THE crisis in Scotland’s NHS dental service was graphically illustrated yesterday when Holyrood ministers announced that 32 Polish dentists were being recruited in an attempt to close a growing gap in provision.

The Scottish Executive, which has pledged to recruit a total of 200 dentists by 2008, also disclosed that several of the country’s health boards are in discussion with an independent health company to provide NHS dental treatment in those areas facing the most severe service problems.

Over the past year in parts of Scotland there have been repeated scenes of hundreds of people queueing to register with a dentist. Thousands of people throughout the country have been forced to re-register as private patients after their dental practice opted out of the health service.

The first 12 dentists from Poland are due to arrive in Scotland by the end of next January and will provide treatment for about 20,000 patients.

The move to recruit both the Polish dentists and the independent dental company to provide NHS services comes less than a week after Scotland’s dentists rejected a £295 million package from the Executive that would have allowed thousands of people the opportunity of treatment on the NHS.

The Dental Action Plan (DAP) was intended to help to lure dentists back from the private sector, but talks broke down after the British Dental Association said that the package would force its members to treat a set number of adults on the NHS before receiving the money.

The Executive sees the level of commitment to the NHS from the dentists as the main stumbling block to resolving the situation.

However, the association maintains that it rejects the ministers’ “all-or-nothing” approach. It said that many dentists working privately or in mixed practices were demonstrating commitment to the NHS by treating children or those exempt from charges. Last night the dentists’ body gave a dusty response to the latest Executive move, describing it as a short-term measure.

Lewis Macdonald, the Executive’s Deputy Health Minister,by contrast, said that the decision to recruit the Polish dentists was “great news” for thousands of people who would now be able to register for NHS dental treatment. “We want to give people the chance to opt-out of private arrangements which they have been forced into and to return to the NHS as we increase the number of directly employed NHS dentists across the country,” he added.

Mr Macdonald said talks were going on with the private company Integrated Dental Holdings (IDH) to provide services in areas where access to an NHS dentist has become a problem for many. “While IDH is a privately owned corporation, it will undertake NHS work directly and will have no financial interest in de-registering NHS patients,” Mr Macdonald said.

The first group of 12 Polish dentists will be employed as NHS salaried dentists in Fife (6), Forth Valley (3) and Argyll & Clyde (3).

A further 20 dentists from the Eastern European country, which this year joined the European Union, will arrive in Scotland to take up posts in April and September next year.

IDH is the largest company operating NHS dental practices in the UK. It is a privately-owned limited company with about 550 dentists and 850,000 registered patients. If final agreement is reached with the Executive, the company will set up practices in Grampian, Highland, Dumfries and Galloway and Borders.

Health boards in these areas would enter into personal dental services pilot contracts to deliver services. This would be the first time such contracts have been used in Scotland and, according to the Executive, they have the benefit of guaranteeing a minimum of 5 years access to NHS services to all categories of patients.

Opposition parties welcomed the news, but said that it fell far short of what was needed to solve Scotland’s dental crisis.

Shona Robison, the Scottish National Party’s Shadow Health Minister, said that ministers must still sort out the difficulties with the dental profession and move the stalled negotiations forward. “It is vital that it is resolved if we are to keep dentists working in the NHS and bring back others who have left,” she said.

The British Dental Association responded to the Executive move by describing it as a short-term measure which would not go far enough to address the problems facing NHS dentistry in Scotland.

The 32 new dentists, while welcome, would, the association said, simply be a drop in the ocean and have very little impact on the experience of most patients in trying to access an NHS dentist.

Dr Andrew Lamb, the association’s Director for Scotland, said: “While the BDA welcomes qualified dentists from overseas to ease the shortage of practitioners, their recruitment is only a short-term measure. A longer-term solution to the problems facing NHS dentistry in Scotland can only be achieved through constructive dialogue between the Scottish Executive Health Department and the BDA.”

The Executive is committed to giving all Scots a free dental check-up by 2007, an initiative to be phased in over the next 18 months — putting even more pressure on dentists working within the NHS.

SCOTLAND'S TEETH: THE FACTS

51 per cent of adults and 35 per cent of children are not registered with a dentist

In middle age the average person has lost 8 adult teeth and has 10 teeth filled

More than half of 65 year olds have lost their teeth

More than 500 oral cancers are diagnosed annually. Half are fatal

Last year the shortfall in NHS dentists was about 200. That number has grown as more dentists go private

Areas suffering most from lack of NHS provision include Grampian, Highland, the Borders and Argyll

There are about 2,600 dentists — 2,100 general dental practitioners, 270 in community dental services and 230 in hospital — according to latest figures

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