S2M-3584 Dentistry

Scottish Parliament

Thursday 17 November 2005

[THE DEPUTY PRESIDING OFFICER opened the meeting at 09:15]

Dentistry

The Deputy Presiding Officer (Trish Godman): Good morning. The first item of business today is a debate on motion S2M-3584, in the name of Lewis Macdonald, on dentistry. I invite members who wish to speak in the debate to press their request-to-speak buttons.

09:15

… … …

11:23

Stewart Stevenson (Banff and Buchan) (SNP): One of the dangers in such debates is that we oversimplify the issue. We all have to concede that it is immensely complex.

In an especially interesting and relevant contribution, Des McNulty referred to the underachievement in oral health in his constituency. I accept his points; they were absolutely true. Nonetheless, in the greater Glasgow area, there are 7.48 dentists for each 10,000 of population—the highest ratio in Scotland. The issue is much more complex than taking a simple measure of the number of dentists. However, we cannae do it without dentists, so it is important that we talk about the numbers.

In the area that I represent—Grampian—we have just over half the number of dentists for each 10,000 of population that people in the greater Glasgow area have. Our figure is 3.9. Elaine Murray's concerns over the issue are graphically illustrated by the fact that her area is at the very bottom of the table, with a figure of 3.46. In areas where there are few dentists, it is clear that too many people cannot access dental services. That applies both to private and to NHS services in certain areas, including, for a time, one of the large towns in my constituency. Simple nostrums do not deliver the answers to complex problems. On that basis, we welcome the debate that the Parliament has had today.

There is nothing so glad to the heart as a sinner who repenteth. I welcome the additional resources and the setting of priorities. I need only look back to the "Draft Budget 2005-06", which is about a year old, to find that there is only one reference—in what is a very large document—to dental services, on page 56. None of the targets and objectives for the health service refers to dentistry and the proposals for the years up to 2008 show a flatlining budget for general dental services for four years in a row from 2004-05. The response by the Executive and the changes that it has made are most welcome, but they are comparatively recent. That illustrates the value of sustained parliamentary pressure from members of all parties—I include in that members of the Executive parties, some of whom have had a Damascene conversion.

When he opened the debate, the Deputy Minister for Health and Community Care said that the Executive's measures were good news for dentists and patients. I would prefer him to have said that they were good news for patients and dentists. Although the difference is subtle, the change of emphasis is not trivial. Let us not talk about dentists, except in so far as they meet patients' needs. My colleague Tricia Marwick made the fine point that we need a degree of clarity on what "patients" actually means; I am sure that the minister will be able to give us that clarity. Unless it means all the people in Scotland who wish to access NHS dentists, we will be missing a trick. I hope that we will get reassurance on that.

The minister said that we must encourage dentists to rejoin the health service, but that might require a lot of courage on their part, given that there will be no substantial economic benefit to them as individuals. Dentists can make quite a lot of money in the private sector, although I would not seek to suggest that dentists in the NHS sector are impoverished. However, dentists who have gone to work in the private sector find that they can spend more time with their patients for similar money and feel that they provide a much higher quality of service. That is one of the fundamental difficulties that we face in recovering from the neglect of dental services that was started during the Tory years. I believe that dentists want to do a good job in delivering good oral health for the people of Scotland.

The minister said that we must have patience. That is certainly true in the sense that there is no quick fix that will deliver a solution overnight but, as Mao Tse-Tung said, a journey of 1,000 miles starts with a single step. We have made slightly more than a single step; we are on the case and we will continue to watch what gets delivered, as distinct from what gets done. The two are quite different—action is no substitute for achievement.

It is true that the dental health of our five-year-olds is the best ever, which is good, but NHS boards will continue not to move dentistry as high up the agenda as I and colleagues would wish it to be until there is a statutory duty on them to deliver NHS dental health services. I do not propose a date by which that duty should be imposed, because that would be for me to succumb to simplistic, knee-jerk reactions, but I think that we should say that we will have a statutory duty in the future, when the resources are in place and we have a plan that sustains that approach. That will give confidence to dentists and—more to the point—patients.

Richard Baker let down the tone of the debate when he attacked some dentists' conflict of interests. On conflict of interests, I need only refer to some of the member's Labour colleagues. Eight days after ceasing to be a Government minister, Baroness Symons became a director of British Airways. Alan Milburn, a former Secretary of State for Health, is now a consultant to Alliance Medical, which has big contracts with the NHS. The former UK energy minister, Brian Wilson, works for AMEC Nuclear and, within months of being Lord Chancellor, Derry Irvine was working as a consultant for Hutchison Whampoa, which wants £77 million from the Government. I ask Richard Baker to think again on conflict of interests.

We can discuss the past ad nauseam, but we cannot change it, so the SNP will make common cause with the Executive to tackle Scotland's oral health deficit. We now need the Executive to make common cause with the dentists.

11:30