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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.

The nub of the reforms is about ensuring that we sustain NHS dentistry in the long term. Like you, I have received lots of emails about the access that people have to dentistry. We have the reforms, but we also need to remember that the Scottish Government has put other grants in place. For example, the Scottish dental access initiative offers £100,000 for a new practice in an area. We have been in discussions with health boards to ensure that we target those grants in the right areas. We also have some remote—although I do not like using that term—grant payments, which are really important.

The conversations that Tom Ferris and I have with the health boards are also important, because the boards have a responsibility to look at how dental services are being provided in their jurisdictions. I was pleased to hear that Scottish Borders, Dumfries and Galloway and Highland are now working together to encourage more dentists to come to areas that have had recruitment issues. As I said to David Torrance, we also need to keep an eye on the breadth of skills in dental surgeries to ensure that they are supported.

As I have said on a number of occasions, we believe that this is the right reform, building on the foundations of the way that dentistry is funded and provided in Scotland.

It is also incredibly important that we continue the dialogue with our dentists to ensure that we are getting the right changes made, whether they relate to governance, workforce or access, which are all important.

I know that Tim McDonnell wants to make some comments about access.

The problem is that there is not an “average patient”. Everyone in Scotland comes as an individual to see their NHS dentist.

The letters that I have been getting—I am sure that you are the same as me, in this regard—are about access to service. That is what people are really pushing for: they want to ensure that we improve access to NHS dentistry. As I said earlier, what we aim to achieve through the changes in regulations and fee structures is sustainability of services.

That is a really good question. The first thing that came into my head on NHS dentistry, and NHS boards more widely, was that people can feed in their views on the Care Opinion website. To be honest, high street dentistry—if I may describe it as that—is very much constructed of individual businesses, as Tim McDonnell has just said. However, I encourage people to use Care Opinion if they want to give feedback on NHS dentistry.

That is a very wide question. As I have said previously, the changes in the fee structure and the regulations will maintain and ensure the sustainability of the service across Scotland.

On encouraging people into dentistry, one of the areas that we want to look at is the workforce. There have been two pretty big impacts on the dentistry workforce. One is from Brexit and the difficulty that it created in getting dentists from outwith the United Kingdom to come to the UK. I have written to all my counterparts and their chief dental officers in the four nations, and we are organising a meeting to talk about how we can improve the throughput if dentists wish to come to practise in the UK—and specifically Scotland, from our perspective.

We also want to look at improving the workforce within dentistry. For example, there are some very highly skilled dental technicians, and we would like to explore giving them a bigger locus in seeing patients. We are talking about the possibility of doing that. That is not a magic bullet that will solve our issues, so we are working together on a lot of things. That is why the connections and discussions that we have with dentists, as Tim McDonnell and Tom Ferris have highlighted, are so important, whether they are through the BDA more widely or through the NHS directors of dentistry.