Chamber and committees

I think that what we are looking at is a prevention-centred dental care service. The childsmile programme that we have rolled out to improve the oral health of young children is not disease-centred; it is very much centred on prevention.

We have also been very clear—again—about sustainability of services and ability to access dental services, which I think are really important.

The change that we are making with regard to unregistered patients is also important, because it moves us into the preventative space. When we bring all the regulations together, they show that we want to ensure that there is sustainable access to NHS dental services for the people of Scotland.

Yes, I can. I am aware of that issue from my conversations with the BDA.

In Scotland, we have a blended method. It combines a capitation payment for the number of people who are seen by a practice—one of the changes that will be made by the regulations is that adults and children will now be treated for the same fee, which, I think, is positive—and a payment for the services that a dentist provides. I think that that method will work very well, given the variety of dental organisations and businesses that we have.

In fact, yesterday Tom Ferris met some of the academics whom I referenced in my letter of 18 October, who are very supportive of a combined method of paying for our NHS dentistry and think that that is the right way. We have been very clear that we are building on a foundation that we already have in Scotland that works very well and on which practices are already built. I think that the reformed blended system is the right way for us to move forward. In that meeting, Tom Ferris discussed the possibility of making changes in Scotland. The advice that we got from academics from North America, Europe and Australia was that, if we look at how dentists’ services work across the world, we see that a simple lift and shift would not necessarily provide a better service. Their strong view was that we should modernise a system that is already working, which is what the Scottish Government has endeavoured to do, through the changes that we are making with the regulations and payment reform.

We have been aware of that in planning for the change, which will happen next week. As I said earlier, my officials have held a number of webinars with dentists to explain the new regulations and way of working. I understand that they have been extremely well appreciated and well attended. I think that there were about 1,000 people at the first webinar meeting, which was oversubscribed. As a result, another one is being held tomorrow evening to ensure that dentists are across the subject. We are also doing webinars on specific subjects, including periodontistry, to ensure that the reform is widely known about across the profession. Feedback has been incredibly positive.

I thank my officials for the work that they have put into that engagement, because I appreciate how important it is that the professionals absolutely understand the changes that we are making.

On public messaging, you are absolutely right. In fact, I walked past a dental surgery in Glasgow the other day and thought, “Oh my goodness, they’ve got their poster out early”, but it was a different poster. We are doing a variety of public engagement and messaging, including posters in dental practices, libraries and so on, as well as a multimedia campaign, so the information will be on the radio and other media outlets. I hope that we have everything covered, but we will evaluate that as we go.

As I said, we have made it very clear that we will have continual discussions with the BDA about the payment reform that we have introduced.

If you do not mind, I will pass that question to Tom Ferris.

That is a really important question to ask. Broadly speaking, we intend to maintain access to NHS dentistry across Scotland through the reforms. I will hand over to Tom Ferris.

We should remember that everybody under 26 gets free dentistry and, as I have said, between 20 and 25 per cent of adults do not pay for their NHS dentistry. What we had to do was look at the best way of ensuring that we sustained the number of dentists and dental practices in Scotland, and it was felt that a slight increase in the fees was the right move. The fees are still capped at £384.

As I think I mentioned earlier, the concern that I have been hearing with regard to dentistry is about access. That is the issue that we believe the changes and amendments in the regulations will help us to address.

Most definitely. The cost of living issue floods through every decision that we make just now, so it is absolutely something that we will be keeping an eye on.

The Government supports people on low incomes in a number of ways. I think that between 20 and 25 per cent of adults in Scotland do not have to pay for their NHS treatment. The fact that we have free examinations is important as well.

Earlier, I highlighted other initiatives, such as childsmile for getting younger children into the habit of cleaning their teeth, which have been incredibly helpful. Statistics that came out today show that 82 per cent of primary 7 schoolchildren have no obvious tooth decay. That high level backs up the investment that we have put into the preventative side of oral healthcare for children.

The nub of the reforms is about ensuring that we sustain NHS dentistry in the long term. Like you, I have received lots of emails about the access that people have to dentistry. We have the reforms, but we also need to remember that the Scottish Government has put other grants in place. For example, the Scottish dental access initiative offers £100,000 for a new practice in an area. We have been in discussions with health boards to ensure that we target those grants in the right areas. We also have some remote—although I do not like using that term—grant payments, which are really important.

The conversations that Tom Ferris and I have with the health boards are also important, because the boards have a responsibility to look at how dental services are being provided in their jurisdictions. I was pleased to hear that Scottish Borders, Dumfries and Galloway and Highland are now working together to encourage more dentists to come to areas that have had recruitment issues. As I said to David Torrance, we also need to keep an eye on the breadth of skills in dental surgeries to ensure that they are supported.