are not the answer to the shortage of dentists. Nonetheless, given that they can carry out some extractions, some fillings, cleaning and polishing, scaling and giving advice, the removal of those restrictions would be very helpful. I understand that Westminster is currently considering that issue.
The dental action plan proposes the establishment of drop-in centres in the major cities and enhancing the role of mobile services. I understand that a drop-in centre is being established in Edinburgh. The use of mobile units would undoubtedly be helpful in rural areas.
Can the minister confirm that NHS 24, given that it is up and running in Aberdeen, is giving advice on dental problems, as promised in the action plan? Can the minister confirm that NHS 24 is also giving advice on access to dental services, which would be so helpful for the people in Moray?
Page 13 of the action plan says:
"Primary Care Trusts should review locally how GDS and CDS"—
that is general dental services and community dental services—
"can work together effectively to complement each other's services"
and draw up a local service plan. Do all areas in Scotland have a local service plan? Are they doing what the Executive has asked them to do and are such plans sufficient to meet the needs of patients?
Finally, I am sorry that Ian Jenkins is not here tonight because he regularly makes the point that the difficulties in accessing dental treatment mean that in many cases oral cancer is not picked up.
I picked up the following figures in the tea room about 10 minutes ago. I was actually quite shocked to see the fall in the number of registrations for general dental services. Since 1997, the registration of children has fallen by about 64,000 and the registration of adults has fallen by 197,464. When comparing health board areas, we see that the percentage of adult registrations in Highland is 38 per cent and in Grampian is 46 per cent, while in the Borders it is 58 per cent. The situation is mixed throughout Scotland.
We often talk about access to dental services and I have come across something that has surprised me. Will the minister confirm that there is no guarantee of access for patients to general dental services, unlike the case with general medical services?
As Margaret Ewing has outlined, the position in Moray is particularly critical. I, too, draw members' attention to the Consumers Association report, which notes that more than 50 per cent of dentists in Moray are over 55. Unless action is taken, the position is likely to get worse rather than better. In the same study, the Consumers Association pointed out that in Edinburgh, 40 per cent of dental practices were not taking on all NHS patients and in Aberdeen 80 per cent of dental practices were not taking on all NHS patients. That means that if Moray patients are seeking NHS dental treatment in Aberdeen, they will have to seek out the 20 per cent of practitioners who will welcome them as NHS patients.
The Consumers Association report also states that dentists had commented that it was not worth taking on NHS patients because of the low fees that dentists get from the NHS. In the Highlands and Islands, one practice had not taken on an NHS patient for five years and another practice quoted charges of £105 an hour. Several dentists in the Highlands said that NHS work did not pay enough to make it sustainable.
Like many members, I welcome the dental action plan, "An Action Plan for Dental Services in Scotland", which was introduced in August 2000. I know that we can all be quite carping and critical about the glossy brochures, but the action plan is excellent and two years later it is probably time to carry out a progress report and produce an update. If everything in the plan had been implemented, people in Moray would not face the problems that they do today.
The other point that has come to my attention in the Highlands is the statutory obligation on authorities to provide dental checks for schoolchildren three times throughout their education. It was confirmed quite recently at a meeting between MSPs and NHS Highland that NHS Highland does not meet that obligation.
Looking back at my file on dentistry, I found several letters from dental therapists, who were seeking to review the dental auxiliaries regulations under the National Health Service (Scotland) Act 1978. The regulations allow them to practise in the public health services but forbid them to work in general dental services. I understand that dental therapists are not the answer to the shortage of dentists. Nonetheless, given that they can carry out some extractions, some fillings, cleaning and polishing, scaling and giving advice, the removal of those restrictions would be very helpful. I understand that Westminster is currently considering that issue.
The dental action plan proposes the establishment of drop-in centres in the major cities and enhancing the role of mobile services. I understand that a drop-in centre is being established in Edinburgh. The use of mobile units would undoubtedly be helpful in rural areas.
Can the minister confirm that NHS 24, given that it is up and running in Aberdeen, is giving advice on dental problems, as promised in the action plan? Can the minister confirm that NHS 24 is also giving advice on access to dental services, which would be so helpful for the people in Moray?
Page 13 of the action plan says:
"Primary Care Trusts should review locally how GDS and CDS"—
that is general dental services and community dental services—
"can work together effectively to complement each other's services"
and draw up a local service plan. Do all areas in Scotland have a local service plan? Are they doing what the Executive has asked them to do and are such plans sufficient to meet the needs of patients?
Finally, I am sorry that Ian Jenkins is not here tonight because he regularly makes the point that the difficulties in accessing dental treatment mean that in many cases oral cancer is not picked up.
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.