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Is this the end of NHS dentistry in Scotland?

Evidence from members shows the Scottish Government have blindly headed down a path that could destroy this service.

David McColl
David McColl Chair, Scottish Dental Practice Committee
An screenshot of Jeff Ellis talking to a camera
GridEditors.Video.PlayVideo
Dentist Jeff Ellis on why the proposed changes could make NHS treatment in his practice unviable

We doubt Cabinet Secretary Humza Yousaf wants to be remembered as the man who killed NHS dentistry in Scotland.

Yet, without a willingness to reflect on his proposal to cut Covid emergency funding by 1 April 2022 it risks becoming his legacy.

The reason we can be so sure is because we asked - and you told us. The responses to our latest survey have been overwhelming. The depth of feeling across this profession, and the uncertainty hundreds of practices are facing is undeniable.

But we are not just gathering evidence. We are determined to hold the Scottish Government to account. We are pushing the news not only across the media, but through Holyrood itself.

Here’s what you need to know:

We risk an exodus

As things stand we face a potential exodus from this service.

Four out of five dentists in Scotland estimate their practices will reduce their NHS commitment. Over a third indicate they are now likely to change career or seek early retirement in the next 12 months should the policy be taken forward. Some 15% say they are likely to practice dentistry outside of Scotland, and 1 in 10 estimate their practice is likely to cease operations.

But what of the pledged millions in capital funding? Your feedback has outlined the Catch-22 facing members. Over 30% have chosen not to apply.

Anyone signing up for support on ventilation is required to make a long-term commitment to the NHS. And with a broken model that’s now impossible to deliver, even if restrictions ease, it’s an impossible choice.

Sounding the alarm

Your evidence has helped win over the opposition.

Scottish Conservative Shadow Health Secretary Dr Sandesh Gulhane said your warning “could not be more stark.”

“These plans raise the threat of many dentists leaving our NHS and practices shutting their doors. NHS dentists have been severely hit by the Covid crisis and the backlog of appointments is ever growing. Humza Yousaf must urgently listen to dentists’ concerns over how they will be funded in future as they aim to recover from the pandemic.”

Scottish Liberal Democrat leader and health spokesperson Alex Cole-Hamilton labelled the Scottish Government’s proposals as “wholly inadequate”.

“The BDA are right to sound the alarm” he said. “The last thing Scotland needs is a mass exodus as dentists stream for the exits.”

While Scottish Labour’s Jackie Baillie stressed “the Health Secretary must listen to the professionals on the frontline and think again.”

Under scrutiny

This week MSPs continued to press the Cabinet Secretary in Holyrood.

Questions on why the BDA is still waiting for a response to warnings we set out last month. On clarity on the huge risks facing Highland and Island communities as a result of this policy was sought. All based on the evidence you gave us.

The Health Secretary defended his position. He claimed needed reform at this stage would be “hugely disruptive”. But at the same time he said the Scottish Government were “talking about potentially moving to a position of withdrawing the emergency payments on 1 April next year.”

Yousaf promised to continue to engage with us and “hopefully get to a position that we can all agree to the future recovery of the dental sector”. But we did not see evidence of the certainty from his previous messages, and we have no intention of letting this one go.

We need an interim funding model to help colleagues clear the backlog. But reform won’t wait.

If Ministers want NHS dentistry in Scotland to have a future, then work needs to begin on development a sustainable new model for delivering care to the patients that need us.