Hansard

I refer members to my entry in the register of members’ interests—I am a practising NHS general practitioner.

There we have it from the cabinet secretary: everything is perfect. The SNP’s plans are perfect. Mr Rennie, why bother having this debate? Well, members and the public at large may recall the SNP promise at the last election to make NHS dentistry free at the point of care to everyone in Scotland by the end of this parliamentary session. Three cabinet secretaries, two First Ministers and nearly three years later, this SNP Government still has no plan for how to make that possible. The reality is that, no matter how big the headline or how many Scots are registered with a dentist, too many patients cannot get an appointment to see a dentist and access full NHS dental services in the first place.

This is not rocket science. A shortage of dental nurses, a lack of dentists and rising costs, including for materials and lab works, have left many practices providing NHS services at a loss, so it is no surprise that practices are folding. The situation is unsustainable and the SNP Government has been warned, time and again, that this would happen. In fact, the SNP’s shortage of dentists is even holding back Scotland’s space industry, as engineers are reluctant to relocate to Sutherland because of a lack of dental care. Holyrood—we have a problem.

I remember being at a conference of local dental committees last April, when a delegate reminded the minister Jenni Minto that NHS dentistry in Scotland is broken and that the SNP Government had broken it. Yesterday’s “NHS Dental Data Modelling Report” for November and December is telling. In December 2023, the number of people who saw an NHS dentist had fallen by more than a third, which begs the question what patients are doing if they cannot see a dentist.

Under the SNP and its botched management, patients are opting for an alternative model of dentistry—the SNP-DIY model. The British Dental Association says that 83 per cent of Scottish respondents to its survey said that they had treated patients who had performed DIY on their own teeth since lockdown. Desperate patients are taking desperate measures and are literally taking matters into their own hands by ripping out teeth, supergluing crowns and even using repair kits ordered from Amazon. That is gruesome.

More and more patients are heading overseas for dental care, as Willie Rennie mentioned. In fact, patients are travelling to central Europe and even India for standard treatment. Refugees from Ukraine are returning to a war zone for care, but the cabinet secretary thinks that that is just unfortunate. That is not medical tourism—it is desperation.

The SNP Government, like Corporal Jones, cries “Don’t panic!” and points to its reformed payment system for NHS dentistry, which was introduced in November last year and which aims to incentivise dentists to stay in the NHS system. It includes changes to fees for many treatments and reduces the number of treatments available from 400 to 45. Although it is too early to measure the real impact of the reform, we know that the SNP has just been tinkering with the problem. The BDA warns that

“the fundamentals of a broken system remain”.

That is because the SNP Government decided to stick with the drill-and-fill model.

All of us who work in primary care understand the importance of preventative healthcare, and we know that it delivers better outcomes for patients. It is also important to understand that oral health can tell us a lot about our overall general health. Regular monitoring identifies and deals early with problems such as oral cancer and bacterial fungal infections that can cause sepsis. In fact, gum disease is linked to a higher risk of heart disease and dementia.

As the Scottish Conservatives argue in our NHS reform policy paper, we support incentivising preventative healthcare, as it is good for patients and cost effective. That is what dentists want and what they believe in. When it comes to prevention, we want to go further than just regular check-ups. Good oral health relies on healthy lifestyles. We need to be effective in tackling unhealthy behaviours including vaping, smoking, consuming alcohol and consuming high-sugar foods and beverages. That is very different from the SNP’s approach to dentistry, which is geared towards saving the Scottish Government money in the short term and is clearly not geared towards long-term dental health.

Cabinet secretary, please go back to the drawing board. We need a root-and-branch reform of the statement of dental remuneration so that dentists are valued and supported and so that patients are helped to stay healthy and not just to queue to be fixed when things go wrong.

I move amendment S6M-12215.3, to insert after “resolve this crisis”:

“; notes with great concern that the number of people able to see an NHS dentist in Scotland fell by over a third in just one month in December 2023, as dental practices abandoned NHS work in droves; stresses that registration rates with dentists in no way indicate satisfactory dental service provision if registered patients are unable to get an appointment; regrets that the Scottish Government has failed to do what is necessary to restore NHS dentistry activity levels to at least pre-COVID-19-pandemic activity levels; expresses concern that people in rural and more deprived areas will likely suffer disproportionately negative oral health consequences from these failures”.