SNP manifesto: Party pledges to abolish NHS dentistry charges and freeze income tax

The SNP has pledged to abolish NHS dentistry charges if re-elected, Nicola Sturgeon has said, with an estimated cost to the public purse of £100 million – although the SNP would also freeze income tax for the next parliamentary term.

Revealing the SNP’s manifesto pledges, which would see an overall £6 billion rise in spending over the next parliamentary term, Ms Sturgeon said she wanted to ensure cost was not a barrier to accessing health care, and that building on the scrapping of prescription charges, NHS dental costs would be abolished.

She said the “inequity” of dental charges, which had seen “Nye Bevan, the founder of our NHS, resign from government” 70 years ago, had to be resolved and by scrapping the fees the SNP would "complete a mission to restore all of Scotland’s NHS to its founding principle – universal healthcare, provided free at the point of need”.

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Ms Sturgeon also announced a "transformational" spending increase for the NHS, promising to boost frontline spending by at least 20 per cent – rising by £2.5bn by the end of the next Holyrood term.

Asked how she planned to pay for increase in spending, Ms Sturgeon said the government had published its medium-term financial strategy in January, which had set out three scenarios for the Scottish budget up to 2025/26 based on figures and estimates on tax take and growth in the block grant from the Scottish Fiscal Commission and Office for Budget Responsibility.

“It set out three scenarios and the spending commitments we have set out today come in slightly below the central scenario – in other words, the most realistic scenario for the growth of the Scottish budget over these years,” she said.

“Scottish tax revenues are estimated to grow by 20 per cent, our overall budget is estimated to grow by around 14 per cent because growth in the block grant will be slower than tax revenue growth. All the spending commitments we are making, which by the last year of the Parliament will amount to £6bn more than spending today, come in that medium scenario.”

However, despite the spending pledges, Ms Sturgeon also said income tax would be frozen for the duration of the next Scottish Parliament if the SNP wins the election next month.

The SNP pledges to abolish dentistry bills if re-elected in May.

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“Given the period of recovery we face and the need for stability for business and household budgets, that’s the right position to take. We would increase the thresholds in terms of the difference between each band of income tax by no more than the rate of inflation.

“Governments always have to retain flexibility should the unforeseen happen, but our intention is to freeze income tax. We reformed it in the last Parliament and the IFS has said we have the most progressive system in the UK, but now is the time for stability.

“Our tax revenues, because of economic recovery and growth are estimated to increase by 20 per cent over the next few years and that will be the basis for the transformational policies we’re putting forward.”

Ms Sturgeon rejected a suggestion she was allowing those who could afford to pay more “off the hook” with the freeze.

"If we hadn’t already made quite significant changes, that may be a stronger point,” she said.

"We are in a global pandemic, the recovery is going to be tough and our judgement is we should not raise income tax at the moment, having already increased it for those at the top end in the last Parliament.

"We also increased council tax for people living in the highest banded houses, but you’ve got to be very careful about drawing a correlation between the band someone’s house is in and the income that they earn.

"We have made sure that those who can most afford it pay more”

On the abolition of dental charges, Ms Sturgeon said the move was expected to cost an initial £75m, but added: “We estimate it will rise to £100m because we expect and hope that demand for dental treatment will increase, because right now there will be people not accessing dental treatment because of prohibitive nature of the costs.

“The choice of what treatment to receive – or indeed whether to receive any treatment at all – can depend on how much someone is willing or able to pay. That is harmful for patients who don’t access the treatment they need. But it also puts pressure on other parts of the NHS.

“In the year before the pandemic struck, almost 4,000 people attended A&E for dental health reasons. Many of these attendances – and a great deal of pain besides – would have been prevented with an earlier visit to the dentist.

“That pressure is likely to grow as we tackle the backlog of care caused by Covid."

Ms Sturgeon admitted there had been no discussion yet with the British Dental Association in Scotland about supporting the abolition of dental charges, but that negotiations would begin to see "if they are of this mind, and I think they will be”.

The British Dental Association said it would work with a future SNP government on the pledges “which could fundamentally change the way dentistry is delivered in Scotland”.

David Phillips, an associate director at the Institute for Fiscal Studies, said of the SNP's manifesto pledges: "Paying for all of these pledges in what could be a tight funding environment over the next few years will require tricky trade-offs though – tax rises or spending cuts in at least some other areas.

"The tougher fiscal situation an independent Scotland would face in at least its first few years would make the challenge of delivering these commitments even harder."

About 20 per cent of the NHS dental budget – some £74m in 2018/19 – is drawn from charges.

The Scottish Government budget for the current year saw £431m go to general dental services, a rise of just 0.6 per cent from the year before, which the BDA has said represents a real-terms cut, following on previous cuts in three out of the past four years.

Public Health Scotland data has shown a dramatic reduction in NHS dentistry due to the pandemic, hitting those in most deprived communities the hardest. Between April and November last year, the number of courses of treatment delivered was 83 per cent lower than during the same period in 2019.

Practices are still operating at significantly reduced capacity to meet infection control protocols. The BDA is seeking capital investment in areas such as ventilation to help restore patient numbers.

David McColl, chair of the BDA’s Scottish Dental Practice Committee, said: “Dentistry in Scotland risks becoming a casualty of this pandemic. We have called for wholesale change to the way care is delivered and we will work with the next Scottish Government to achieve that.

“These are big plans to bring down barriers to care and improve access, but they must go hand in hand with needed investment if services millions depend on are going to remain sustainable.

“Practices are now operating at a fraction of their former capacity. Dentists will need real and ongoing support if we’re ever going to meet historic levels of demand.”

Ms Sturgeon also promised voters a £10bn programme on investment in NHS facilities, combined with a minimum 25 per cent rise in mental health spending and the establishment of a National Care Service, and fast-track cancer diagnostic centres in every health board area.

She said every GP practice in the country would have access to a dedicated mental well-being link worker, creating a network of 1,000 additional staff.

"It is practical but unashamedly optimistic and it is transformational in its ambition."

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