A DENTIST who previously exposed financial mismanagement at NHS Grampian has warned that patients and taxpayers are being let down by Scotland’s “double-standard” inspection regime.

Ross McLelland said an overhaul in how dentists are regulated means that Scotland’s 35 private-only dental practices are now subject to much more rigorous scrutiny of their patient care and finances than the hundreds of NHS practices where the vast majority of patients are treated.

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The new system was introduced because, previously, private-only dentists were not subject to any inspection regime. They will now be visited by Healthcare Improvement Scotland (HIS).

However, Mr McLelland, who is taking up the case with MSPs, said the new regime has ended up creating a “bizarre double standard” where patients who pay for treatment in Scotland’s handful of purely private dental surgeries will be able to see how their dentist was rated by inspectors - but the vast majority who attend NHS dental practices cannot.

This is because Healthcare Improvement Scotland - which also inspects hospitals and care homes in both the private and public sectors - routinely publishes all its inspection reports on its website.

However, equivalent reports on NHS dental practices - which are inspected by health boards, not by HIS - are not routinely published.

This differs from the regimes in England, Wales and Northern Ireland, where inspection reports for all dental practices - private or NHS - are publicly available.

Mr McLelland said: “I don’t want to make it an NHS versus private issue, it’s not about that. But why is everyone not being subjected to the same degree of scrutiny – that’s my gripe.”

Under the new inspections, which will begin in March 2019, private-only dentists will also be required to provide inspectors from Healthcare Improvement Scotland with three years’ worth of accounts - even though they receive no public funding.

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In comparison, NHS dental practices which received around £350 million from taxpayers last year to reimburse them for rent or mortgage costs, business rates, and providing dental treatments to NHS patients, do not have their income and outgoings routinely audited.

In fact, NHS Practitioner Services Division (PSD) – the body which authorises and processes all payments to dentists – confirmed that it has investigated just seven NHS practices in Scotland in the past five years over potential irregularities in the sums being claimed.

Mr McLelland, a partner at private-only Waverley Dental Practice in Aberdeen who has practised in the city for 30 years, said the situation was “baffling”.

He said: “I receive no public money whatsoever from anywhere, but I have to hand over three years’ worth of accounts. What has it got to do with them what my business finances are?

“Yet you can have another practice that is virtually private, but as long as it does a little bit of NHS work it escapes this process entirely.

“Equally, a practice could be mainly NHS and getting the bulk of its income from the Scottish Government – getting their rent paid for them, their rates covered, reimbursed for treatments – but they’re never having their account inspected. It’s all done on trust.”

The British Dental Association (BDA) said NHS practices in Scotland must seek prior approval from PSD for any treatment costing more than £410, and PSD authorises claims for payment submitted by NHS practices.

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Mr McLelland previously campaigned to expose financial mismanagement at NHS Grampian, eventually sparking an investigation by Audit Scotland in 2015.

A subsequent audit by accountants PwC revealed that of the 20 practices collectively awarded £3 million under the Scottish Dental Access Initiative (SDAI), only one had been subjected to annual monitoring to ensure that they were complying with the grant conditions.

Mr McLelland added: “High standards of regulation and inspection can only be a good thing, but not applying that standard equally across all service providers fails to protect the public, and also leaves Scotland completely out of step with the rest of the UK.”

Mike Rumbles, LibDem MSP for the North East, has written to Health Secretary Jeane Freeman to highlight concerns over the situation in Scotland.

He said: “There should be one set of rules for every dentist working in Scotland and patients should have access to the same high standard of dental care regardless of which practice they use.

“I have written to the Cabinet Secretary for Health to ask her why this only seems to be an issue in Scotland and to see if we can get this changed.”

In a statement, BDA Scotland said it has “grave concerns” over the long term sustainability of dental services in Scotland, with real-terms income for NHS practitioners down 30% in the past decade and two in five Scottish NHS practices struggling to fill vacancies.

David McColl, chair of BDA’s Scottish Dental Practice Committee said the sector faced much more serious problems than the inspection regime.

He said: “All dentists in Scotland are struggling in the face of red tape and over-regulation. NHS practitioners have seen a collapse in earnings without parallel in our public sector, while compliance costs have shot up by over 1000%.

“The real problem is underinvestment. With morale on the floor NHS dentistry now faces an uncertain future, as recruitment and retention problems mount.”

The BDA added that NHS dentists faced rigorous inspections covering health and safety, infection control, staff training, and dental records, among a range of issues.

A spokeswoman for the Scottish Government said private-only dentists had escaped scrutiny previously.

She said: “[Before now] wholly private dental practices were not subject to any scrutiny or inspection. They will now be subject to the same level of scrutiny and inspection as their NHS counterparts.

“Private Dentists meet the definition of an Independent Clinic and will therefore be regulated by Healthcare Improvement Scotland (HIS). The first inspections of private dental practices will commence in March 2019.”