Meeting of the Parliament 21 February 2024
There are pressures across the dentistry sector. I do not think that it would be fair to say that any one part is facing the pressures alone. That is why we have developed the reform, which I will go on to talk about shortly.
Although controls were relaxed, they were still a significant barrier to full productivity in the sector and thus to dental-contractor incomes. The Scottish Government responded with more than £150 million of additional emergency financial support to sustain and, ultimately, to preserve the sector. We recognised then, and continue to recognise now, how important dental care is.
Although the immediate impacts of the pandemic on activity are now behind us, the dentistry sector continues to feel the impact of the pandemic in relation to access and the available workforce. Parliament will recall that all undergraduate and vocational training was suspended for a year at the height of the pandemic, due to the IPC restrictions, and that loss of an entire cohort of 160 dentists is undeniably still being felt today and is recognised by members across the chamber, I am sure.
I want to address Willie Rennie’s opening comments and the awful examples that he gave of people seeking NHS dentistry and the lengths that some people have gone to in the absence of access to it. I recognise that there are challenges—of course I do—and I recognise the difficulties that have been faced by people of late.
I recognise, as well, that the Liberal Democrats have set out their own action plan for dentistry and I thank them for that plan. People who are paying attention will see that the plan is, in many areas, a direct copy of the actions that this Government is already taking. Their proposed plan outlines the intention to reform the funding structure for NHS dentistry—something that the Scottish Government has already delivered through significant root-and-branch payment reform on 1 November last year.
The reformed payment system comprises a completely new fee structure, which is designed to attract dentists to provision of NHS care and, ultimately, to improve patient access.
That builds on the commitments that we set out in our 2018 “Oral Health Improvement Plan”. It follows one of the biggest consultations with the dental sector in recent times, and it is the most substantial reform of NHS dental services since the introduction of the NHS in 1948, backed by a recurring investment from this Government of almost half a billion pounds. The data that was published yesterday shows almost 400,000 unique patient contacts in NHS primary care dentistry in November 2023 alone. That does not reflect a system that is “in crisis”, as has been suggested.
That said, although I am encouraged by how the sector has engaged with payment reform, I am not complacent. We recognise that payment reform is not a remedy for all the ills, and we know that in some areas local access problems remain, driven in part by the same workforce problems that I alluded to earlier.
Again, aligned to the action plan, we are already actively consulting the sector on ways to strengthen the NHS dental workforce, including greater utilisation of highly skilled dental therapists. The Minister for Public Health and Women’s Health has also initiated and led discussions with her counterparts in the other UK nations regarding ways in which we can increase the number of overseas dentists coming to the United Kingdom. I am pleased to see that, as a result of those discussions, the Department of Health and Social Care has already moved to consult on reform of that vital pipeline.
I am under no illusions—I know that the NHS dental sector has faced, and continues to face, significant challenges, so I give my heartfelt thanks to dentists working in the NHS for their resilience and dedication. The shadow of the pandemic and other external factors remain, not just in Scotland but across the UK. I am, however, proud that Scotland is the only nation in the UK to actively tackle those challenges head-on through significant generational reforms. That is despite our already being in a relatively stronger position.