Four in 10 Scottish dentists ready to quit NHS and go 'fully private'

The looming crisis comes just days after statistics revealed that the number of NHS dental treatments carried out in Scotland during 2020/21 fell by 77.5 per cent compared to 2018/19, the last full financial year unaffected by coronavirus. 

That equates to a 390,000 fewer procedures in children, and 3.3 million fewer for adults. 

SPECIAL REPORT: 'This will be the end of NHS dentistry' - Warning amid bitter funding row with Scottish Government 

The backlog reflects restrictions on dentistry, which closed practices and curtailed aerosol-generating procedures (AGPs) on the NHS for most of 2020, with caps initially on the numbers of NHS patients and AGPs which could be performed per day even
after the sector re-mobilised in November last year.

Private dentistry - including the full range of AGPs, subject to infection management protocols - resumed much earlier as the independent sector is outwith Government control.

Source: Public Health Scotland

Since November 2020, dental practices operating within the NHS have been entitled to Covid support grants of up to 85% of their pre-pandemic income in exchange for carrying out 20% of their pre-pandemic NHS workload.

The scheme was designed to keep NHS dentistry afloat while patient numbers were restricted by Covid infection control measures including cleaning and fallow time between treatments and physical distancing, which limited waiting room occupancy.

The BDA argues that it would be unsafe to ramp up patient numbers to the 30-40 per day necessary to make NHS dentistry financially viable if these grants are withdrawn.

A survey of 1,164 dentists carried out in the past week found that two thirds (68%) of practices are still operating at between 20-59% of their pre-pandemic capacity, despite £5m of Scottish Government funding to upgrade ventilation to at least 10 air changes per hour - necessary to cut time between patients.

However, by accepting the taxpayer cash, dental practices must commit to NHS provision for at least three years - something many have been reluctant to do.

The survey found that one in three practices had not applied for funding, with half saying it was because they are "unwilling to commit to the NHS for the next three years" while 33% said the allowance of £1,500 per surgery was "inadequate".

READ MORE: Warning over rocketing NHS waiting lists and 'two-tier' dental system

David McColl, a Glasgow dentist and chair of the BDA's Scottish Dental Practice Committee, said dentists are "unwilling to be shackled to a corpse"

He added: "When aid hinges on committing to an NHS model that is now frankly unsustainable it is unsurprising take up appears so modest.

“We doubt Humza Yousaf wants to be remembered as the man who killed NHS dentistry in Scotland. Without a willingness to reflect on choices made in recent weeks that risks being his legacy.”

David McColl, chair of the BDA's Scottish Dental Practice Committee

Of the respondents who had secured funding to improve their ventilation, 175 said it had made no difference to their capacity, and 138 said it had boosted it by just 1-10%.

Asked what changes dentists anticipate to their working life in the next 12 months if Covid support grants are withdrawn, 79% of practitioners said it was either likely or extremely likely that they will "reduce my commitment to the NHS".

Just over 40% - 474 respondents - said they will go "fully private", and 438 (38%) said they will change career or seek early retirement.

One in 10 said they believed their practice - in essence a business which contracts dental services to the NHS - would simply cease to operate.

The BDA has called for and interim funding package to be put in place until the treatment backlog is reduced and a longer term alternative to the pre-pandemic 'low cost-cost, high turnover' model devised.

READ MORE: Dentists' anger amid 'ludicrous' funding row

Jackie Baillie, Scottish Labour's health spokeswoman, said: “This stark warning from the BDA makes it abundantly clear that the very existence of NHS dentistry in Scotland is on the line.

“By removing support at this crucial point, the SNP is threatening to force scores of dentists out of the profession or into the private sector."

Scottish Conservative Shadow Health Secretary, Dr Sandesh Gulhane, added: “These plans raise the threat of many dentists leaving our NHS and practices shutting their doors.

“Patients who can afford to will be forced to go private, while those who can’t face being denied dental treatment altogether. That is completely unacceptable.

A Scottish Government spokesman said: “We’re doing everything we can to support the dentistry profession – and it is simply not true to say our model for dental care is unchanged from before the pandemic. We want to put patients at the centre of a sustainable public service.

“From February 2022, we will bring in new and increased fees for dentists for a range of treatments, supporting them in their efforts to clear the backlog which has built up during the pandemic.

“We have already provided £50 million of financial support, plus an additional £30-£35 million of PPE, to ensure NHS dental services emerge well-placed to care for the oral health of everyone in Scotland.

“Indeed, it is precisely because we recognise the importance of dental care that we have set out our ambitious plans to remove dental charges for the public.

“We are of course in regular contact with the BDA, we are immensely grateful to them and their members for all they have done to keep services running through the pandemic and we will discuss the findings of this survey with them.”