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Scotland: Preventing the collapse of NHS dentistry

Blog Author David McColl

Blog Date 25/02/2022

Opposition parties are joining our call for meaningful support and real reform.


                                                   Parliamentary debate 23 February


With over 3.5 million NHS dental appointments lost as a result of the pandemic and morale in the profession at an all-time low, we have warned that failure to take action risks sparking an exodus from the workforce – which would mean families across Scotland losing access to NHS dentistry for good.


We are making the case for better support for the profession and necessary long-term change with both the Scottish Government and opposition parties. The Parliamentary debate which took place on 23 February on "preventing the collapse of NHS dentistry in Scotland" shows that we are winning the argument on behalf of our members.


MSPs from all opposition parties were unanimous in accusing the Scottish Government of complacency and failure to act to prevent an exodus from NHS dentistry and restore access to millions. While the Government MSPs voted against a motion on support for NHS dentistry, which was tabled by the Scottish Conservatives and backed by both Scottish Labour and Liberal Democrats, the lively debate saw pressure mounting on the Government to deliver meaningful support and real reform as we emerge from the pandemic.


No return to 'business as usual' 

"Dentists are having to sacrifice their own welfare for the sake of providing basic services that they should be given the resources to deliver."

Ministers have been planning to cut pandemic support from April. We have consistently warned that the plans to end COVID support payments and return to a low margin/high volume model of care would devastate dental services across the country.


Our concerns were echoed by MSPs from all opposition parties who condemned the decision to return NHS practices to pre-pandemic models of work and end Covid support payments from April.


"Dentists are having to sacrifice their own welfare for the sake of providing basic services that they should be given the resources to deliver" argued Leader of the Scottish Liberal Democrats Alex Cole-Hamilton MSP. "Dentists within the NHS are being handed a severe lack of funding and slashed unit prices, which is being combined with an increased demand for dental services. It is a perfect storm." 


Both Conservative and Labour spokespeople called for support payments to continue beyond April, stressing they were essential while infection control restrictions remain in place. The sponsor of the debate, Conservative Health Spokesperson Dr Sandesh Gulhane MSP concluded: "The Scottish Government has failed to grasp that NHS dentistry needs to be adequately funded to retain a skilled workforce. If we do not help the profession, we risk losing NHS dentistry forever." 


Profession looking for the exit  

80% of Scottish dentists plan to reduce their NHS commitment and one in 10 expect their practice to close if the Government reverts to pre-pandemic arrangements. We have warned that a failure to act risks sparking an exodus from the workforce which would mean families across Scotland losing access to NHS dentistry for good.


"Dentists are exhausted and demoralised, and many are looking for the exit."

"Dentists are exhausted and demoralised, and many are looking for the exit" warned Dr Gulhane.

 

"Morale in the profession is at an all-time low, with more than a third of dentists stating that they will leave the profession altogether in the next 12 months, should the minister's current funding model go ahead," argued Labour MSP Paul O'Kane. "Without an immediate and comprehensive support plan being put in place, the Government risks the collapse of NHS dentistry in Scotland becoming its legacy." 


Scottish Labour's Deputy Leader Jackie Baillie MSP also highlighted the "plummeting staff morale" stressing that "urgent action is needed to pull our NHS dentist services back from the brink." 


Need for meaningful reform  

MSPs stressed that the crisis in dental services in Scotland pre-dates Covid. "Even before the pandemic the SNP was letting down NHS patients with its conveyor belt approach to dentistry." argued Conservative MSP Sue Webber.


Parliamentarians have echoed our warnings that the current fee-per-item model is not sustainable for NHS dentistry in the long term, and pressed for a new system that prioritises prevention, is patient-centred and reflects modern dentistry.


Dr Gulhane called the current payment system "ridiculous" and called on the Scottish Government to work with the BDA to deliver "root-and-branch" reform.

 

Jackie Baillie said: "The very existence of NHS dentistry in Scotland is currently under threat. The issue is the outdated funding model and I desperately encourage the Cabinet Secretary to reform it." 

 

MSPs accused the administration of "indecision and ineffectiveness" and urged the Ministers to "get a grip of the situation and bring forward a credible plan" for the future. 

 

Cabinet Secretary for Health and Social Care, Humza Yousaf MSP acknowledged the need for a "root-and-branch reform of the sector" but said, "the immediate priority has to be to work through the backlog". We were disappointed to see him and various parliamentary colleagues try to dismiss the reality colleagues are facing on the frontline as "sensationalist" and "unfair." But he did stress the Government would continue working with us on a new funding package from April.  

 

We continue to negotiate with the Scottish Government on a new financial settlement and will keep up the pressure for meaningful support for our members and real reform for the future. 



David McColl

David McColl
Chair of the Scottish Dental Practice Committee