The next item of business is a statement by Tom McCabe on modernising dental services in Scotland. The minister will take questions at the end of his statement; therefore there should be no interventions.
The purpose of my statement today is to advise of the Executive's intention to undertake a consultation on the future arrangements for primary care dental services in Scotland. Consultation is required to deliver the undertaking in the Executive's white paper "Partnership for Care" that we would take forward, in discussions with the dental professions and the general public, proposals for changes to the system for rewarding primary care dentistry, in order to promote prevention, improve access to services, and improve recruitment and retention.
The minister will take questions on his statement. I will allow until 1 o'clock for questions.
I thank the minister for an advance copy of his statement.
We have made it clear that the supply of dentists is important. Of course, there are about 120 dental graduates each year in Scotland. We are committed to increasing that number. That is why the partnership agreement contains a commitment to establish an outreach centre in Aberdeen. We are committed to examining the possibility of upgrading that to a full training centre if that is required.
I, too, thank the minister for advance copies of the consultation document and his statement.
I have said many times, and our partnership agreement contains a firm commitment on the fact, that we recognise that dental health in Scotland is poor. We are determined to make a substantial difference to that. People in Scotland have warmly received our proposal to make available free dental check-ups to all in Scotland by 2007, which will be part of the process of substantially improving dental health.
Introducing further financial incentives to recruit new dentists is really good news. The Liberal Democrats are pleased that the Executive has accepted that we need to train more dentists in Scotland, which is excellent. I have a specific question on the commitment in the partnership agreement for the outreach centre in Aberdeen. The minister previously announced that £100,000 would go towards funding the research work that is needed for that. Can he give us some idea of the time scale in which those plans will be complete and ready to take forward to the next stage?
Mr Rumbles has quite rightly identified the fact that we previously announced that £100,000 had been made available to establish the planning process that is necessary for that outreach centre. As I said at the time, we expect a conclusion to be reached within six months and we hope that, thereafter, the process will move ahead without any undue delay.
I whole-heartedly welcome the quick response to representations that have been made to the minister on this important subject. He is aware that NHS dental services have, in effect, been withdrawn from large numbers of communities around Scotland—most recently from Longniddry and Haddington in my constituency. I also had a letter from my own dentist in the Borders last month giving notice of imminent withdrawal of NHS services. Is it the Executive's intention that NHS dental services should be restored in areas where they have been lost, so that every citizen of Scotland will again have local access to dental treatment under the NHS?
That is exactly what our intention is. We recognise that the dental service clearly needs to be modernised. We are in the process of modernising a whole range of areas within the national health service, including junior doctors and consultants—the list goes on and on. Dentistry needs the same attention, as it plays such an important role in Scotland. It is very important for the general public in Scotland to know that when they need access to NHS dentistry, it is there for them, when and where they want it.
As from now, I expect shorter questions and answers. I call Eleanor Scott.
I welcome the consultation document, because dental health has been a big issue up in the Highlands, where I come from. I seek an assurance that the consultation meetings referred to will take place in the most rural areas, so that people there who are really suffering from a lack of dental services will be able to make their views known. I hope that the absence of the F-word—fluoride—from the document means that the Executive is now abandoning the idea that that would solve our dental health problems. There is no substitute for dental services.
I can give an absolute assurance that the consultation meetings will take place in every part of Scotland. Given the problems that have been experienced in rural areas in the recent past, there will undoubtedly be a series of meetings in the Highlands of Scotland.
I also welcome the minister's statement and thank him for responding to views expressed by MSPs from around the country. How many dentists will have to be recruited nationally before the minister can achieve his objectives? What discussions has he had with the Minister for Health and Community Care, Malcolm Chisholm, with regard to the shortage of specialist consultants and theatre staff, whose work is also related to this important topic?
With regard to the number of dentists, our work force planning arrangements continue to keep such matters under review. That is why we are considering an outreach centre in Aberdeen and are prepared to consider the possibility of upgrading it if necessary. That is why we are consulting members of the dental professions: to hear their views on exactly what needs to happen. The thread that runs through the entire document is that nothing is ruled out.
I acknowledge the excellent work that Paul Martin and the dental think-tank are doing in the Highlands and I hope that the minister will work with them, as many MSPs have done.
A moment ago, I said that the fact that nothing will be ruled out will be the thread that runs through the consultation. Clearly, we will listen to whatever representations are made during the consultation and take on board as many of those as we can. As with any consultation, we will be able to accept some arguments and not others, but where we cannot respond to demands, we will be obliged to explain why we do not think it appropriate to do so at that time.
Like the other members who have spoken, I welcome the minister's announcement of a substantial package of remote allowances and other incentives to encourage more people to go into dentistry. Of course, there will be a delay in the implementation of the whole package. That must be addressed.
Both the new and the existing initiatives that I have spoken about today encompass a realisation that when allowances are paid, some degree of commitment is expected from new graduates within the NHS, so there is a degree of tie-in in that regard.
I note from the minister's statement that the most significant problems arise in areas of deprivation. How will the measures that he has announced ensure that we address that specific issue?
To reply in general terms, the modernisation of the dental service and the fact that we will allow the service to concentrate on specific issues—as it has been asking to do for a considerable time—will address that matter. It would be desirable for the service to concentrate on young people, to try to stop the rot—if members will pardon the pun—as early as possible. In areas of deprivation, a modernised dental service that offers more flexibility and frees dentists from the bureaucracy that has tied them down for far too long will provide opportunities to target specific groups in the community to improve people's dental health.
I refer the minister to the statement that he issued—rather than the one that he delivered—in which he names the designated areas, one of which is the Scottish Borders. Given that my constituents, from Hawick to Peebles, have like many other people been turned away from NHS dentists, and given that the allowances will not, as I understand it, come into effect until 1 April, can the minister give a time scale for when my constituents will again be able to access NHS dental services?
On a point of order, Presiding Officer. I might be mistaken, but did Christine Grahame refer to a copy of the minister's statement? I would like to make the point that copies were not made available to other back benchers.
I seek your guidance, Presiding Officer. I was simply seeking to assist the minister, who referred to designated areas but did not define them, as he did in his statement as issued.
There is a point here. I will consult the clerks and I suggest that we continue with questions in the meantime.
There is a complete list of designated areas and, as Christine Grahame will know, it includes mainly rural areas, where access problems have been most severe. I understand her point; the new allowances and initiatives do not come in until 1 April next year. However, a range of initiatives are in place and have made a contribution. As I said earlier, the signal that we send today to the dental professions will give food for thought to dentists about the Executive's intentions and about what the future holds for them. I am confident that they will reconsider many of the decisions that they have taken.
Is the minister aware that no NHS or private dentists in my constituency have open lists? Will he assure us that the welcome measures will be monitored closely and regularly to ensure that they work in areas such as mine? Will the Executive consider making it possible for NHS boards to give people who are on low incomes financial assistance to enable them to travel to other NHS board areas to access dental health treatment?
NHS boards can contact the Executive and request our thoughts on a range of issues, one of which is travelling expenses. If a case is made for the provision of such expenses, we would, of course, consider it. I recognise the severe problems in the member's area. I recount again that, in my statement, I announced £1.5 million for enhanced emergency dental services, which, I hope, will reduce an awful lot of the pressure in the worst-affected areas. That £1.5 million is in addition to the money that is already available to NHS boards for the provision of emergency dental services.
Does the minister anticipate that dental services might increasingly be provided alongside primary medical services—in community hospitals, for example—to increase access to primary dental services for people of all ages in remote and rural Scotland?
I hope that that is the case and that that will be possible. As we modernise primary care services and consider how we can bring together a range of allied health professionals to deliver a more comprehensive local service, where the opportunity exists to do what Nanette Milne suggests, I hope that it will be taken up. I hope that our opening up of the question of modernising the dental health service will allow far more discussion between GPs, dentists and a range of other allied health professionals. That will allow them, on their own and in conjunction with health boards, to consider how best to arrange services to serve patients' needs better.
I welcome the minister's statement. Will he confirm that, in proceeding with the package of work, he will seek radically to reduce the bureaucracy and complexity of the existing fees and charges system? Will he seek to establish a fairer and more transparent system that is significantly more comprehensible to dentists and patients than the current one is? Does the minister agree that dentists would say that we must address both prevention and cure? Will he confirm that the dental professions are overwhelmingly of the view that fluoridation is the biggest single measure that could be taken to improve dental health in Scotland?
To address the final point first, we will respond to the consultation on children's oral health in the near future. I know that I risk giving a less than complete answer to Susan Deacon, but I do not want to pre-empt that announcement.
I welcome the minister's statement. He talked about the partnership agreement delivering free dental check-ups, but also about the difficulty of telling members when any changes will come about following the consultation period. Will he at least give members the assurance that changes to the provision of services will come about first, before the introduction of free dental checks? Surely it would be absurd to give something free that is not provided at all.
I do not think that there would be anything absurd about the provision of free dental checks to people throughout Scotland. The reaction, so far, to that commitment in the partnership agreement has been a wide and warm welcome throughout Scotland. Perhaps Mr Monteith's question reflects the jealousy of the Tory party because it did not come up with such a proposal.
In view of the widespread dental ill health that exists in Scotland, which the minister has acknowledged, will he consider changing the rules so that, as happens with general medical services, health boards are required to find an NHS dentist when a patient cannot?
A series of changes are going on relative to the responsibilities that health boards have. In some of the forthcoming legislation, we will establish community health partnerships and, through those, a substantial range of alterations to the way in which things are done may take place.
I apologise to the seven or eight members who have not been called to speak.
Presiding Officer, I seek your guidance on a matter concerning constituency members. Is it in order for regional members to use such a statement—which has been offered to the front-bench spokesmen of Opposition parties—to raise constituency cases when that is an opportunity that back-bench constituency members such as I do not have? Can you offer guidance as to how such statements are given out? If they are given to front-bench spokespeople, what are the rules regarding that?
I can hardly be expected to give guidance immediately, Mr Purvis. However, I will reflect on the matter and will come back to you personally, or perhaps to the chamber.
It might be helpful if you were aware, Presiding Officer, that I was asked by my colleague about the list of designated areas, which is unchanged. I noticed that it was on the document that was in front of my front-bench colleague, which I passed back to provide the information. It is therefore down to me, Presiding Officer.
I take that as confirmation that the minister did not give the statement to Christine Grahame. I do not have any great objection to the statement's going to Christine Grahame, as she is the convener of the Health Committee; however, it may be that every member should have been given a copy. We certainly were not.
Presiding Officer, can you confirm that, as soon as a minister sits down, the statement is available to all members anyway at the back of the chamber, as previously agreed, and that every member had access to that statement as soon as the minister sat down?
The point is that Christine Grahame did not get it after the minister sat down. She had it and had been given privileged information. That needs to be looked into.
For clarification, I did not have the statement in advance. Statements are available to all members. The rule is that, once the statement has been given by the minister, written copies are available. As has been stated, I was clarifying the position with regard to designated areas. I glanced at the statement, after the minister had sat down, to clarify the position with regard to the Borders. I did not have the statement in my position as the convener of the Health Committee.
On a point of order, Presiding Officer.
Do you really want to pursue this, Mr Scott?
I understand from my colleague David Davidson that copies of the statement were available from the Scottish Parliament information centre as soon as the minister had made the statement.
Thank you. I really do not want to pursue the matter now. We are in a situation of he said, she said. I cannot possibly make a judgment off the top of my head. I will reflect on the matter and come back to it when we return this afternoon.
Meeting suspended.
On resuming—
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