Hansard

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 services on 25 October, Iain Gray and Susan Deacon made it clear that we are committed to an effective and accessible NHS dental service for all who wish to use it. I acknowledge, however, that there are some problems with access to NHS dental services in some parts of Scotland that need to be addressed. Mike Rumbles referred to his own constituency in that regard this evening.

In the primary care sector, where around 90 per cent of dental patients are treated, most general dental practitioners are independent contractors to the NHS. I find it regrettable that in some parts of Scotland there has been a reducing commitment to the NHS by some general dental practitioners. Looking at the figures, however, it appears that the percentage of those who are registered with an NHS dentist in Grampian is only marginally less than the Scottish average.

Mike Rumbles referred to unrealistic fees. That is not the only issue, but I must tell him that increases in service fees have been recommended by the independent review body on doctors' and dentists' remuneration, which reaches decisions on increases, taking into account all the evidence submitted by the British Dental Association and the UK Department of Health. On a related matter, Ben Wallace suggested extending the commitment payment scheme for NHS dentists. That has just been introduced. The first payments were made this month, and more than £2 million will be paid this year. The same review body will comment on further remuneration.

The problem of access is one of a number of issues that will be considered by the implementation support group that has been set up to take forward the action plan for dental services in Scotland. The group had its first meeting on Monday, and comprises a cross-section of experts with an interest in dental issues.

To achieve improvements in dental provision, we need to have the people to deliver them—the right number of people with the right skills in the right place. Apart from the action plan, we issued in September a discussion paper on planning the dental work force, which proposes that the target for dental schools should now be an output of 120 graduates per year, which Mike Rumbles referred to. I remind him that that is a considerable increase over the past few years, and we are aiming to keep the output at 120. We have been able to arrange with the Scottish Higher Education Funding Council to implement that target.

We are also close to achieving the target of providing postgraduate vocational training places for all Scottish graduate dentists—that did not exist in the past. We can influence where that training takes place, and we will look at the north-east in that regard, which may partly answer Mike Rumbles's point about extending out from Dundee, although I hope to have other things to say about that in a moment.

I will turn now to the hospital sector, which was referred to in general terms by Richard Lochhead, and with specific reference to restorative dentistry by Mike Rumbles. Although 90 per cent of dental treatments are in primary care, hospital specialists are a vital part of the service. We are aware of the concerns in Grampian, in particular about the number of specialists in restorative dentistry. There are 22 such specialists throughout Scotland, or one per 230,000 population, which is better than the guidelines recommend. They are based in the four main cities, and provide outreach services to other health board areas. As with other dental specialties, there is a geographical imbalance between population and the number of specialists, and we need to deal with that through managed clinical networks. Those are currently being discussed for orthodontics and oral-maxillofacial surgery, and restorative dentistry will follow. Those networks ought to involve new links between Dundee and Aberdeen.