Chamber and committees

The figures requested are as follows:

Actual 1997-98	Actual 1998-99	Actual 1999-2000	Budget 2000-01
7,415,635	8,090,992	8,590,525	8,835,984

I understand that Greenpeace in Germany claim to have found tributyl tin (TBT) in disposable babies' nappies. The levels reported do not appear to give rise to a risk of harm, but, as a precautionary measure, the UK is conducting research into TBT in UK consumer products, including nappies.

As I said in Parliament on 21 September, a wide-ranging document on children's oral health will be issued in the New Year. It will describe what the Executive is currently doing and seek views on what further measures might be taken. It will also seek views on fluoridation of public water supplies as well as other options such as fluoride tablets and fluoridated drinks.

Provision of general dental services is kept under review by health boards and Primary Care NHS Trusts. It is open to them to plan the establishment of drop-in centres for dental care in response to local needs.

Research indicates that the major proportion of children who are not registered with a dentist live in the most deprived areas and that dental attendance is poor among pre-school children. The Executive is committed to improving the dental health of these children.

On a national basis, and in addition to continuing dental health promotion initiatives, the early years enhanced capitation scheme has been introduced to pay dentists enhanced monthly capitation fees for registering 0-2 year old children on the NHS, with the level of fee paid linked to the category of deprivation of the area where the child lives. Enhanced capitation fees are also paid to dentists registering 3-5 year olds in the lowest deprivation categories. The Executive also plans to introduce enhanced capitation payments for registering and fissure sealing the first molars of 6-8 year olds in the most deprived areas.

A number of local schemes are in place in Scotland, mainly involving health visitors, which seek to encourage mothers to register their babies and toddlers on the NHS with a dentist. Health education programmes with nurseries, playgroups and schools are also underway to encourage registration and attendance. In addition, school screening by the community dental service has been extended to nurseries to identify oral disease and encourage registration.

All NHS patients should be given information and support to ensure they are fully involved in decisions about their own care. The Executive has been taking forward a number of initiatives to foster a better understanding of this requirement within the NHS. While these have not been aimed specifically at dental care, the principles are equally applicable.

Under current Regulations, a dentist is already required to provide a patient registered with him or her on the NHS with a plan outlining such details as the NHS care and treatment considered necessary and an estimate of the associated patient charge. Dentists must also display information about NHS dental charges approved by the Primary Care NHS Trust or island health board and make available patient information leaflets listing the dentists working in the practice(s) and other helpful information such as opening hours and access for those patients in wheelchairs. In addition, dentists must inform their NHS patients about the practice-based complaints procedure which he or she operates.

The Executive also provides a free telephone information service, the NHS Helpline, which is able to provide callers with information on the availability of NHS dentists and dental treatments.

The Scottish Executive has published within its Action Plan for Dental Services in Scotland proposals to fund enhanced capitation payments (including fissure sealants) for children in deprivation categories 5, 6 and 7.

In the majority of health boards such targeting will limit these treatments to between 30-50% of the child population.

However, in rural and remote health boards such as Highland and Western Isles deprivation indices are not an accurate tool for targeting resources and the Scottish Executive will discuss with health boards and the British Dental Association how to appropriately target such services based on clinical criteria and/or social background.

A wealth of materials is available to support teachers in the delivery of health education. In particular the Health Education for Living Project (HELP), distributed to schools in 1995 and updated in 1998, is a curriculum framework for health education designed for use with all stages, from pre-school to S6. Oral and dental health issues are addressed at appropriate stages throughout HELP.

Consultants in Dental Public Health and Health Promotion Departments in health boards and Directors of Community Dental Services in Primary Care NHS Trusts liaise on strategic dental and oral health care issues with education authorities. At operational level, community dentists and dental health educators employed within the community dental service collaborate with general medical practitioners, general dental practitioners, health visitors, community dieticians and teachers on oral health promotion programmes, including dental health education, and on dental public health programmes, such as toothbrushing initiatives. The target groups for such programmes include children in schools, nurseries, playgroups, the parents of these children, pregnant women and nursing mothers.

In 1999 the Scottish Executive set up a working group to review workforce requirements for dentistry. Initial findings will shortly be published in the discussion document Workforce Planning for Dentistry in Scotland - A Strategic Review. This report will identify the number of dental hygienists, dental nurses, dental therapists and dental technicians recommended to be trained in Scotland.

Following the publication of this report, discussion will occur with educational bodies, health boards and Trusts on how to develop appropriate training courses and pathways for all the professions complementary to dentistry in Scotland.

A review group was also established in 1999 to consider workforce planning and education issues for the professions complimentary to dentistry, including dental nurses.