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Chamber

Meeting of the Parliament 08 February 2023

08 Feb 2023 · S6 · Meeting of the Parliament
Item of business
National Health Service Dentistry

I am very pleased to rise for my party to speak in this debate. There is a dentistry crisis in Scotland. It can be felt everywhere—it is visited in each of our mailbags and is inflicting pain on people up and down the country every day—yet the Government’s amendment seeks to delete that reality from the parliamentary proceedings. That is astonishing. Again, it shows the cognitive dissonance that we have come to know well from the Government, which has its head in the sand and displays the dead hand of ministerial disinterest in things that matter to real people.

Indeed, it was a show of astonishing timing that the Government published a letter last night that evidenced its paltry effort in kicking issues down the road, with promises of jam tomorrow to our hard-working dentists.

Far too many Scots face huge obstacles in accessing NHS dental check-ups. The number of NHS treatments that are being conducted is dramatically below pre-pandemic levels. Liberal Democrat research has revealed soaring waits for dental treatment, with some patients waiting more than three years for help. Imagine having to deal with dental pain for three years—it is astonishing.

The situation is dire right across the country. Eleven health boards recorded patients having to wait more than a year for treatment. A freedom of information request to health boards showed that dentists submitted about 3.2 million claims for NHS work between January and November last year. That sounds like quite a lot, but if we compare that with the 5.6 million claims for NHS dental work in 2019, we start to understand the quantum of the problem and the fall-away in dental work.

Put simply, many people either are forced to wait months for NHS dental treatment or are unable to access NHS care at all. In rural communities, the situation is even more acute. In Orkney and Shetland, the number of NHS dental claims has fallen by more than 50 per cent, while many practices in Dumfries and Galloway have closed their doors to NHS work entirely. The warning lights are well and truly on, and they are blinking, but the Government’s response has been achingly slow.

Let us think about how we got here. The business model for dentistry is straightforward. There has always been a balance between NHS work and private work, but, over time, stagnation in payment for NHS work has led to that balance shifting inexorably towards private work. That is not the fault of dentists—they have people to employ, lights to keep on and bills to pay at home. It is a result of, as I said, ministerial disinterest in the funding model. We know from senior dentists that the Government has, in their words, had its head in the sand.

I note that the Government has, once again, referenced the impact of the pandemic. The pandemic has, of course, had an impact. We know that that is, in large part, why there has been a backlog of procedures. However, as Paul Gray, the former chief executive of NHS Scotland, said, the crisis in our NHS, including in dentistry, was always coming—Covid just hastened the date.

The Government talks in lofty tones about protecting our NHS from privatisation. It rightly speaks of prescription charges being a tax on the sick. However, under the Scottish National Party-Green Government, thousands of people are denied the dental treatment that they desperately need. Why are they denied it? It is because they simply cannot afford to pay for private treatment, which is the only other option available to them.

Of those who responded to a United Kingdom-wide poll that was conducted by my party last year, a quarter of people said that they were forced to pay for private dental treatment. Many people said that they delayed seeing a dentist despite suffering pain. When the pain got too bad, many of those who could not afford to go private turned to DIY dentistry. That means that they carried out dental work on themselves or asked somebody equally unqualified to do it for them.

Last year, a staggering one in five people who failed to get an NHS dental appointment resorted to that. Imagine that. We are not living in the dark ages; this is 21st century Scotland. The fact that so many people are being forced to take such a measure is a national scandal and an absolute indictment—

In the same item of business

The Deputy Presiding Officer (Annabelle Ewing) SNP
The next item of business is a debate on motion S6M-07812, in the name of Alex Cole-Hamilton, on addressing the crisis in NHS dentistry. 15:25
Alex Cole-Hamilton (Edinburgh Western) (LD) LD
I am very pleased to rise for my party to speak in this debate. There is a dentistry crisis in Scotland. It can be felt everywhere—it is visited in each of o...
Sandesh Gulhane (Glasgow) (Con) Con
Does Alex Cole-Hamilton agree that, since the Scottish Conservatives previously brought a debate on dentistry to the chamber, things have got worse?
Alex Cole-Hamilton LD
Dr Gulhane is absolutely right: things are getting worse. I am sad to say that I sometimes fear that we are becoming inured to the level of crisis in our de...
The Deputy Presiding Officer SNP
Excuse me. Could we not have sedentary chitchat, please? Thank you.
Alex Cole-Hamilton LD
If the cabinet secretary wants to come in, I would be quite happy to take an intervention.
The Cabinet Secretary for Health and Social Care (Humza Yousaf) SNP
Does Alex Cole-Hamilton recognise that Brexit, along with the pandemic, has had an impact on the dental workforce? If so, does he therefore disagree with his...
Alex Cole-Hamilton LD
Wow. I think that I have turned up to the wrong debate. Interruption. Nevertheless, I invite the cabinet secretary to explain that to senior dentists, who ha...
The Deputy Presiding Officer SNP
I call Maree Todd to speak to and move amendment S5M-07812.3. You have up to six minutes, please, minister. 15:32
The Minister for Public Health, Women’s Health and Sport (Maree Todd) SNP
I am grateful for the opportunity to debate the important matter of access to NHS dental care, given the unprecedented impact of the pandemic and the uncerta...
Alex Cole-Hamilton LD
Will the minister give way?
Maree Todd SNP
Certainly—if the member is brief.
Alex Cole-Hamilton LD
The minister talks about the uplift in dental work compared with 2021-22. I remind her that non-aerosol generating procedures were not allowed in 2021-22, so...
Humza Yousaf SNP
It is progress!
Maree Todd SNP
There you go. It is undeniable that we are making progress—really good progress—towards pre-pandemic levels. We are still in the midst of a global pandemic.
Jackie Baillie (Dumbarton) (Lab) Lab
Will the member give way?
Maree Todd SNP
Give me one moment to make some progress. There is now a clear necessity to provide continued support to the sector as we move to the payment system reform....
Jackie Baillie Lab
I welcome the minister’s contribution, which is outlining reform, but can she please give us a timetable?
Maree Todd SNP
The timetable is clearly seen in the commitment to maintaining the bridging payments to the end of October this year; we expect the new system of reform paym...
Finlay Carson (Galloway and West Dumfries) (Con) Con
The minister has mentioned improvements. Could she point to the improvements in Dumfries and Galloway? Dentists are not leaving the region but leaving the NH...
Maree Todd SNP
The member is well aware of the particular conditions in Dumfries and Galloway, which have contributed to the situation in which we are now. That area is par...
The Deputy Presiding Officer SNP
Briefly, Mr Carson, because the minister should now be bringing her remarks to a close.
Finlay Carson Con
I appreciate the minister taking the intervention. The Brexit remark was going to come; we were just waiting for it—it is like bingo. Dentists are not leavi...
Maree Todd SNP
I know that the member does not like us to talk about Brexit. However, more than 60 per cent of the dental workforce is European, so it is undeniable that Br...
The Deputy Presiding Officer SNP
You are over your time; you need to conclude, minister.
Maree Todd SNP
More than 95 per cent of the Scottish population continues to be registered with an NHS dentist—a situation that we are determined to progress and improve. ...
The Deputy Presiding Officer SNP
Thank you, minister. I call Sandesh Gulhane to speak to and move amendment S6M-07812.2. 15:39
Sandesh Gulhane (Glasgow) (Con) Con
NHS dentistry is in crisis. That is happening on the SNP’s watch, yet when we listen to the minister, the message seems to be, “Aren’t we doing well?” That d...
Maree Todd SNP
I am very clear in acknowledging the challenges that the sector faces at the moment. Would Sandesh Gulhane join me in recognising the very welcome statistic ...
Sandesh Gulhane Con
The minister will hear in the rest of my speech how badly the Government has been doing when it comes to NHS dentistry, so I ask her to listen. Interruption.