Chamber and committees

Does anybody have a different view?

My understanding, though—please correct me if I am wrong—is that the fair work criteria are not requirements. They are strongly encouraged, there is guidance on them and they are clearly what the Scottish Government wants out of the policy—I recognise that—but if the criteria are not required there is no direct consequence if a company is not meeting them as is defined in the fair work convention that the Scottish Government signed up to.

Good morning to the minister and her colleagues.

We have taken evidence from various stakeholders over the past two weeks. We have heard from NHS boards, representatives of patient interests and dentists in the profession. Minister, in your letter to the convener of 25 May, you said:

“The policy of the Scottish Government throughout the pandemic has been to preserve and protect NHS dentistry. In my view we have successfully done this.”

I am bound to say that I do not think that the evidence that we have heard reflects that statement. For example, we heard last week from the dentists that 52 per cent of the capacity in NHS dentistry has been lost since Covid. In fact, many of the issues with NHS dentistry existed pre-Covid but were accelerated and exacerbated by the pandemic. There are many areas in Scotland now where there are no NHS dentists at all. Kinross in the convener’s constituency, which he will be familiar with, is an area where you cannot get an NHS dentist. Newburgh in Fife, in my region, is another area and there are lots of other examples.

Where people are registered with NHS dentists, they are waiting extreme periods of time to get appointments for routine work. We have also heard that, although we have new entrants coming into the profession, graduates do not want to do NHS work; they want to go into private practice, because they will have more time to spend with patients.

The picture that we have had painted for us is a very unhappy one. Would you like to revise your comment in your letter that everything is fine?

We heard from dental practice owners that under 26s are asking for cosmetic treatments such as teeth whitening, which is putting a burden on practices. I wonder whether that is the best use of limited resources. You mentioned the commitment to extend free services to everyone. How credible is it that that will be delivered? The whole system is creaking at the seams and there is not enough money to fund what we are offering at the moment. Is it realistic to think that, within three years, we can give free NHS dental care to everyone, that that care will actually be accessible and that there will be the dentists to deliver it?

But it is not happening, is it? All the evidence that we hear, both at the committee and as local representatives, is that access to NHS dentistry is still reducing. There are still practices that were doing NHS dentistry that have now stopped and there are people coming to us all the time saying that they want to get an NHS dentist and cannot find anyone who will take them on their books.

Well, we will see in due course whether progress is being made.

Let us consider the pattern of change. You are absolutely right: I remember that, 20 years ago, there was a big issue with a lack of NHS dentists, and there were queues outside practices. There was then a big ramp-up in the training and recruitment of dentists, a lot more dentists came into the profession and that was a great success.

Over the past five years or more, however, NHS dentists have been progressively moving to do more private work. During Covid that, suddenly accelerated and people are increasingly having to turn to private dentistry because they cannot get an NHS dentist. People who are in a fortunate position can perhaps afford to do that, but many people cannot afford it and they are therefore falling through the gaps, so we have a real issue of inequality.

What is the Scottish Government’s vision for dentistry? We have always had a mixed economy here: there have always been dentists doing private work and NHS work. The growth has been in private work, while NHS work has shrunk. How does the Government see the profession going forward? If we are going to retain NHS dentistry—given that, as we know, a lot of the young people who are coming into the profession are more attracted to doing private work—will that be achievable only with a substantial injection of additional cash? If so, where is that coming from?

If they can find one.

Sorry: if they can find a dentist.

I echo your thanks to everybody who has contributed to the committee. I thank our clerking team, the Scottish Parliament information centre and all those who have helped us. I also thank you, convener. Your stint as convener has been a very short one, but you can put it on your CV for future reference that you convened a parliamentary committee, albeit for just a few weeks. Thank you for leading the committee in collegiate style.

I also thank our committee advisers, whom we have not seen for quite a long time, but who were initially regular attenders at the committee: Professor Peter Donnelly, Professor Susie Dunachie and Professor Helen Stagg. Members will recall that they came more or less on a weekly basis to give us updates at the height of the Covid pandemic, and their input was extremely useful to us. We should record our thanks to them. I do not know whether we are going to write to them formally to express our thanks, but I think that we should do so.

As a personal reflection, I was the first convener of the COVID-19 Committee in the previous session. If I remember rightly, the committee was established in May 2020, and here we are, just over three years later, bringing this particular journey to an end. I hope that that is an indication that Covid is behind us—and I hope that my saying so does not give a hostage to fortune.

Nevertheless, there are some very important lessons that we need to learn from Covid. A lot still needs to be done and put right, post-Covid, in the public sector and in public services, and I hope that the important work that the committee has been doing will be continued by other subject committees as we go into the next parliamentary year.

Witnesses should not feel that they need to repeat what other people have said, but if anyone has anything to add, please come in.