21 April 2005

S2M-2708 Dental Health Services

Scottish Parliament

Thursday 21 April 2005

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

… … …

Dental Health Services

The Presiding Officer (Mr George Reid): The next item of business is a debate on motion S2M-2708, in the name of Roseanna Cunningham, on behalf of the Health Committee, on access to dental health services in Scotland.


… … …


Stewart Stevenson (Banff and Buchan) (SNP): I note, as I am sure do other members, that the Scottish Socialist Party, the most toothless party in the Parliament, is again absent from a debate that we would expect to be of particular interest to a party that trumpets its support for the disadvantaged in society. The matter is clearly too difficult for the SSP. However, the rest of us can have a serious debate, as is right.

The Health Committee did an excellent job in commissioning much new information and data. Members know that I always pore over numbers. I am always excited when I have a new source of data on which I will be able to draw for some time.

I received a letter today from the Deputy Minister for Health and Community Care, for which I thank her, which relates to a parliamentary question that I asked about dentists per capita. She says that in certain respects the numbers

"should be treated with caution."

That is probably wise. However, a broader issue is opened up, not just for the Opposition but for the Government, which we must try to discuss. I will return to that issue.

The British Dental Association has come in for a certain amount of stick in the debate. I am not an apologist for the BDA, but the organisation makes important points. Before the minister made her announcement on 17 March, the BDA sent a submission to the Health Committee, which was considered on 22 February. The BDA said:

"The existing dental examination Item 1(a) in the Statement of Dental Remuneration is insufficient to determine the needs of patients and to identify and discuss and agree with them the care regimes they should receive as part of a modern dental service."

I agree with the BDA and I suspect that the minister also agrees with its comment.

We must accept that the minister's announcement represented a move forward. However, after she made her statement, the BDA said in its press release:

"Today's announcement does little to tackle the fundamental issues facing NHS dentistry in Scotland. The BDA's hope is that this is not the final chapter and that the Executive will continue to look at dentistry as a priority issue."

Helen Eadie highlighted that point.

There are ways in which the Executive can demonstrate its good faith in treating dentistry as a priority. The minister has heard me compare and contrast health boards' obligation to find a general medical practitioner for a patient with the situation in relation to dentists. If a patient cannot find a GP, the health board must do so. Until we place an obligation on health boards to find an NHS general dental practitioner for a patient who cannot do so themselves, the dental profession will remain the poor relation of the medical profession. Of course, currently we cannot realistically deliver on that proposal and I do not suggest that we make such a change next week. However, we must make it our objective to be in a position to be able to do so.

Mike Rumbles talked about training. On 5 September 2002, I said that we supported the

"suggestion of conducting NHS training in the north-east."—[Official Report, 5 September 2002; c 13510.]

Mike Rumbles will be rather late if he congratulates the Scottish National Party on accepting that position.

Mike Rumbles: The member knows very well that the only occasion on which the SNP's health spokesman has announced the party's support for the establishment of a third dental school in Scotland was this morning.

Stewart Stevenson: My comment of three years ago is on the record and I suggest that the member reads it.

There is particular value in training dentists in Scotland. The helpful research report, "Access to Dental Health Services in Scotland", indicates why that is the case: although 72.5 per cent of NHS dentists were born in Scotland, 88.8 per cent were trained in Scotland. The existence of dental training in Scotland is a key contributor to increasing the number of dentists available in Scotland. The 285 dentists who stayed in Scotland because they were trained here represent 16.3 per cent of NHS dentists. That is why training is so vital and why I, like Mike Rumbles, support every effort to provide additional training.

Over a time I have pursued concerns about the apparent inability to measure what is going on in NHS dentistry. There is an old management truism that what cannot be measured cannot be managed. The £150 million will help, but we do not quite know how it will help, because we are missing the figures. The minister has acknowledged that we do not have enough information on health boards to enable us to plan. That is a fair comment. However, although we pay NHS dentists by item and have statistics about how many dentists are making claims on the NHS and about dentists' activities, we seem unable to analyse the statistics and produce credible information about what is going on. I find that passing strange.

When I was elected as an MSP in 2001, I expected that there would be some privileges. Quite the most unexpected was that, for the first time in a while, I was able to get an NHS dentist, but only because I travel down to the central belt once a week and am able to get one down here. That is excellent for me but not the slightest help to my constituents.

As members know, I am one of the two mathematicians in the Parliament. A neat piece of mathematics describes the present situation: it is called catastrophe maths. It is represented by a folded curve on a graph and is illustrated by this example. If a bullet is fired from a gun, the action cannot be undone by pushing the trigger forward again; an entirely different solution is required. In a similar way, we cannot undo many years of neglect simply with money. Finding a solution will take time however much money is thrown at the problem.

A start has been made and I welcome that. However, more money is not enough. We must make the system more efficient. The Health Committee's report will give us something to chew over for some time to come—that is, for those of us who still have teeth with which to chew.


Stewart Stevenson
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