Chamber and committees

At the beginning of the pandemic, dentists had to adapt quickly to new ways of working. They were forced to close during the early months of the pandemic and then drastically reduce the services that they could offer due to the risk of Covid transmission during aerosol-generating procedures. It has been an extremely challenging period for dentistry, and the huge backlog of care that has built up over the past two years means that it will remain challenging for some time. Dentists continue to operate considerably below pre-Covid levels due to infection prevention and control measures, which mean longer waiting times.

As we recover from Covid, it is right that people who are at higher risk be prioritised and that the frequency of dental appointments be based on clinical need. We need to trust dentists to make those assessments, because they are the experts. However, we currently have a system in which people who can afford to pay can access dental care more quickly. That inequality cannot continue; otherwise, as other members have said, a two-tier system will be established in Scotland.

Dentists have a vital role to play in the prevention and early detection of illnesses such as oral cancer. That is one of the best examples of how preventative healthcare can make a difference to lives, but it is undermined when patients cannot see dentists regularly. Figures that were published last month by Public Health Scotland revealed a sharp fall in the number of patients attending an NHS dentist, as well as a widening gap in attendance between the most and least deprived areas. In Scotland, we have lifetime registration, which the Greens fully support, but we need people to go to the dentist. The pandemic will certainly have discouraged some people who might be less likely to attend; others will have fallen out of the habit of going.

Oral health inequalities existed before the pandemic and the gaps continue to widen. The data show record gaps in participation rates. In 2008, the gap in the participation rates between the most and least deprived areas was only three percentage points, but, by September 2021, it had increased to 18 percentage points. Every effort must be made to re-engage people with services, particularly those who are most at risk of developing tooth decay or other health conditions, such as oral cancer. I am keen to hear from the cabinet secretary what strategies could be used to reach people who have fallen out of contact with dental services.

As I said, dentists have an important role to play in the detection of oral cancer. Since the early 1970s, oral cancer rates have been increasing, and the rate in Scotland is significantly higher than the UK average. According to the BDA Scotland, it remains unclear how the pandemic has impacted on that. Deprivation is a risk factor for oral cancer, which underlines the importance of improving participation rates in deprived areas. Given the difficulties with access to dentistry that have been caused by the pandemic, it is more important than ever that everyone is aware of the symptoms of oral cancer. Those include red or white patches on the lining of your mouth or tongue, ulcers that do not heal, or a lump in your neck. A person’s risk is also increased if they are a heavy smoker or drinker. I encourage anyone who has concerning symptoms to seek medical advice.

I will conclude with a few words on the future of dental charges. The Scottish Greens believe that dentistry, like other parts of the NHS, should be free at the point of need.

I am sorry, but I am in my last minute. I need to conclude.

Access to healthcare should never be dependent on someone’s ability to pay. We fully support the Government’s intention to remove all dental charges to patients by the end of this session of Parliament. However, for patients to feel the full benefit, issues with access must be addressed and the backlog of care must be worked through. That will be no small undertaking, and the dental profession must be supported.

The BDA Scotland has expressed concern about a lack of communication regarding the decision to extend free NHS dental care to 18 to 25-year-olds. I would be grateful to hear from the cabinet secretary about the Government’s plans to engage with the dental profession while we move towards the removal of dental charges entirely.

Can the minister confirm that, if companies did not provide the living wage or recognise trade unions, for example, they would be ineligible for support?

To ask the Scottish Government how it will apply fair work and net zero criteria to the freeport developments with the United Kingdom Government. (S6O-00766)

Audit Scotland highlights in its briefing that there is

“No individual social care record in the same way that each member of society has an NHS record.”

It says:

“This makes it difficult to assess whether social care is meeting people’s needs.”

What are your views on the introduction of a single social care record?

Audit Scotland has highlighted that cultural differences between partner organisations are barriers to collaborative working. How can we better overcome those barriers and foster collaborative working and greater integration of services?

I will briefly pick up on something that Donald Macaskill said. For some care workers, there is a lot of recording of visits. It is often to support families in terms of knowing what has happened during visits, but it can be used to try to keep track of workers because of mistrust in them. How do we improve the culture for care workers in particular, as we go forward?

On behalf of the Scottish Greens, I associate ourselves with the solidarity with the people of Ukraine that has been shown across the chamber.

The UK Government’s decision to scrap the requirement to self-isolate and to scale back free testing will undermine Scotland’s ability to recover from Covid. It also signals the abandonment not only of a four-nations approach but of people who were previously asked to shield. How can those people protect themselves from the virus if they do not know where it is? What steps can the Scottish Government take to mitigate the risk that is being posed to clinically vulnerable people and ensure that they continue to be protected and supported?

LGBT history month gives us an opportunity to celebrate Scotland’s diversity and reflect on historic injustice and persecution. Let us be clear: Scotland is an inclusive nation, and our commitment to human rights must not waver. That is why it is so shocking for many that bigotry and damaging practices such as conversion therapy still happen in this country. This week, it was revealed that crimes against LGBT people accounted for more than one third of all hate crimes that were reported to the British Transport Police in the nine months to January this year.

Will the First Minister stand with the LGBT community, condemn those hate crimes, and outline what more she and her Government can do to tackle anti-LGBT discrimination in Scotland?

To ask the Scottish Government how it is supporting households that are facing hardship and debt as a result of the rising cost of living. (S6O-00736)