Seòmar agus comataidhean

If there is a chapel or church within the 200m buffer zone, their doing so inside that building will be absolutely fine. That is not captured by the bill.

Good morning, and thank you for the opportunity to speak about the dental regulations, which are to be dealt with under the negative procedure. As the convener has noted, I am supported today by my senior policy officials Tom Ferris and Tim McDonnell, and legal official Ailsa Garland.

If I may, I will talk briefly about the purpose of the regulations, as well as the changes that we will be making under them. As the committee will be aware, the Scottish Government has been working on NHS dental payment reform for some time now. In my letter of 18 October to the committee, I outlined the key components and benefits of the new payment system, which will be implemented in just over a week. I will be happy to take any questions on that during the meeting.

In relation to the regulations, a number of key changes are required to various existing regulations to support payment reform. As part of those changes, we are introducing a single capitation arrangement for all patients, regardless of age, and all treatment items will, where it is clinically appropriate, be available for both adult and child patients.

We are also making changes to support unregistered patients. The system that is known as “occasional treatment”, under which unregistered patients can receive only a reduced set of care and treatments, will be removed through the amendments that will be made by the regulations. That means that both registered and unregistered patients will be able to access the same comprehensive range of treatments, by removal of what might be construed as a two-tiered system of care.

The changes are also focused on bringing clinical practice up to date. The new single capitation arrangement will rest on “managing” the oral health of the patient, by replacing the requirement to

“secure and maintain the oral health of the patient”.

The more achievable aim of managing oral health recognises that self-care is an important determinant of successful oral health outcomes.

I confirm that the equality impact assessment for the regulations reports no significant issues, and that the business regulatory impact assessment reports no adverse consequences.

In summary, the regulations are part of the significant work that we have undertaken to prepare for implementation of payment reform on 1 November 2023. The changes will support the introduction of the most significant reform to NHS dentistry in a number of years, and it is our intention that the reform will help to sustain and improve patient access to NHS dental services for the long term.

I am happy to take questions from the committee.

As we know, we lost one cohort of dental students during the pandemic, which is about 160 students, or 5 per cent of the workforce. I am pleased to be able to let the committee know—I might also have referenced this in my letter—that 183 dental students are going through training this year, which is incredibly positive.

With regard to the point about dental students not wanting to move into NHS dentistry, I know that the COVID-19 Recovery Committee took such evidence. However, evidence that the Scottish Government and officials have had does not, in fact, show that. Many students want to go into the NHS because it gives them such a fantastic training base. My local practice on Islay supports trainees to come and experience working in a rural practice, which gives them a wide range of training opportunities.

I have been in this role, and have been an elected person, long enough to know that it is very difficult to guarantee anything in this life. What we have done is based on discussions with dental practitioners in Scotland and takes cognisance of academic research, to which I referred earlier. We believe that it is the right change at this time to ensure that access to NHS dentistry in Scotland is maintained.

I mentioned payment reform specifically because that is what we are talking about now. We have continual meetings with the BDA and dentists, and everything is always on the table when we are in discussion with them.

As I said in response to the convener’s question earlier, we will work very closely with dentists to ensure that we get a note of and recognition of how the changes improve accessibility and sustainability of the service. That will be on-going work, once the system is bedded in.

No. The intention is to also improve access. We have been very clear that we intend that the regulations will improve the sustainability of, and access to, NHS dentistry in Scotland.

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.