Letter from LDC Lanarkshire to the Cabinet Secretary

Dear LDC Mandate holders and colleagues,

Following discussions at our recent committee meeting on 1st September, Lanarkshire Local Dental Committee agreed that, due to the mounting challenges facing the profession and an unacceptable lack of communication from Scottish Government, we had no option but to contact the Cabinet Secretary and CDO directly to voice our concerns. The following letter, sent on Tuesday 6 September, has been widely supported by dentists across Scotland. If you share our concerns, have any comments or would like to add your voice to any of the issues raised here please contact us at committee@ldclanarkshire.org.uk

Kind regards,

Caroline Pryce

On behalf of Lanarkshire Local Dental Committee

Dear Cabinet Secretary,

As representatives of Lanarkshire GDPs, and after extensive consultations with our colleagues, we feel it is imperative that we write to convey the extreme anguish, disillusionment, and indeed mental health issues our profession finds itself with during these unprecedented times. Like many professions, dentistry faces spiralling costs, staff shortages and low morale. However, this is further compounded by poor communication and a lack of urgency or clarity from Scottish Government to the dental profession.  

We ask that Scottish Government address and action the following points with immediate effect:  

• Communication 

On multiple recorded occasions during the term of our CDO’s office our profession has requested an improvement in the communication between Scottish Government/the CDO office and our profession. These requests have been directed from local committee level to our national representatives (SDPC) who continually report that little improvement has occurred. Indeed, we have been informed in recent times that our CDO has failed to attend meetings with the DOD’s and SDPC without appropriate notification or explanation. Our CDO has informed LDC’s that he will only communicate with the appropriate bodies however it is quite apparent that this is not occurring to a satisfactory standard. We are particularly concerned with the continual lack of appropriate communication and consultation on the changing financial multiplier that the profession is currently receiving. To be informed on a Friday afternoon of changes to be introduced on the following Monday, borders on negligence and is unacceptable. Practice owners are unable to adequately plan patient treatments or provide security or certainty for their staff and this is affecting patient care and staff morale. Like any other business we need short-, medium- and long-term projections.  

• Financial Support 

Whilst we are appreciative of the multiplier, which was and still is necessary to facilitate the return of our profession to practice during COVID, it is quite apparent that the remuneration package outwith this support is inappropriate for effective patient care on the NHS. As Scottish Government will be acutely aware (after consultation with the SDPC) the Scottish dental profession remuneration has lagged inflation for some time pre COVID, however this has now been exacerbated with the recent increase of the inflation rate to more than 10% compared with the proposed 4.5% being offered to the profession. Significant increases in lab bills and spiralling energy costs, coupled with increasing staff wages to retain staff, has led to many of our colleagues who provide NHS care declaring their businesses will not survive, unless there is improved financial support.  

• Patient Care and Inequality 

After consulting with our fellow Lanarkshire professionals there is an overwhelming belief that if the current package being offered to our colleagues is maintained without change, this will lead to a reduction in the availability of NHS care within our practices. Patient care will be adversely affected, and inequality will thrive. Our members wish to maintain a strong NHS service however they report that this is becoming more and more difficult to sustain without improved financial support from Scottish Government. We wish to be able to provide access, quality of care and address inequalities but we also want an environment that is safe, healthy, and rewarding. Scottish Government’s election pledge to provide free NHS dentistry for all may be extremely difficult to facilitate if practices make the difficult decision to reduce their NHS commitment to allow the survival of their businesses!  

• SDR Changes / OHIP 

We have been informed for many years since the OHIP consultation was introduced that change was imminent. Whilst we appreciate COVID has provided difficulties in this implementation the rate of progress has been astonishingly slow. If Scottish Government really wants to get dentists on board, they must show that they value our profession and facilitate the necessary progression of change with urgency.  

• Workforce 

During consultations with our colleagues, we have repeatedly been informed there is concern over the exodus of our NHS workforce which is becoming increasingly evident. Despite practices offering significantly improved remuneration packages – associates, dental nurses, hygienists, and managers are leaving our profession, reporting job dissatisfaction, increased aggression from patients and stress as major factors. Young and recently qualified dentists report they see no future in NHS dentistry and are being approached by corporate groups who offer increased private revenue. Reports of associates who aspire to be the next generation of practice owners believe that private dentistry will be the only option for them to run viable practices. Practitioners who have worked for decades in NHS dentistry are now so demoralised they are retiring early (even if that means losing part of their pension income). Change is required to reverse this exodus.  

• Staff Wellbeing  

For many of the reasons stated already our profession is currently working in extremely stressful environments. As a result, many practice owners report they have witnessed unprecedented levels of staff with mental health issues. We need change and we need it now, before the unimaginable occurs and there is further loss of life.  

Whilst we appreciate this communication is not through the routes as recommended by our CDO these are unprecedented times, which require unprecedented actions. Many of our professionals believe we are now approaching a “point of no return” and change is required with immediate effect to facilitate the survival of NHS dental care. The time for the reform space is now. As we look to our compatriots in various professions who have taken the industrial action route, we request that Scottish Government commit to negotiating, communicating and change, so industrial action is avoided. This will facilitate an NHS dental service that is not just surviving but thriving and allows our profession to address inequality, provide a platform which allows patient care to excel and provides an environment where dental teams are appreciated and valued for the caring profession we are. 


Lanarkshire Local Dental Committee

This letter is supported by:

Glasgow and Greater Clyde Local Dental Committee

Tayside Local Dental Committee

Grampian Local Dental Committee

Forth Valley Local Dental Committee

Highland Local Dental Committee
Your LDC….

Please remember your LDC is here for support and advice for GDPs across Lanarkshire.   Our committee is made up of many practice owners & associates with varying NHS/private commitments.  We have several VT trainers, a practice inspector, clinical tutors and members who sit on several other local or national committees so we are acutely aware of the issues being experienced by GDPs.  The last 2 years have been extremely turbulent for the profession and with uncertain times ahead we are keen to help and support GDPs so please do not hesitate to contact us, details can be found on the Lanarkshire LDC website.

We would like to encourage all GDPs to complete a LDC mandate to support the continued work of the committee.  Sadly, over recent years several LDCs across Scotland have had to “close their doors” due to lack of support.  All LDC funding comes from GDP mandate fees, currently only 30% of GDPs in Lanarkshire pay an LDC levy.  You can check this on line 28 of your schedule.  If you have moved practice or changed list number since you last completed a mandate please complete a new one via this link https://ldclanarkshire.org.uk/set-up-a-mandate/  It is a small amount (£2 per thousand pound of monthly NHS gross) but it makes a big difference and will allow the LDC to continue to run CPD events and to represent GDPs in Lanarkshire. More information on our committee can be found at https://ldclanarkshire.org.uk/about-us/