I’ve taken the helm of the Scottish Dental Practice Committee, a year out from a Holyrood election. Payment reform has probably seen the biggest change to NHS dentistry in Scotland for a generation, and we are now 18 months in.
I wanted to know what the frontline felt at this crucial juncture. Your message is clear: this can’t be the final destination.
A place to build a career?
First the good news. As the only UK nation to have experienced something resembling 'contract reform' there are reasons to be cheerful.
The clear consensus from the frontline is the reformed SDR is clearly an improvement on what came before. But, in terms of sustainability, bureaucracy, prevention, access and inequality there is still much more to do.
For me, the number that struck me most is that nine out of ten of my colleagues couldn’t describe the NHS as an attractive place for dentists to build and maintain a career.
This simple fact is why we must ensure the Scottish Government don’t view payment reform as the end of the road.
It's the problems with recruitment and retention, not just for dentists, but for our whole teams. It’s the lack of career progression; it’s the reality that if you’re working in NHS dentistry, stress and burn out are endemic.
As dentists we believe in prevention. And that principle needs to be applied to the pressures we’re under. Because broken systems have a very human cost.
A reckless budget
The National Insurance and National Minimum Wage hikes in the UK Government’s last Budget kicked in this month, and we know it is going to impact on how we run our businesses.
I’m concerned this will take a wrecking ball to already struggling practices, undoing the progress we've secured with payment reform. We’ve directly lobbied the First Minister and Cabinet Secretary for Health and Social Care, to continue to press for mitigations of these new costs.
To spell out the facts on the real consequences of these hikes. I’m grateful to the dentists who’ve joined with us to ensure hundreds of messages have landed with MSPs.
You’ve told them what this means for your practices, and the care that you might not be able to provide for thousands of their constituents. What remains clear in your feedback is that one Government – either North or South of the border - is going to have to fix it.
We’ve stood shoulder to shoulder alongside the other primary care independent contractors in Scotland, including the BMA, Community Pharmacy Scotland, and Optometry
Scotland. We’ve backed a joint message from the First Minister to the Chancellor of the Exchequer.
Workforce needs to work
A practice-level workforce census was sent to all dental practices by the Scottish Government in the spring of 2024. It’s stated purpose was to better understand the current dental workforce. We understood they would use the results to inform workforce planning.
From where I’m sitting in my practice, I know recruitment of dentists into NHS dental practice is hugely challenging. Colleagues are choosing to work less than full time, many are building up their private work, as costs are mounting.
The net result is gaps we can’t fill. And it’s not just dentists, its every member of the team we depend on. We know that we can’t go on like this. This workforce census needs to be put to work.
It should underpin an evidenced based workforce plan. We are calling on the Scottish Government must develop a fully-costed, fully-funded NHS dental workforce plan, as a matter of urgency.
Reform isn’t done
I don't have a crystal ball – but I can read a calendar. And we are a little over a year out from the next Scottish Elections.
I don't know who will form the next government. But we made a point of asking dentists what they wanted from it, what message would you deliver to the next Scottish Government?
The one answer that stuck in my mind was short and simple: “Reform needs to continue”.
The next government cannot see payment reform as a final destination. We want this service to be a place where dentists choose to build a career. Let’s be clear, there can be no NHS dentistry without NHS dentists.
I will ensure your voice is heard by the Scottish Government and across all political parties. We need appropriate resource both in terms of funding and workforce, to allow NHS primary care dentistry to have a sustainable future.
The SDPC will continue to fight for a service fit to work in. One which not only retains but also attracts dentists to provide NHS dental care. We will also continue to represent the needs of all those providing care in the GDS in Scotland, be that privately or via the NHS.
Thank you for voicing your concerns and for standing with us.