Scotland: Government plans require forensic scrutiny

We seized the opportunity to spell out to Holyrood’s Health, Care and Sport Committee about the key issues affecting dentistry in Scotland.

We had been expecting to focus on big themes – specifically the need a fully funded workforce plan for the whole dental team – but potentially reckless ideas trailed just ahead of our session meant we had to refocus on new risks.

The Scottish Government have decided to make a top-down reorganisation of the NHS in Scotland a centrepiece. Health boards will be cut from fourteen to two, in a plan the First Minister claims will lead to lead to joined-up delivery, improved access to care and lower inequality.

We can’t fault those objectives, but it’s unclear following publication of the Programme for Government how any of them will be achieved through these proposals.

We’ve stressed to the media and to Members of the Scottish Parliament that experience shows top-down reorganisations of the NHS rarely deliver the goods for taxpayers, patients, or practitioners.

BDA Scotland Director Charlotte Waite warned, “these plans need to be subjected to forensic scrutiny. The only thing we can be sure of at this stage is unintended consequences.”

What seemed completely missing from the Programme for Government was a clear sense of how Scotland will get the dental workforce it requires to meet the needs of its population.

The Public Dental Service cares for the most vulnerable patients in society, but it has seen a fall in headcount of over a fifth over the last decade. We’ve warned that they not only don’t have the intent to meet this need, but they also don’t have the granular data on whole time equivalence to even benchmark the scale of the problem.

We stressed that recent reforms we secured to the payment system may have made the General Dental Service more sustainable – but progress here risks being undermined by failure to tackle surging costs, including 2024’s National Insurance hike.

Back in the recent Scottish Election we showed that one in five adults in Scotland face unmet needs for NHS dental care. We will of course engage constructively with the Government whatever consultations move forward. But as it stands the Programme for Government lacks the detail and ambition we need.