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Thank you for that question. The frequency of check-ups has been commented on in the media. The yearly review is in-depth and follows the National Institute for Health and Care Excellence guidelines.

However, it is really important for everyone to understand that it is for the dentist to make the decision based on the patient. In response to Dr Gulhane, I referenced the fact that there is not an “average patient”. It is important to recognise that if your dentist feels that you need to be seen more regularly, he or she can choose that.

I was disappointed to be told by my dentist that I had to come back in six months, because I thought that I was looking after my teeth’s health pretty well and was hoping for a check-up in nine months. However, the approach is really focused on the patient. That is what the regulations give us the opportunity to do.

I am sure, Mr Sweeney, that if you were to reflect on that and were being seen by another area of the health service and were told that you did not need to come back in six months but in nine months, you would see that as good news. We need to remember that the frequency of check-ups is based on the patient and the clinical expertise of the dentist.

Thank you for that question. As you will have seen in the BDA’s response to the committee’s letter on the regulations, it said that that approach is actually something that it had been looking for. It feels that managing patients’ oral health is doing things at the right level because we all have a degree of responsibility for looking after our health.

I take on board the point about access; I underline, yet again, that we are seeking to improve access through the payment reforms that we will put in place next week.

I think that what we are looking at is a prevention-centred dental care service. The childsmile programme that we have rolled out to improve the oral health of young children is not disease-centred; it is very much centred on prevention.

We have also been very clear—again—about sustainability of services and ability to access dental services, which I think are really important.

The change that we are making with regard to unregistered patients is also important, because it moves us into the preventative space. When we bring all the regulations together, they show that we want to ensure that there is sustainable access to NHS dental services for the people of Scotland.

Yes, I can. I am aware of that issue from my conversations with the BDA.

In Scotland, we have a blended method. It combines a capitation payment for the number of people who are seen by a practice—one of the changes that will be made by the regulations is that adults and children will now be treated for the same fee, which, I think, is positive—and a payment for the services that a dentist provides. I think that that method will work very well, given the variety of dental organisations and businesses that we have.

In fact, yesterday Tom Ferris met some of the academics whom I referenced in my letter of 18 October, who are very supportive of a combined method of paying for our NHS dentistry and think that that is the right way. We have been very clear that we are building on a foundation that we already have in Scotland that works very well and on which practices are already built. I think that the reformed blended system is the right way for us to move forward. In that meeting, Tom Ferris discussed the possibility of making changes in Scotland. The advice that we got from academics from North America, Europe and Australia was that, if we look at how dentists’ services work across the world, we see that a simple lift and shift would not necessarily provide a better service. Their strong view was that we should modernise a system that is already working, which is what the Scottish Government has endeavoured to do, through the changes that we are making with the regulations and payment reform.

As I said in response to the convener’s question earlier, we will work very closely with dentists to ensure that we get a note of and recognition of how the changes improve accessibility and sustainability of the service. That will be on-going work, once the system is bedded in.

I mentioned payment reform specifically because that is what we are talking about now. We have continual meetings with the BDA and dentists, and everything is always on the table when we are in discussion with them.

No. The intention is to also improve access. We have been very clear that we intend that the regulations will improve the sustainability of, and access to, NHS dentistry in Scotland.

We should remember that everybody under 26 gets free dentistry and, as I have said, between 20 and 25 per cent of adults do not pay for their NHS dentistry. What we had to do was look at the best way of ensuring that we sustained the number of dentists and dental practices in Scotland, and it was felt that a slight increase in the fees was the right move. The fees are still capped at £384.

As I think I mentioned earlier, the concern that I have been hearing with regard to dentistry is about access. That is the issue that we believe the changes and amendments in the regulations will help us to address.

We have been very clear about that since we started discussions a number of months ago with the British Dental Association and, more widely, with dentists in Scotland. That work will start once the system is bedded in. We have already started with some very well-attended webinars to ensure that dentists understand what the changes are and how they will implement them in their practice.

We will constantly keep review of the system in mind. Tom Ferris meets dentists and directors of dentistry regularly through national health service boards and the BDA. We have been very clear with the BDA that we want to work with it to ensure that this is the right start for the reforms that we are looking at.

Good morning, and thank you for the opportunity to speak about the dental regulations, which are to be dealt with under the negative procedure. As the convener has noted, I am supported today by my senior policy officials Tom Ferris and Tim McDonnell, and legal official Ailsa Garland.

If I may, I will talk briefly about the purpose of the regulations, as well as the changes that we will be making under them. As the committee will be aware, the Scottish Government has been working on NHS dental payment reform for some time now. In my letter of 18 October to the committee, I outlined the key components and benefits of the new payment system, which will be implemented in just over a week. I will be happy to take any questions on that during the meeting.

In relation to the regulations, a number of key changes are required to various existing regulations to support payment reform. As part of those changes, we are introducing a single capitation arrangement for all patients, regardless of age, and all treatment items will, where it is clinically appropriate, be available for both adult and child patients.

We are also making changes to support unregistered patients. The system that is known as “occasional treatment”, under which unregistered patients can receive only a reduced set of care and treatments, will be removed through the amendments that will be made by the regulations. That means that both registered and unregistered patients will be able to access the same comprehensive range of treatments, by removal of what might be construed as a two-tiered system of care.

The changes are also focused on bringing clinical practice up to date. The new single capitation arrangement will rest on “managing” the oral health of the patient, by replacing the requirement to

“secure and maintain the oral health of the patient”.

The more achievable aim of managing oral health recognises that self-care is an important determinant of successful oral health outcomes.

I confirm that the equality impact assessment for the regulations reports no significant issues, and that the business regulatory impact assessment reports no adverse consequences.

In summary, the regulations are part of the significant work that we have undertaken to prepare for implementation of payment reform on 1 November 2023. The changes will support the introduction of the most significant reform to NHS dentistry in a number of years, and it is our intention that the reform will help to sustain and improve patient access to NHS dental services for the long term.

I am happy to take questions from the committee.