Scotland: NHS dentistry remains at risk as Government forces through support plans
3 March 2022
We have warned that dental practices will continue to face grave uncertainty, as the Scottish Government moved to impose an interim funding model for the service without meaningful negotiation.
We welcome the introduction of a 'multiplier' to be applied to dental fees. However, dentists have significant concerns that the planned 3-month review will have serious implications for patient care and will leave practices unable to plan. We remain steadfastly opposed to the return to the unworkable high volume/low margin model of care that operated pre-COVID, and have urged the Government to apply the multiplier until new contractual arrangements are in place.
We have consistently argued that the Scottish Government needed to significantly increase the current inadequate fees for extractions and denture repairs. Increased lab fees mean that dentists often provide these treatments at a loss, and the treatments are particularly prevalent in more deprived areas so any reduction in provision may further widen oral health inequalities.
This announcement follows a bruising debate in Holyrood last week, in which all opposition parties accused the Scottish Government of failing to heed the warnings from the BDA on the potential collapse of NHS dentistry in Scotland. A BDA survey from late last year reported that 80% of dentists expect their practices will reduce their NHS commitment should the Scottish Government withdraw emergency support and return to pre-COVID models of care.
We have also warned that comments made yesterday by the Public Health Minister fly in the face of the facts, given the tight restrictions practices continue to work to. Maree Todd MSP incorrectly stated that "from April, the new system will support dentists to see more patients": an impossibility without meaningful change to COVID operating procedures.
Both the Scottish Government and the BDA recognise the urgent need for long-term contractual reform. The Government has committed to start discussions as soon as the interim funding model is in place. We have stressed that the negotiations must include all practice activity – including work on prevention that is currently unremunerated - and adopt an evidence-based approach to address the current low fees.
David McColl, Chair of the British Dental Association's Scottish Dental Practice Committee, said:
"Bruised by the political pressure that's been brought to bear in recent weeks, Ministers have railroaded through a package that will leave practices totally unable to plan.
"The idea this package is the result of meaningful negotiation is laughable, and any idea that practices can see more patients from April flies in the face of the facts. Dentists are still working to tight restrictions, and there is no sense we are returning to anything resembling 'business as usual'. The Government needs to communicate this clearly to patients.
"Applying a multiplier is the right call but the Government should have taken this opportunity to address derisory fees. We have faced the absurd situation where dentists are providing NHS care at a loss.
"What NHS dentists desperately needed was some certainty on what's expected of them in the year ahead. The choice to put these new arrangements in place for just three months is an exercise in futility."