The Strange Case of Scotland’s Dental Services

toothConcern is growing in Orkney over the provision of dental services to National Health Service Users.

Everyone in Scotland is entitled to treatment by a NHS Dentist, however, what many are finding is that a NHS Dentist is becoming a rare if not quite extinct animal.

Recent figures proclaim NHS dental registrations in Scotland are up by 2 million in the last 10 years with  92% (4.9 million) of the Scottish population registered with a NHS dentist as at the end of September 2016.

In response to the figures Shona Robison, Cabinet Secretary for Health in the Scottish Government said:

Shona Robison

Shona Robison

“These new figures are very encouraging and show the great progress that has been made in the last 10 years. Availability of NHS dental services has improved substantially under this Government and we remain committed to ensuring that everybody who wants access to NHS dental services can receive it.

“Substantial investment by this Government, and the actions taken by NHS Boards, means that across Scotland 4.9 million people were registered for NHS dental services at September 2016 compared with 2.6 million at March 2007.”

WATCH: How to register with an NHS dentist in Scotland

“When you register with a dentist you’ll be registered for life, unless you or your dentist request your registration to be withdrawn.” NHS Inform

Registration Withdrawn

Here’s how it goes:

  1. New Dental Practice is set up
  2. People encouraged to register as NHS patients
  3. Treatment received and paid for (funding from Scottish Government to allay some of the costs to the patient)
  4. Client list built up
  5. Practice decides to provide private treatment only
  6. NHS patients removed or can remain as private clients
  7. NHS patients attempt to find another dentist
  8. No vacancies with NHS dentist (if you can find one)

WATCH :The truth about NHS dentistry

The official statistics tell only one part of the story. It does not tie in with what people are actually experiencing in their local communities.

There is an ongoing crisis in the provision of dental services in Scotland which is not being addressed effectively by the Scottish Government.

To say that the National Health Service provides free treatment to all those who require it does not apply to the care of our teeth. The dental examination is the only part of the process that is free to most patients.

Free Treatment

You can get free NHS dental treatment if, when the treatment starts, you are:

  • aged under 18;
  • aged 18 and in full-time education;
  • pregnant or have borne a child within the 12 months before treatment starts;
  • an NHS in-patient and the treatment is carried out by the hospital dentist;
  • an NHS Hospital Dental Service out-patient
  • a Community Dental Service patient.

 Also when the treatment starts or when the charge is made:

  • you are getting, or your partner gets:

Income Support, Income-related Employment and Support Allowance or Income-based Jobseeker’s Allowance (Incapacity Benefit, Employment and Support Allowance (Contributory) and Disability Living Allowance do not count as they are not income-related), or Pension Credit Guarantee Credit;

  • you are entitled to, or named on, a valid NHS tax credit exemption certificate;
  • you are named on a valid HC2 certificate issued under the terms of the NHS Low Income Scheme.

And for Veterans  – due to your pensionable disablement.

First: Find a NHS Dentist with a vacancy!

Reporter: Fiona Grahame

If you have a story or an opinion to share or about dental services you can use the contact page on this website or email: 

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7 replies »

  1. Hi Fiona,

    Thank you for this article. I am having exactly the problem you refer to about treatment being withdrawn.
    I went to my Dental Clinic in King Street to make an appointment and was told that my registration has been cancelled. I have been going there for years, and yet I was given no advance warning whatever, even though a Scottish Govenment leaflet says we are usually given three months’ notice.

    My dentist still works there and there are other dentists at the practice but I was told I cannot be transferred to another dentist as they now have “different roles”, whatever that means. Footballers? Ballet dancers?

    The rather vague answers the clinic gave to my complaint didn’t actually say they are “going private” but I can’t think of any other reason for my being suddenly struck off their list, and I know am not the only one in this position.

    I hope the Freedom of Information request that I intend to submit will make it clearer.

    It is time we all protested about such disgraceful treatment, which is affecting tihe poorest among us – those who can’t afford to pay for private treatment. We may not have cash in hand but we do have voices, and we must make long and loud complaints to our local Health Boards, local papers, parliament and government representitives. Those who train at public expense have a moral obligation to care for their fellow citizens rather than over-indulging in their own greed for more, more, more.

    Julie Switsur

    • Julie,

      I was with King Street and they sent out advanced notifications of the change many months before it happened. They helpfully spelled out the options available and I was able to register with another NHS dentist very quickly and I’ve been going there for at least a couple of years. I seem to remember that the onus was on the patient to maintain registration by going for regular check-ups. From your message, it would seem that you have not done this and your registration has lapsed. Your final paragraph is a bit intemperate, I think. The problem is perhaps one of perception? Doctors and nurses work in the NHS to “care for their fellow citizens” (except they don’t all) so why not dentists? Opticians? The system is what it is and only a fundamental change in it would mean that no-one pays for treatment. Suffice to say that you haven’t been “suddenly struck off their list”, you have allowed you registration to lapse.

  2. Has dental care not been like this almost always? Examination is free and so is treatment for those who can’t afford it. Given the system (that NHS Scotland doesn’t employ dentists) we can hardly blame NHS Scotland if dentists don’t want to live and work here.

    • what happens Andy is that they start off their practice as NHS then once they have built up a client list they change to private only. You then either have to register with them as a private patient or try to find another NHS one. I would also add that because something has ‘almost always been’ does not make it a good way to run things. It’s nothing to do with wanting to live and work in Scotland.

  3. Given that we pay by not charging them for their Uni education then surely it would only be right if they decide to go Private then they have to repay their tuition fees? Can I also suggest that they have to pay a hefty annual Practice Licence.

  4. Sorry, I don’t agree. “They” don’t all do this. I don’t disagree that it’s not he best way to run it, if you want free dental treatment. However, as I said above, the treatment is free for thsoe that can’t afford it. I’m sure that the goverment statement that “Availability of NHS dental services has improved substantially” is true – but not necessarily in Orkney. My comment about dentists coming to live and work here was meant to refer to Orkney, not Scotland as a whole.

  5. Andy , why do you assume that I have allowed my registration to lapse? I have been attending this clinic for very many years and at one time I seemed to have a different dentist and a new form to fill in every time I went.
    I aim to have check-ups every two years, as recommended by the NHS, but have sometimes needed treatment more frequently than this, so I am a regular visitor.

    But whatever the reason for my being struck off the list I should have been given the Government’s recommended three months’ notice, so that I might have time to register with another dentist, if one should be available. The clinic did provide me with a ready-prepared list of three alternatives and at the same time told me that the only suitable one was already full. I was also told I could phone for an emergency appointment, but that was not what I had requested.

    When I emailed the clinic to complain that I had not been given any notice, the response was “Letters will be going out in the future to inform patients of the change, to date, we are informing patients when they contact us.”

    Wrongly or rightly I took this to infer that I am not the only patient to have been de-listed.

    I hope my FOI request will clarify the situation by publishing the percentage of patients who have been struck off, the reason for de-listing them, and the criteria used to decide who to de-list and who to keep on or re-register

    I will let The Orkney News hear when I find out.

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