Chamber
Plenary, 30 Nov 2000
30 Nov 2000 · S1 · Plenary
Item of business
Dental Services (Grampian)
I welcome the opportunity to debate this matter and the constructive approach of Mike Rumbles's motion. He is primarily concerned with access to dentistry in rural areas; my main focus is on similar issues in the city of Aberdeen and the position of NHS dentistry as a whole.
In the bad old days of internal competition in the NHS, general medical practitioners in the Grampian Health Board area led the way in opting out of mainstream funding arrangements in favour of fundholding practices. Happily, because of local health care co-operatives, those medical general practices have come back into NHS structures based on consistently high standards of care across the city and region.
In general dental practice, NHS patients in and around Aberdeen have been losing out more than most, in much the same way as was the case with GPs, as more and more dentists have opted out of providing mainstream NHS services. It is a matter of record that the number of NHS dentists is 31 per 100,000 population compared with an average of 37 per 100,000 in Scotland as a whole. The situation is even more serious than those figures suggest because general dental practitioners continue to appear in the figures until they have removed the very last NHS patient from their list. So, for example, although the list of a dental practice in Aberdeen Central has dropped from 1,800 NHS adult patients five years ago to only 35 today and it has stopped accepting new NHS child patients, it continues to have an NHS number and to count as a provider of NHS services. That is typical of the situation in and around Aberdeen. When a dentist ceases to provide NHS services, typically he or she also cuts the total number on the list, seeing perhaps 60 patients on a private basis for every 100 seen on the NHS.
I support what Mike Rumbles said about how we address the issue. It is not that doctors and dentists in Aberdeen are greedy or less socially aware than those elsewhere, but that they face cost and other pressures to an exceptional extent. Because dental practices operate as self-contracted, self-employed, commercial enterprises, those cost pressures exacerbate the differences between levels of provision in one region and another. For the minister to find ways to increase NHS dental services, we need to address the status of general dental practitioners and how they relate to the NHS as a whole.
In the bad old days of internal competition in the NHS, general medical practitioners in the Grampian Health Board area led the way in opting out of mainstream funding arrangements in favour of fundholding practices. Happily, because of local health care co-operatives, those medical general practices have come back into NHS structures based on consistently high standards of care across the city and region.
In general dental practice, NHS patients in and around Aberdeen have been losing out more than most, in much the same way as was the case with GPs, as more and more dentists have opted out of providing mainstream NHS services. It is a matter of record that the number of NHS dentists is 31 per 100,000 population compared with an average of 37 per 100,000 in Scotland as a whole. The situation is even more serious than those figures suggest because general dental practitioners continue to appear in the figures until they have removed the very last NHS patient from their list. So, for example, although the list of a dental practice in Aberdeen Central has dropped from 1,800 NHS adult patients five years ago to only 35 today and it has stopped accepting new NHS child patients, it continues to have an NHS number and to count as a provider of NHS services. That is typical of the situation in and around Aberdeen. When a dentist ceases to provide NHS services, typically he or she also cuts the total number on the list, seeing perhaps 60 patients on a private basis for every 100 seen on the NHS.
I support what Mike Rumbles said about how we address the issue. It is not that doctors and dentists in Aberdeen are greedy or less socially aware than those elsewhere, but that they face cost and other pressures to an exceptional extent. Because dental practices operate as self-contracted, self-employed, commercial enterprises, those cost pressures exacerbate the differences between levels of provision in one region and another. For the minister to find ways to increase NHS dental services, we need to address the status of general dental practitioners and how they relate to the NHS as a whole.
In the same item of business
The Presiding Officer (Sir David Steel):
NPA
We now come to the members' business debate on motion S1M-1347, in the name of Mike Rumbles, on access to national health service dental services in Grampian...
Motion debated,
That the Parliament recognises that improving access to NHS dental services is a public health priority, welcomes the publication by the Scottish Executive o...
Mr Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
I am pleased to open this evening's debate, which is designed to highlight the problems of accessing NHS dental treatment, particularly in the Grampian area....
The Deputy Presiding Officer (Mr George Reid):
SNP
Six members have asked to speak, so speeches should be around three minutes, please.
Lewis Macdonald (Aberdeen Central) (Lab):
Lab
I welcome the opportunity to debate this matter and the constructive approach of Mike Rumbles's motion. He is primarily concerned with access to dentistry in...
Richard Lochhead (North-East Scotland) (SNP):
SNP
I congratulate Mike Rumbles on securing this evening's debate and on sporting a Highland outfit. I think it is fair to say that the subject of the debate was...
Ben Wallace (North-East Scotland) (Con):
Con
I would like to thank Mike Rumbles for giving us the chance to highlight the continuing problems in Grampian. His outline of the situation and his proposals ...
Nora Radcliffe (Gordon) (LD):
LD
I would like to thank Mike Rumbles for this members' debate, which allows us to put on record our concerns about the provision of dental services in the nort...
Mary Scanlon (Highlands and Islands) (Con):
Con
I congratulate Mike Rumbles on securing today's debate and thank him for giving us an opportunity to discuss dentistry. I would also like to take the opportu...
The Deputy Minister for Health and Community Care (Malcolm Chisholm):
Lab
I congratulate Mike Rumbles on securing this debate, and I am grateful to all members who have contributed to it.During the debate on primary care dental ser...
Richard Lochhead:
SNP
I welcome the minister's comments on the need for more consultants which has been recognised in Grampian. Does the minister also accept that for every new co...
Malcolm Chisholm:
Lab
The discussion paper to which I referred earlier proposed significant increases in the number of professionals who are complementary to dentistry to enhance ...
Ben Wallace:
Con
Will the minister take on board the fact that members of Grampian Health Board have almost stopped advertising? Having spent so much money on trying to recru...
Malcolm Chisholm:
Lab
I hear what Ben Wallace is saying. I am told that an advertising campaign is going on and that, in January 2001, adverts will be placed, but I will check on ...
Meeting closed at 17:43.