Chamber and committees

I think that we would all describe childsmile as a flagship programme. It was introduced by the last Labour Scottish Government and has helpfully been continued by the SNP.

We are seeing growing inequality, particularly in children’s oral health, between the least and most deprived areas. There was already a problem, but that problem has been exacerbated by Covid and we are now seeing registrations of very young children drop dramatically. Only 25 per cent of children under two years old are registered, which is desperately worrying, given the impact of this issue in later life. We do not think that childsmile has returned to pre-pandemic levels. What are you doing to address concerns about children’s oral health?

We know, too, that there are concerns about adults, so what specific measures are you taking to address inequalities in adults’ access to dentistry?

Speaking more widely about prevention, I very much welcome the fact that the dentists who gave evidence to the committee mentioned prevention with virtually every breath they took. However, they described a funding model that is “high-volume, low-fee” and “disease-centred” and said that they feel they are not able to do the kind of prevention work that they want to. One dentist highlighted the ability to bring together a group of children to do education work on prevention, saying that the fee model did not allow them to do that.

I am keen to know what improvements you will make to enhance dentists’ ability to carry out prevention work, and I would also like to know what the Government will do, at the population level and beyond the touch points that you have described, to improve access to dentistry and ensure that more preventative work is done.

I do not want to put words in your mouth, but what I seemed to hear is that the ability to be more flexible around prevention is not part of the current discussion about fees.

The dentists described the model as preventing them from doing the kind of dental work that I have described. We will need to wait and see what you come up with.

I am trying to get a sense of the urgency with which this is happening. If the registration level for zero to two-year-olds is still sitting at only 25 per cent, that will have a knock-on effect. We know that if we do not prevent disease, it costs more money to treat it later on. Therefore, I am keen to get a sense of when you expect those targets to be achieved. Are you doing any kind of additional remediation to recover from Covid?

I think that it is lower now than it has ever been.

Thank you for the opportunity to contribute to your discussion about the petition. I also thank the petitioners Audrey Baird and Fiona Baker for their continued interest in this area.

I recall asking the then environment minister Màiri McAllan to go out and consider the issue. I understand that she has been too busy to do so. I welcome the fact that the committee has undertaken a visit and that the petitioners’ latest submission centres around their visit from Scottish Forestry officers on location in Argyll in April, which showed first hand the destructive effects of non-native conifers on the ancient woodland.

That visit revealed that, despite the site at Glenbranter forest being described as a rare gem

“where native oakwoods cloak a series of spectacular waterfalls”,

the gorge and the falls are now barely visible, and the ancient oaks are all close to death. Our Scottish historic landscape, which I know we all value, has been overrun by non-native conifers. According to the petitioners, Scottish Forestry officers admitted that they do not know the scale of the non-native conifer wilding problem and that they would be “quickly overwhelmed” if members of the public decided to report it to them.

The University of Stirling published a report recently that is helpful. It looked at the highest-altitude trees and discovered that a colossal 56 per cent of all trees that were recorded at the highest altitude are American Sitka spruce. That gives you an idea of the scale of the problem. It has taken only a few decades for that to happen.

We are allowing—or, if I may be so bold, the Government and the industry are allowing—conifers to self-seed out of plantations, creating new seed sources, which is further encouraging the takeover of our ancient woodlands.

There seems to be a disconnect between what the Scottish Government says in its letter and its sense of urgency on saving ancient woodlands, and its action to reverse its disappearance. It would be extremely useful if the Cabinet Secretary for Rural Affairs, Land Reform and Islands could provide timescales for when work on the new national register of ancient woodlands that is mentioned in her submission will to be undertaken and when it will be completed. It would also be helpful if, through the committee, she could outline what plans the Scottish Government has to identify the scale of the non-native conifer wilding problem on ancient woodlands, and what action it intends to take.

We know from previous discussion that other countries, such as New Zealand, are working to remove non-native conifers where they have seeded in ancient woodlands and elsewhere. It would be good to know whether the Scottish Government has any plans to remove those non-native invasive species from sites such as Glenbranter forest.

The petitioners have also raised valid concerns about what they described as an apparent lack of concern from the cabinet secretary about current regulatory powers not protecting Scotland’s woodland. In England, the Forestry Commission and Crown Prosecution Service pursued four successful prosecutions in 2022 alone, and in Wales, a defendant was convicted and fined £36,000 for illegal felling in October 2022. However, not one prosecution has occurred in Scotland.

The petitioners feel that there is no deterrent to the complete erasure of our natural historic identity if there are no prosecutions, so we need not just to see guidance and warm words but to see proper enforcement action. I would be enormously grateful if the committee would continue to press the Scottish Government on this important issue.

Sure. I just needed to understand that point so that we are clear about it.

You seemed to suggest that the model that is currently in place with the statement of dental remuneration for treatments and materials clearly disincentivises people from going into NHS dentistry because, as Douglas Thain and you have described, the activity is not matched by the sheer pace of payment. How would you change that to a prevention model?

Thanks. Other people will ask you about childsmile. I will just say that I share your view of it.

I want to turn to the issue of dental corporates operating in the United Kingdom, some of which are now operating in Scotland. What impact do you think that that has on NHS dental services?

That is helpful. Thank you.

The BDA did a survey that suggested that 59 per cent of dentists have reduced their NHS commitment and that that figure is likely to increase, and that 34 per cent were either retiring or leaving to start a new career. David McColl, can you rehearse for us why people are leaving and why dentists are reducing their NHS commitments?