Chamber
Plenary, 05 Sep 2002
05 Sep 2002 · S1 · Plenary
Item of business
NHS Dental Services (Moray)
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. As one would expect, she presented her arguments with dedication and focus. I congratulate her on securing the debate.
As we have heard, nearly every member of the Parliament has some experience of the issue of dentists and the lack of NHS dentists. I receive a large number of letters expressing concern about the lack of dental provision in Moray and throughout the Highlands and Islands. Far too many people feel that they have been left high and dry by the continuing drift of dentists into private practice. I do not altogether blame the dentists. I receive letters from dentists who say that they have tried to include an NHS dentist in their practice, but that they cannot attract new NHS dentists. People come to a town, examine the practice, see what they will be paid by the NHS and then go to another place where they can work privately and be paid more.
This problem dates back not four years, but as long as 10 years. I remember when my dentist closed his NHS lists. I hung on and was assigned not to a partner, but to an assistant. Assistants came and went, while the partners practised privately. People could have their teeth examined and take out Denplan at vast expense. I refused to have my teeth examined so that an estimate could be made of the cost of keeping them in trim, because I knew that it would be horrendous. I said that I wanted to stay with the NHS and that, if I needed to have extensive work done on my teeth, I would face that problem when it happened.
Recently two old-age pensioners who had been with an NHS dentist all their lives were suddenly told that they could no longer receive treatment on the NHS and that they had to go private. The alternatives were not explained to them properly. They had to ask their MSP where to find a dentist who would treat them on the NHS. People in that situation must be given much more information. I raised the issue with the local health board, which said that it would ensure that people were given proper information about where they could access NHS dentists.
For many people there is no alternative. As has been mentioned, people in Moray have to travel to Aberdeen, which means paying £25 for a return ticket on the train. If they do not do that, they are forced to pay more for the treatment that they previously received. That is not an option, so they do not go to the dentist. I am convinced that, as a result, dental health is declining in the Highlands and Islands.
Mary Scanlon mentioned oral cancer. All sorts of problems may go undetected because people have stopped going to the dentist. We do not want to return to the situation that existed in my mother's generation. People would go to the dentist at 20 to have all their teeth removed, so that they would never have to pay to go again. We must ensure that this problem is addressed.
As Margaret Ewing said, the situation in Moray is very serious. No practices in Moray are taking on NHS patients. The Executive has responded to concerns by announcing investment of £1 million, which I welcome, and I hope that the money will improve the recruitment and retention of NHS dentists. There are some training practices in the north—the practice that I use is one of them.
The new investment is welcome, but will it be enough to stem the movement of dentists into private treatment work and to encourage new dentists to work in the NHS? The answers to those questions are not immediately forthcoming, as the investment will take time to filter through. We must accept that. However, I notice that in the announcement this investment was described as an initial package. I hope that, given the spending review and the increase in health service spending nationally, dental service provision will feature heavily in forthcoming spending announcements.
Grampian Primary Care NHS Trust is also taking action. At the beginning of August, the trust informed me that it intended to mount a recruitment campaign for salaried dentists who will be directly employed by the trust, as a way of tackling the shortage. As Margaret Ewing indicated, the new suite at Dr Gray's hospital in Elgin is receiving financial support from the Executive. However, again there has been a delay.
In mentioning Grampian Primary Care NHS Trust, I am reminded of another case that I dealt with in Moray. The case involved a young teenager who required orthodontic treatment on the NHS. She was told that she would have to wait five years—she would be grown up before the treatment could take place. The alternative was for her to pay several thousand pounds to have the work done within a few months. It is not on for people to have to make such choices.
We need long-term thinking and long-term plans if the problems in Moray and elsewhere are not to be repeated. I hope that the minister and her officials will examine closely the reasons why this situation has developed. The situation is not new; it did not start under the current Administration. It started at least 10 years ago, when the then Government cut the fees that dentists received from the NHS. The situation has developed over time, but many people are left wondering why the welcome measures that the Executive has announced were not put in place much earlier. Hindsight is valuable, but so is an evaluation of why the situation has developed so that we might try to prevent something similar from happening again.
As we have heard, nearly every member of the Parliament has some experience of the issue of dentists and the lack of NHS dentists. I receive a large number of letters expressing concern about the lack of dental provision in Moray and throughout the Highlands and Islands. Far too many people feel that they have been left high and dry by the continuing drift of dentists into private practice. I do not altogether blame the dentists. I receive letters from dentists who say that they have tried to include an NHS dentist in their practice, but that they cannot attract new NHS dentists. People come to a town, examine the practice, see what they will be paid by the NHS and then go to another place where they can work privately and be paid more.
This problem dates back not four years, but as long as 10 years. I remember when my dentist closed his NHS lists. I hung on and was assigned not to a partner, but to an assistant. Assistants came and went, while the partners practised privately. People could have their teeth examined and take out Denplan at vast expense. I refused to have my teeth examined so that an estimate could be made of the cost of keeping them in trim, because I knew that it would be horrendous. I said that I wanted to stay with the NHS and that, if I needed to have extensive work done on my teeth, I would face that problem when it happened.
Recently two old-age pensioners who had been with an NHS dentist all their lives were suddenly told that they could no longer receive treatment on the NHS and that they had to go private. The alternatives were not explained to them properly. They had to ask their MSP where to find a dentist who would treat them on the NHS. People in that situation must be given much more information. I raised the issue with the local health board, which said that it would ensure that people were given proper information about where they could access NHS dentists.
For many people there is no alternative. As has been mentioned, people in Moray have to travel to Aberdeen, which means paying £25 for a return ticket on the train. If they do not do that, they are forced to pay more for the treatment that they previously received. That is not an option, so they do not go to the dentist. I am convinced that, as a result, dental health is declining in the Highlands and Islands.
Mary Scanlon mentioned oral cancer. All sorts of problems may go undetected because people have stopped going to the dentist. We do not want to return to the situation that existed in my mother's generation. People would go to the dentist at 20 to have all their teeth removed, so that they would never have to pay to go again. We must ensure that this problem is addressed.
As Margaret Ewing said, the situation in Moray is very serious. No practices in Moray are taking on NHS patients. The Executive has responded to concerns by announcing investment of £1 million, which I welcome, and I hope that the money will improve the recruitment and retention of NHS dentists. There are some training practices in the north—the practice that I use is one of them.
The new investment is welcome, but will it be enough to stem the movement of dentists into private treatment work and to encourage new dentists to work in the NHS? The answers to those questions are not immediately forthcoming, as the investment will take time to filter through. We must accept that. However, I notice that in the announcement this investment was described as an initial package. I hope that, given the spending review and the increase in health service spending nationally, dental service provision will feature heavily in forthcoming spending announcements.
Grampian Primary Care NHS Trust is also taking action. At the beginning of August, the trust informed me that it intended to mount a recruitment campaign for salaried dentists who will be directly employed by the trust, as a way of tackling the shortage. As Margaret Ewing indicated, the new suite at Dr Gray's hospital in Elgin is receiving financial support from the Executive. However, again there has been a delay.
In mentioning Grampian Primary Care NHS Trust, I am reminded of another case that I dealt with in Moray. The case involved a young teenager who required orthodontic treatment on the NHS. She was told that she would have to wait five years—she would be grown up before the treatment could take place. The alternative was for her to pay several thousand pounds to have the work done within a few months. It is not on for people to have to make such choices.
We need long-term thinking and long-term plans if the problems in Moray and elsewhere are not to be repeated. I hope that the minister and her officials will examine closely the reasons why this situation has developed. The situation is not new; it did not start under the current Administration. It started at least 10 years ago, when the then Government cut the fees that dentists received from the NHS. The situation has developed over time, but many people are left wondering why the welcome measures that the Executive has announced were not put in place much earlier. Hindsight is valuable, but so is an evaluation of why the situation has developed so that we might try to prevent something similar from happening again.
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.