Meeting of the Parliament 21 February 2024
As Willie Rennie highlighted, we are seeing more people struggling to get access to NHS dentistry in Fife. David Torrance can defend the Scottish Government if that is what he wishes to do, but he must also recognise that constituents in Kirkcaldy have recently been told that Redburn Dental is going fully private and that he will have constituents who will not be able to access an NHS dentist.
The Scottish Government points to 95 per cent of Scots being registered with an NHS dentist. However, following the introduction of lifetime registration in 2010, that figure actually tells us little. Far more relevant is the percentage of people who have seen an NHS dentist in the past two years, which is only around half of those who are registered. The dental statistics that were published this week unfortunately do not give an update to that figure. I hope that future publications will assess any impact of the changes on access to NHS care.
We need more information on registration. Registration numbers do not show that a third of children who are registered have not seen a dentist in the past two years; they do not include the fact that people who are registered with a practice but are currently without a dentist within it are unable to access routine treatment; and they do not include patients who are currently at practices that will close in the next couple of months and who, in the meantime, cannot get an appointment. Registration without access to dentistry is meaningless.
Recruitment and retention are clear challenges. The overall increase in the number of dentists since 2010 has evaporated since the pandemic, and issues with the supply of dentists from training or from other countries are a major pressure on the system. In evidence on dentistry to the COVID-19 Recovery Committee, it was noted that private practice was not experiencing the same difficulties.
We know that dentists are leaving NHS practice and that practices are struggling to recruit new dentists. Practices are closing, leaving patients without access to care. In Fife, Nanodent in Glenrothes will close in April due to a lack of staffing. One dentist is moving to another practice, but all adult patients with other dentists will be deregistered. Patients have been struggling to get appointments for the past two years due to low staffing, and that struggle will now continue as they try to find somewhere else in Fife that offers NHS care. Another practice in Glenrothes is to relocate many of its patients to a dentist 14 miles away in Cowdenbeath. For those who rely on public transport, real issues exist around accessibility.
Letters that advise of closures tell patients that it proved impossible to recruit dentists. The letters also recognise the difficulties in finding a dental practice that is willing to accept NHS patients. More than 80 per cent of NHS practices in Scotland are no longer taking on new patients, with a similar number reducing their lists. As of this morning—as has been the case for some time—zero NHS dentists in Fife are taking on new patients, whether people are under 26 or not. Patients who are looking to register with a dentist can do nothing but wait, and out of more than 50 listed NHS dentists, only two practices in Fife are even operating waiting lists.
The BDA is clear that lower attendance at dentists will result in a higher dental disease burden down the line, with health inequalities expected to widen further. The organisation is also clear that the changes that were brought in late last year were not the “root and branch reform” that those in the profession sought. Instead of shifting to a more prevention-based system, the Scottish Government has merely tinkered with the drill-and-fill model, and it is not clear how that will make NHS dentistry a more attractive place to be for practitioners or how that will improve access for patients.
The promise of free dental care for all was not made before the pandemic; it was made at a point when dental services had been heavily impacted and we knew that there would be on-going consequences. However, the majority of Scots are not only still paying for dental treatment; since November, they are now paying even more than they used to.
I am concerned that, rather than providing free, quality dental care, we are in a situation in which people are being pushed into using private dentistry with no other option available to them. The changes that were made in November must be only the beginnings of much more comprehensive reform if NHS dentistry is to have a future.
16:45