Hansard

I, too, am delighted to see Margaret Ewing back. If I may say so, Margaret looks very well. It is nice to see her back in her stride, as feisty as usual, for the people in Moray.

I picked up the following figures in the tea room about 10 minutes ago. I was actually quite shocked to see the fall in the number of registrations for general dental services. Since 1997, the registration of children has fallen by about 64,000 and the registration of adults has fallen by 197,464. When comparing health board areas, we see that the percentage of adult registrations in Highland is 38 per cent and in Grampian is 46 per cent, while in the Borders it is 58 per cent. The situation is mixed throughout Scotland.

We often talk about access to dental services and I have come across something that has surprised me. Will the minister confirm that there is no guarantee of access for patients to general dental services, unlike the case with general medical services?

As Margaret Ewing has outlined, the position in Moray is particularly critical. I, too, draw members' attention to the Consumers Association report, which notes that more than 50 per cent of dentists in Moray are over 55. Unless action is taken, the position is likely to get worse rather than better. In the same study, the Consumers Association pointed out that in Edinburgh, 40 per cent of dental practices were not taking on all NHS patients and in Aberdeen 80 per cent of dental practices were not taking on all NHS patients. That means that if Moray patients are seeking NHS dental treatment in Aberdeen, they will have to seek out the 20 per cent of practitioners who will welcome them as NHS patients.

The Consumers Association report also states that dentists had commented that it was not worth taking on NHS patients because of the low fees that dentists get from the NHS. In the Highlands and Islands, one practice had not taken on an NHS patient for five years and another practice quoted charges of £105 an hour. Several dentists in the Highlands said that NHS work did not pay enough to make it sustainable.

Like many members, I welcome the dental action plan, "An Action Plan for Dental Services in Scotland", which was introduced in August 2000. I know that we can all be quite carping and critical about the glossy brochures, but the action plan is excellent and two years later it is probably time to carry out a progress report and produce an update. If everything in the plan had been implemented, people in Moray would not face the problems that they do today.

The other point that has come to my attention in the Highlands is the statutory obligation on authorities to provide dental checks for schoolchildren three times throughout their education. It was confirmed quite recently at a meeting between MSPs and NHS Highland that NHS Highland does not meet that obligation.

Looking back at my file on dentistry, I found several letters from dental therapists, who were seeking to review the dental auxiliaries regulations under the National Health Service (Scotland) Act 1978. The regulations allow them to practise in the public health services but forbid them to work in general dental services. I understand that dental therapists are not the answer to the shortage of dentists. Nonetheless, given that they can carry out some extractions, some fillings, cleaning and polishing, scaling and giving advice, the removal of those restrictions would be very helpful. I understand that Westminster is currently considering that issue.

The dental action plan proposes the establishment of drop-in centres in the major cities and enhancing the role of mobile services. I understand that a drop-in centre is being established in Edinburgh. The use of mobile units would undoubtedly be helpful in rural areas.

Can the minister confirm that NHS 24, given that it is up and running in Aberdeen, is giving advice on dental problems, as promised in the action plan? Can the minister confirm that NHS 24 is also giving advice on access to dental services, which would be so helpful for the people in Moray?

Page 13 of the action plan says:

"Primary Care Trusts should review locally how GDS and CDS"—

that is general dental services and community dental services—

"can work together effectively to complement each other's services"

and draw up a local service plan. Do all areas in Scotland have a local service plan? Are they doing what the Executive has asked them to do and are such plans sufficient to meet the needs of patients?

Finally, I am sorry that Ian Jenkins is not here tonight because he regularly makes the point that the difficulties in accessing dental treatment mean that in many cases oral cancer is not picked up.