Chamber and committees

Abortion is highly regulated in healthcare, which is incredibly important. The committee heard some important evidence from women who had accessed abortion services that they were slightly surprised at the level of questioning and advice that they got to ensure that they were making the right decisions for themselves. I thought that that evidence was very powerful.

You also heard what I felt was very powerful evidence from Professor Cameron about the level of support that members of staff give to women who are exploring or seeking abortion. When leaflets that have been handed out by protesters or people holding vigils were shared with members of the committee, it was clear that they did not contain the right medical information. I find that concerning. It was noted in evidence that, after some women had received those leaflets, the staff in the facilities had to provide more assurance—which is right, as all the questions should be asked. However, I go back to what I said earlier, which is that abortions are very regulated, and the healthcare that is provided is very regulated and supported. I believe that it is from healthcare professionals that people should be seeking that level of advice and support.

I think that, in evidence to you, the police made it clear that they would not be asking people whether they were praying, which I believe happened to one of the women who gave evidence to you. As I said earlier, there would have to be other things around the demonstrations, which the police would look for.

What we are protecting individuals and society from is the intention to cause alarm and distress and impede access.

If there is a chapel or church within the 200m buffer zone, their doing so inside that building will be absolutely fine. That is not captured by the bill.

Good morning, and thank you for the opportunity to speak about the dental regulations, which are to be dealt with under the negative procedure. As the convener has noted, I am supported today by my senior policy officials Tom Ferris and Tim McDonnell, and legal official Ailsa Garland.

If I may, I will talk briefly about the purpose of the regulations, as well as the changes that we will be making under them. As the committee will be aware, the Scottish Government has been working on NHS dental payment reform for some time now. In my letter of 18 October to the committee, I outlined the key components and benefits of the new payment system, which will be implemented in just over a week. I will be happy to take any questions on that during the meeting.

In relation to the regulations, a number of key changes are required to various existing regulations to support payment reform. As part of those changes, we are introducing a single capitation arrangement for all patients, regardless of age, and all treatment items will, where it is clinically appropriate, be available for both adult and child patients.

We are also making changes to support unregistered patients. The system that is known as “occasional treatment”, under which unregistered patients can receive only a reduced set of care and treatments, will be removed through the amendments that will be made by the regulations. That means that both registered and unregistered patients will be able to access the same comprehensive range of treatments, by removal of what might be construed as a two-tiered system of care.

The changes are also focused on bringing clinical practice up to date. The new single capitation arrangement will rest on “managing” the oral health of the patient, by replacing the requirement to

“secure and maintain the oral health of the patient”.

The more achievable aim of managing oral health recognises that self-care is an important determinant of successful oral health outcomes.

I confirm that the equality impact assessment for the regulations reports no significant issues, and that the business regulatory impact assessment reports no adverse consequences.

In summary, the regulations are part of the significant work that we have undertaken to prepare for implementation of payment reform on 1 November 2023. The changes will support the introduction of the most significant reform to NHS dentistry in a number of years, and it is our intention that the reform will help to sustain and improve patient access to NHS dental services for the long term.

I am happy to take questions from the committee.

As we know, we lost one cohort of dental students during the pandemic, which is about 160 students, or 5 per cent of the workforce. I am pleased to be able to let the committee know—I might also have referenced this in my letter—that 183 dental students are going through training this year, which is incredibly positive.

With regard to the point about dental students not wanting to move into NHS dentistry, I know that the COVID-19 Recovery Committee took such evidence. However, evidence that the Scottish Government and officials have had does not, in fact, show that. Many students want to go into the NHS because it gives them such a fantastic training base. My local practice on Islay supports trainees to come and experience working in a rural practice, which gives them a wide range of training opportunities.

I have been in this role, and have been an elected person, long enough to know that it is very difficult to guarantee anything in this life. What we have done is based on discussions with dental practitioners in Scotland and takes cognisance of academic research, to which I referred earlier. We believe that it is the right change at this time to ensure that access to NHS dentistry in Scotland is maintained.

I mentioned payment reform specifically because that is what we are talking about now. We have continual meetings with the BDA and dentists, and everything is always on the table when we are in discussion with them.

As I said in response to the convener’s question earlier, we will work very closely with dentists to ensure that we get a note of and recognition of how the changes improve accessibility and sustainability of the service. That will be on-going work, once the system is bedded in.

No. The intention is to also improve access. We have been very clear that we intend that the regulations will improve the sustainability of, and access to, NHS dentistry in Scotland.