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I thank Finlay Carson for his follow-up question, and I recognise how much I appreciated visiting a community-led pharmacy in Newton Stewart, in his constituency, in the summer.

I recognise that we have to ensure that all boards have pathways to ensure that people who need obesity-reducing drugs can have them. We have been speaking directly with NHS Dumfries and Galloway, alongside other health boards that are considering how to implement such pathways, but we have so far been unable to reach an internal agreement on how to progress that through services, finance and primary care. However, I am happy to follow that up with Finlay Carson.

I, too, thank Kenneth Gibson for his motion and thank members from across the chamber for their helpful contributions.

The Scottish Government is committed to ensuring that all people in Scotland who live with long-term conditions, including chronic kidney disease—CKD—are able to access the best possible care and support and can benefit from healthcare services that are safe and effective and that put people at the centre of their own care. I thank all the organisations that are here tonight and the individuals who help and support those with CKD.

I will first respond to the points made by Mr Gibson and others about the long-term conditions framework. That framework recognises that, although every condition is different, there are universal standards that everyone should expect, no matter which condition they have. I thank Kidney Care UK, Kidney Research UK and the chronic kidney disease working group of Kidney Research UK in Scotland for contributing to the consultation on the framework, as well as thanking everyone else who contributed to our public consultation. We received 371 validated responses to that consultation and an analysis report will be published in October.

We will soon announce the governance arrangements, including the role of the third sector and those with lived experience in the development of the framework’s action plans. The Scottish Government and I place a huge importance on hearing from organisations representing people with long-term conditions and hearing directly from people with lived experience. That will be an important aspect of how we develop the framework and the on-going action plans to improve services for people with long-term conditions, including CKD, especially in highlighting inequalities.

I note the important role that the third sector has played over the years in driving improvements in condition-specific strategies. We want to ensure that kidney organisations can play that role, too. Importantly, this will be an opportunity for kidney organisations, as well as organisations representing other conditions, to come together and work collaboratively with the Scottish Government on improving care for people with long-term conditions. I very much look forward to meeting Kidney Care UK soon to discuss the framework and to attending Kidney Research UK’s summit in the next few weeks.

I also want to note where our wider Government policies deliver the asks of the motion regarding prevention, early diagnosis, equitable access to transplantation, a home-first approach to dialysis care and improving donation rates. That is important, as I agree with the points that Brian Whittle and others made about the impact that those issues can have on people and on Scotland’s economy.

In the “NHS Scotland Operational Improvement Plan” document, which was published on 31 March, the cabinet secretary set out that we will work to ensure that people receive the right care in the right place. Home dialysis can offer many benefits to NHS boards and patients, as many members have said.

Last year, we implemented a Scotland-wide policy of reimbursing home dialysis patients for the extra electricity costs incurred in their treatment, as Foysol Choudhury noted. That removes the financial disincentive to choose home dialysis over in-centre treatments, allowing personal choice in where and how to receive treatment, whether people are in a rural, urban or island community. I note the targets that the Nordic countries are aiming for, which Mr Choudhury mentioned, and I will take them into further consideration.

I will quickly respond to Kenneth Gibson’s points about transport and, in doing so, thank Kidney Care UK for its in-centre dialysis transport report, “Left to get on with it”. In October 2024, we published the “Transport to Health Delivery Plan” document, which sets out 20 commitments across the Scottish Government and partners. We look forward to hearing from a short-life working group that was created by the chief executives of NHS boards to address the issue of transport and renal dialysis access. Once we get the outputs from that, we will consider them closely.

Our cardiovascular disease risk factors programme is undertaking work in that area, with the aim of reducing avoidable CVD death by 20 per cent in 20 years by improving the identification and management of high blood pressure, high cholesterol, raised blood sugars, obesity and smoking. As part of that programme, we have committed to supporting 100,000 patients with enhanced-service GP appointments by March 2026 for those key risk factors, with a particular focus on supporting people living in areas of deprivation.

The Scottish Government is also committed to improving outcomes for people living with diabetes. Through sustained investment, innovation and strategic policy, we are transforming diabetes care to reduce complications and support long-term health. Notably, more than £42 million has been invested in the type 2 diabetes prevention framework, supporting early intervention and remission strategies such as the Counterweight plus programme.

Through the actions that are set out in the “Donation and Transplantation Plan for Scotland: 2021-2026” document, the Scottish Government is committed to increasing organ donation numbers and access to life-changing and life-saving transplantation. I thank Christine Grahame for hosting, in September, a parliamentary event focused on organ donation, as we need to work to increase the number of organ donations that are made. Key to that is ensuring that as many people as possible have registered their decision on the organ donor register. Scotland has a good record on that in comparison with other parts of the UK, with 57.9 per cent of the population now having recorded their decision.

We need to recognise that, although one big launch does a lot, we need to continue to get that information out there, which is why I am pleased that we will be conducting a Scottish Government-led publicity campaign.

As Christine Grahame says, we have done well, but we must do more. That is why, during this year’s organ and tissue donation week, in September, we will be encouraging as many more people as possible to register. That is the best way to ensure that people’s wishes in respect of donation are respected.

The Government is committed to supporting everyone to live longer, healthier and more fulfilling lives. We know that improvements to the health of our population have stalled and that inequalities have widened in recent years, which experts attribute to the combined impacts of UK Government austerity policies, Brexit, the Covid pandemic and the cost of living crisis, and that incidence of non-communicable disease is forecast to rise if action is not taken to prevent those illnesses.

Brian Whittle regularly—perhaps in every speech that he makes regarding health—talks about prevention, and I hope that he has read and supports our recently published population health framework, which was co-authored with the Convention of Scottish Local Authorities and sets out our 10-year strategy to improve the wider determinants of Scotland’s health through a whole-system, cross-Government and cross-sector approach that is focused on prevention. As Jackie Baillie said, that work has to be anchored within our communities.

A key priority of the framework is to improve levels of healthy weight, including by ensuring that a healthy diet is accessible and affordable to all. By shifting the focus from treating illness to preventing it, addressing the root cause of poor health and targeting our efforts where they are needed most, we can ensure lasting improvements for this generation and the next.

One of the most life-affirming experiences that I have had was witnessing a live kidney organ transplant and meeting families who have benefited from that amazing surgery. I was struck by their humbling appreciation and their wish to give back to society by encouraging people to register and raising awareness by sharing their stories.

Like Emma Harper, I pay tribute to the fantastic teams of nurses, clinicians and scientists from our NHS who support and care for those living with chronic kidney disease and, of course, the third sector organisations, many of whom are represented here. I thank Kenneth Gibson for bringing this important motion to the chamber.

I thank Mr Carson for his intervention. As he will recognise, dentists operate independent businesses, and it is up to them to decide on their model. That is why we introduced payment reform in November 2023 and why we are continuing to work through the regulatory, workforce and governance issues. That touches on exactly the point that Mr Rowley made about corporates.

As part of further long-term transformation, my officials are taking forward work to consider how we strengthen the existing governance model in NHS dentistry to improve the patient experience and ensure that patients can be seen and offered the appropriate care. As part of that, we are exploring options to make mandatory training for dentists, with its focus on patient safety, more efficient and flexible, to expedite recruitment across Scotland.

Officials are also looking at opportunities for boards to influence the provision of care in their area, including consideration of a declaration of compliance to raise awareness of dentists’ terms of service and their social and community responsibilities. They are also considering how to support boards in ensuring that dentists and dental bodies corporate adhere to those commitments.

I recognise that, in some of the areas that have been discussed today—specifically Fife, which a number of contributions have focused on—overreliance on practices with certain business models can present issues when the NHS footprint is suddenly reduced. I have therefore tasked my officials with looking at the issue to better secure continuity of care for affected patients.

In closing, I reassure members that, through the introduction of a new payment system—which, as I have been clear in saying, was the first step—and through investment in our workforce and local tailored solutions, we have implemented a policy framework that will support NHS dental services and deliver on our ambition to ensure high-quality, sustainable and equitable public services.

That situation is very concerning, which is why we have continued to invest in Childsmile, and we have increased the budget, given the impact of the pandemic, when children were not able to see their dentist and Childsmile nurses were not able to visit children. We have ensured that that activity has ramped up again. We have a number of dental nurses who can go out and provide that education. I do not have the figures to hand, but we are seeing improvements.

I am acutely aware that access continues to be challenging in some areas of Scotland. Fife and Dumfries and Galloway have been mentioned. The challenges are largely due to historical non-dentistry-specific recruitment and retention difficulties in those areas, which some members have recognised.

We continue to make available a range of additional financial support to areas of unmet dental need, and we will work to better target that as part of the commitments that are set out in our operational improvement plan. This year, we have taken targeted action in Shetland and in Dumfries and Galloway through the provision of additional funding to sustain access to dental services and ensure that there is adequate patient care.

Finlay Carson and Emma Harper mentioned the outreach facility that NHS Dumfries and Galloway has been operating, where 12 undergraduates are providing care. I am pleased to say that it is looking at how it can expand that.

That is in addition to practice funding support that is provided through the Scottish dental access initiative. As Alex Rowley said, a practice in Dunfermline with five SDAI-supported surgeries opened in August. We have also been able to approve applications in Inverclyde and in Dumfries and Galloway.

Increasing the dental workforce is a priority for the Scottish Government, and I am encouraged by the progress that we are seeing, with the number of high street dentists working in Scotland increasing by 5 per cent in the past year. We have also committed to providing additional funding this year, to increase the number of domestic dental students by 7 per cent from this month. We are growing the pipeline of staff entering the NHS workforce and providing additional capacity for NHS dental services in the future.

I will come on to that exact point, because we have talked about that in relation to the governance of dentistry.

Alexander Stewart asked for there to be broad change. We are making that change. We are also looking beyond domestic capacity and working closely with NHS Education for Scotland to deliver an innovative training package that will better support dentists who qualified overseas in achieving registration as a dentist with the General Dental Council. In fact, the chief dental officer and his team met the organisation today to press it to be a bit more flexible in that regard.

Carol Mochan and, I think, Willie Rennie called for my leadership on the issue. Acting with leadership is exactly what I have been doing. As others have pointed out, the regulation of dentists remains reserved to the UK Government. I am very disappointed that, despite discussion at four-nation meetings, which I led and in which all nations spoke of their concerns for the dental workforce, the UK Government has decided not to proceed with the necessary legislative changes to enact provisional registration for overseas qualified dentists. Although that makes the delivery of our programme with NES more challenging, I remain committed to exploring all alternatives to widen our pool of available dentists in the shorter term, in addition to growing our domestic talent. I would appreciate support from Scottish Labour in speaking with the UK Government about that.

I will continue on this topic and then come to Mr Carson.

Immigration is another matter that is reserved to the UK Government. I do not understand why the UK Government chose to remove key dental care professions from eligibility for the skilled worker visa from July 2025. That will impact on dental nurses, hygienists and technicians—exactly the roles that Claire Baker spoke about—who could help us to improve the dentistry service that we provide.

I share the British Dental Association’s concerns about the significance of those changes to the capacity of dental practices and to dental treatment. The move comes amid a significant drop in the number of dental professionals relocating from the European Union to practise in the UK following the UK’s exit from the EU, which puts further strain on dental care in our communities. I have therefore written to UK Government ministers to urge them to reconsider those detrimental changes, which will further negatively impact our available workforce.

Once I have finished my point.

I was struck when one director of dentistry told me—I think that others have made this point—that a person’s mouth gives an indication of their health, which is why dental health is so important. That is why, along with the chief dental officer, I have pressed for dentistry to be included in the preventative health agenda and have increased the budget this year.

I, too, thank Alex Rowley for bringing the debate to the chamber. It is important that we can use this space to talk about the concerns that members hear about from their constituents, and which I hear about from mine. I very much appreciate the tone in which the debate has been conducted, and I welcome members’ valuable contributions.

I reaffirm the Scottish Government’s commitment to securing equitable and sustainable access to NHS dental services. As many members have pointed out, in November 2023, we brought in a new payment reform as part of a comprehensive modernisation of the service. That prevention-based model is delivering high levels of service and has been welcomed by the profession, but I recognise that that is not the case across the board, which is why we are focusing on other opportunities.

I welcome the official statistics that were published last week, which show that more than 7 million courses of treatment have been delivered since the introduction of the payment reform in November 2023. That demonstrates that the significant continuing investment in NHS dentistry is supporting high volumes of patient access to NHS care and is delivering on our aims to sustain NHS dental services. In the quarter that ended in June 2025, 1.14 million courses of treatment were delivered. In the same quarter, 998,000 patients were seen by NHS dentists. As others have pointed out, 95.7 per cent of Scotland’s population are registered with dentists.

I remain absolutely clear that payment reform is only the first step in ensuring the sustainability of the service, which is why our recently published operational improvement plan sets out key actions to improve the NHS dental workforce and to support equity of access to NHS dental services across Scotland. That is backed by an increase of almost 15 per cent in funding in 2025-26, which takes total funding to more than £500 million for the first time. I echo Willie Rennie’s point about the support that we got from the Liberal Democrats in that area.

I agree with Mr Rowley, Ms Baker and others that prevention is hugely important, as is teeth hygiene, especially in the early years, which we are addressing through the Childsmile programme. That fits within our population health framework, in which dentistry is a key aspect of health prevention work.

The Scottish Government knows that transport plays an important role in supporting patients’ health journeys. Removing transport barriers and other barriers will help to ensure that patients across Scotland can access the right care in the right place and at the right time. I would be happy to write to NHS Forth Valley in that regard.