Covid disarray threatens a dental health ‘disaster’
●NHS dentists are unable to practise while private sector opens for business
Scotland’s dental profession is in a “state of disarray” as a result of confused government coronavirus guidelines, with NHS dentists warning of a “severe drop in the oral health” of Scots if they are not allowed to conduct routine treatment soon.
The country’s Chief Dental Officer, Tom Ferris, has been called on to take immediate action to prevent a widening of health inequalities as private dentists are allowed to practise, including offering fillings, while NHS dentists are prevented from doing so.
The Scottish Dental Practice Owners group, which represents more than 400 dental practice owners, over 700 NHS surgeries and nearly three million patients, has written to Mr Ferris, as well as to First Minister Nicola Sturgeon, finance minister Kate Forbes and public health minister Joe Fitzpatrick, seeking urgent clarification on a developing two-tier system of dentistry in Scotland.
Dentists fear a collapse in practices as a result of the lockdown but SDPO chairman Dr Mohammed Samad, who practises in Glasgow’s East End, said the group had received no responses to any letters it has sent to the Scottish Government.
He said: “The dental profession has
been put into a state of disarray by the Scottish Government and their lack of action in allowing NHS dental practices to open and treat their patients and has left millions of patients without access to their own dentist.
“Health Improvement Scotland have allowed private dental practices to open and given permission for aerosol-generating procedures (AGPS) to be completed but NHS and mixed dental practices have been forbidden to do AGPS.
“There is no evidence to support this as many countries worldwide have been completing AGPS during the outbreak with no spread of Covid-19 in the public or the profession.” Dr Samad said that a government announcement last Friday had said NHS patients could now go to their dentist for “routine non-aerosol care” but that would mean no drilling or the use of compressed air, used in check-ups.
He added: “A thorough examination cannot be satisfactorily completed as cavities and many other dental problems are missed without this. And even if examinations were being completed, we cannot then follow up to provide any routine treatments.
“Information to the public is very confusing as there is no clarity and patients are not made aware of the severe limitations placed on NHS dental practices moving into phase three. The information and guidance from the CDO [Mr Ferris] is sparse and extremely unprofessional in the manner it is being released.
“Patients are receiving emails from local health boards stating that dental practices are ‘open’ but absolutely no clarity is given to the restrictions the dental profession is placed under by the Scottish Government.
“There has been no communication or consultation with the dental profession in respect to what is expected moving forward into each phase, and the profession is left to find out through social media and news outlets.
“Patients have been suffering from dental health issues needlessly for the last 12 weeks and there does not seem to be any sign of this abating. We have a duty of care but our hands have been tied and we are helpless in the services we can offer due to the restrictions still placed on the profession.”
He said if a practice has fitted masks and appropriate PPE, as set out by the Faculty of General Dental Practitioners, it should be able to provide AGP procedures to NHS patients.
Dr Samad said: “This has been a political decision with no evidence to support it. We sincerely hope that the Scottish Government stand up and take a serious look at the delicate position they have placed millions of NHS dental patients in and the restrictions they have placed on the practices. If something is not done soon there will a severe drop in the oral health in Scotland.”
Scottish Labour’s health spokesperson Monica Lennon said the SDPO had shown “another example of chaos and confusion” in the Scottish Government. “Scotland faces a dental health disaster if NHS services remain in lockdown for much longer,” she said. “It’s not right that there’s one set of rules for private dental work and those who can afford it and another set of rules for everyone else. Dentists and their patients need SNP ministers to get their act together.”
Scottish Conservative health spokesman Miles Briggs said he had also written to Health Secretary Jeane Freeman looking for “clarity and action” on the dental sector.
The Scottish Government said: “There is no two-tiered system of dental health care in Scotland. NHS patients are able to receive care and treatment including aerosol-generating procedures through one of the 71 urgent dental care centres in Scotland.
“As part of phase three the Chief Dental Officer has commissioned an expert review of aerosol-generating procedures and will be writing to the profession shortly on how they might be introduced safely.”
There is a debate to be had about Scotland’s experience of the Covid-19 pandemic, presuming, of course, that debate is still allowed. I add that caveat because in a Scotland that is deeply damaged by the continuing constitutional straitjacket, anything debated by those, such as myself, who seek to shine light on Scotland’s scandalously bad experience will be branded as “anti-scottish” – even by supposedly independent government advisers who should be encouraging discussion, not marginalising it.
The First Minister is apt to say that nothing she does or says regarding Covid-19 is at all political – a statement that is political in itself, for it seeks to claim the wholly undeserved moral high ground. Well, I too am just as entitled to make that claim, for nothing I write here is party political given I am apt to criticise all Scottish parties if not practically all politicians. I simply find the evidence the First Minister employs is often at odds with her claims of Scotland doing well – and, despite the many more difficult challenges that England faces, worse than Boris Johnson and Matthew Hancock are managing.
I have no doubt when we have finally passed through the pandemic and proper enquiries are able to be held some excoriating evidence shall come to light that shall condemn decisions taken by both the Prime Minister and First Minister as, at the very least, illadvised if not significantly wrong. What shall matter is to what extent either individual acted against advice that later proved to be sound or ignored evidence that pointed in a different direction from that chosen.
The possibility that we have also knowingly been told lies by politicians is also likely. It would not be the first time for either individual to be economical with the truth by offering, say, to die in a ditch for Brexit, or that Alex Salmond never claimed to have legal advice on an independent Scotland remaining in the EU. Such a breach of trust might only be forgiven if a public consensus accepts some extenuating justification that the truth might have caused unmanageable panic, disorder or a collapse in public morale.
The truth then, will eventually come out, I have no doubt.
We need not wait, however, on a public or parliamentary enquiry before establishing the truth, because our politicians must address these matters now – not to salve their conscience, not to work out what they must cover up to protect themselves – but because there remains the very real possibility there shall be a second spike of Covid-19 in the winter and that it could be worse than the first.
I am indebted to Chris Snowdon – the scourge of public health officials, junk science and mendacious research masquerading as evidence – that the government’s SAGE advisory committee had said back in March that even with a lockdown there would be a second wave of Covid-19 in the winter, and this advice has not changed.
If that possibility becomes real we have every right to ask of our political leaders what have they now established they got wrong in handling the first spike and therefore what would they do differently the second time around?
This is a very important question because it demands of our politicians – irrespective of party – to admit to errors of judgment, no matter how well intentioned, and