NHS dentistry in Highlands in crisis, says Alba candidate for Caithness, Sutherland and Easter Ross
Urgent action is needed to aid recruitment and retention of dentists for NHS Highland, according to the Alba candidate for Caithness, Sutherland and Easter Ross.
Steve Chisholm called on the Scottish Government to take action, saying NHS dentistry in Scotland was burdened by myriad challenges which hindered service delivery and negatively impacted patient care.
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Mr Chisholm said the implications were far-reaching, affecting urban centres and remotes areas with the Highlands one of the worst-affected areas with problems involving workforce shortages, funding constraints, an aging population, and systemic inefficiencies.
“One of the most pressing issues is the acute shortage of dental professionals,” he said.
“There simply aren’t enough dentists, dental nurses, and other essential dental care workers.
“The situation is especially challenging in the Scottish Highland’s rural and remote communities where other issues, such as a lack of housing and constraints to other public services make recruitment and retention difficult.
“This shortage has led to prolonged waiting times and diminished access to necessary care.”
Mr Chisholm said the General Dental Council (GDC) bore significant responsibility for the shortage due to its limited offering of overseas registration exams. He said even when experienced professionals were identified who wanted to work for the NHS in Scotland, they faced additional hurdles such as mandatory self-funded courses and “Golden Hello” rules which were administered is such a way as to exclude certain professionals willing to relocate to a Highland practice.
“Funding and budget constraints have severely strained the NHS dental services in Scotland,” Mr Chisholm said.
“Dentistry remains the only segment of the health service where patients must pay at the point of need and treatment is often severely rationed.
“This rationing leads to many essential services being unavailable, a situation that starkly contrasts with the principle of free healthcare at the point of need. Integration with general healthcare remains inadequate, making it challenging to provide holistic care for patients with complex medical histories and is a significant oversight given the integral role of oral health in overall well-being.”
He said older patients often had more complex dental needs requiring specialised care and resources.
“Facilities like the health sciences building in Inverness, which functions as a mini dental hospital, showcase the potential for addressing these needs,” he said.
“Expanding this facility into a full-fledged dental hospital and creating a graduate school of dentistry in association with the University of the Highlands and Islands (UHI) could significantly improve service delivery, especially with the involvement of experienced General Dental Practitioners.
“They could and would gladly mentor new undergraduates and continue to support post graduation. This initiative could also help retain graduates in the Highlands, offering a sustainable solution to the workforce issue.”
Mr Chisholm said the emphasis on preventive measures was insufficient, leading to a high incidence of preventable dental problems.
“Dentists are not adequately incentivised to focus on prevention, despite its potential to reduce the long-term burden on the NHS significantly,” he said.
Also, the impact of the Covid-19 pandemic could not be overlooked.
“The pandemic disrupted routine dental services, creating backlogs and necessitating additional infection control measures that have further stretched already limited resources,” he said.
“During the pandemic, the Scottish Government prevented dentists from working despite meeting the highest cross-infection control standards. Meanwhile, their European colleagues continued to operate safely.
“This prolonged suspension of services saved the Scottish Government a considerable amount of money, which has not been reinvested into NHS dental provision.”
He said budget constraints made it difficult for NHS practices to afford technological advancements, contributing to the emergence of a two-tier system where only private practices could offer state-of-the-art care while regulatory and administrative burdens further complicated the landscape.
“Increasingly stringent requirements and excessive paperwork detract from clinical time, affecting the efficiency and morale of dental professionals,” he said. “The regulatory environment is perceived as toxic, with unrealistic expectations and inadequate remuneration.”
