Scottish Government tinkering around edges of dentistry reform

27 July 2023
By Bill Heaney

The British Dental Association has said Scottish Government reforms to NHS dentistry fall short of the root and branch change required to make the service fit for the 2020s.

Following tense negotiations, a reformed payment system will be rolled out from 1 November 2023.

This includes changes to the fees provided for many treatments and will see the number of items on the ‘menu’ at dental practices slimmed down – purportedly meant to make it less burdensome – to 45 codes down from around 400.
The BDA had stressed that surging costs had left practices delivering some NHS care at a financial loss, particularly for items like dentures that require laboratory work. These items have seen significant increases in fee levels.

However, the professional body has stressed reforms offer no fundamental changes to the current model of care.

The service is still predicated on a low margin/high volume system, without the appropriate targeting of resources for those in highest need.
The BDA had been seeking a clean break towards a new patient-centred and prevention-focused model and say the package as it stands will do little to tackle deep oral health inequality across Scotland.

Dentist leaders have warned ministers not to view the current package as a “final destination.” There is uncertainty over whether these changes will be sufficient to halt the exodus of dentists from NHS services and restore access to millions.

The Scottish Parliament COVID Recovery Committee recently concluded its inquiry into the recovery of NHS dentistry, including a recommendation that the Scottish Government provide costings for – and consults on – different service model options, including those that it does not prefer, in partnership with the sector so that the opportunity is not missed to consider a full range of options for the future of service delivery.

David McColl, Chair of the British Dental Association’s Scottish Dental Practice Committee said: 
“We’ve secured some improvements, but the fundamentals of a broken system remain unchanged. 

“The Scottish Government have stuck with a drill and fill model designed in the 20th century. They were unwilling to even start a conversation on making this service fit for the 21st.

“Ministers cannot pretend this is a final destination for NHS dentistry in Scotland. We struggle to see how these changes alone will close the oral health gap, end the access crisis or halt the exodus from the NHS.”

Scottish Labour health spokesperson Dame Jackie Baillie said: “For years Scotland’s dentists have been let down by this SNP government.

Labour’s Dame Jackie Baillie and LibDem health spokesperson Alex Cole-Hamilton.

“The SNP’s payment reform plans fall far short of the mark and risk forcing more and more dentists into the arms of private practice.

“The very existence of NHS dentistry is in doubt on the SNP’s watch.

“The government must listen to dentists and implement proper pay reform before access to dentistry becomes even worse.”

Under the SNP, tooth-care is fast becoming a luxury, leaving Scots struggling in pain, according to the LibDems.

The British Dental Association has claimed that Scottish Government reforms to dentistry “fall short of root and branch change required to make the service fit for the 2020s,”.

The Chair of the BDA’s Scottish Dental Practice Committee has indicated that “the fundamentals of a broken system remain unchanged.”

Scottish Liberal Democrat leader and health spokesperson Alex Cole-Hamilton MSP said:  “The Scottish Government has abandoned NHS dentistry. Tinkering around the edges is a complete insult to dentists and patients.

“As research from my party has shown, there has been a colossal drop in the number of treatments and check-ups being carried out on the NHS.

“Over a million people registered with an NHS dentist haven’t seen them for over 5 years and hundreds of dentists have been lost.

“Under the SNP, tooth-care is fast becoming a luxury, leaving Scots struggling in pain.

“Scottish Liberal Democrats have set out plans which would deliver quality, accessible dental care in every community.

“To save NHS dentistry, we would reform funding structures, enable more NHS patients to be seen and rewrite the NHS Recovery Plan to include a comprehensive plan for dentists.”

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