Uist dental plan ‘cover’ for closing theatre

Opponents claim that some Uist residents could face a round trip of 70 miles to access dental care if NHS Western Isles’ plans to centralise dental services go ahead.
Photo credit: Joseph Shohmelian via Pixaby.

Plans by NHS Western Isles to centralise dental services in a new clinical hub in Uist and Barra Hospital have been attacked by a local councillor as a “diversionary tactic” and a “flanking move” intended to secure the long-term closure of the hospital’s operating theatre. 

The claims, by Councillor Calum MacMillan, who represents the Barraigh, Bhatarsaigh, Eiriosgaigh agus Uibhist a Deas ward, come following the announcement last week by the health board for the decision to relocate four dental chairs to the hospital in Balivanich, with the new dental facility being backed up by ‘mobile dentist chair’ service providing services to localities in the community and in care homes and which, said NHSWI, will “allow the service to be co-located with other clinical services”.

The move would also see the closure of the dental clinics in Lochmaddy and Liniclate following the closure of a similar facility in Lochboisdale in 2017, with opponents of the plan claiming that some Uist residents would face a round trip of 70 miles to access dental care if the relocation proceeds.

Councillor MacMillan said in his statement this week: “This decision on dental provision is the tactical part of the strategic decision by Western Isles NHS to close Uist Hospital by locating the dental surgery in the operating theatre suite.

“Centralising the dental service into the Uist Hospital is a flanking move to close Uist Hospital operating theatre suite.

“The SNP comhairle group had a budget amendment to dedicate money to provisioning the dedicated room in Taigh a’Cridhe Uile Naobh as the dental surgery to replace the Lochboisdale Surgery. The proposal was supported by the two SNP councillors in the Barra and South Uist Ward and the five SNP councillors from Lewis and Harris.”

In his statement, Councillor MacMillan also accused Labour Highlands and Islands MSP Rhoda Grant of calling for a government inquiry into the issue as a means of “taking the focus” off of comhairle convenor Councillor Norman A MacDonald – whom he described as a “Labour party colleague” to Rhoda Grant – and who has voted, according to Councillor MacMillan, to back the Uist dental plan. 

Councillor MacMillan added: “Rhoda Grant’s proposal for an inquiry is a politically motivated diversionary tactic designed to prevent the truth about Labour Party councillors voting to close the medical provision at Uist Hospital. 

“Rhoda Grant should instead call for the Western Isles NHS to start telling the truth, to publish the voting record of the [Integration Joint Board] (IJB) meeting and explain the real reason for centralising the dental provision into the Uist Hospital which is to close the Operating Theatre and Resuscitation Room to remove the surgical capacity from the hospital.”

Responding to the claims, Norman A MacDonald stated that he wasn’t present at the last IJB meeting, and said that “assurances had been given” that the relocation of the dental service in Uist would have “no detrimental impact on the Uist and Barra hospital whatsoever.

The convenor added: “After the original vote at the IJB on this matter resulted in a split vote, from then on it was up to the chief executives to decide what would take place.

“I have no idea what kind of influence Councillor MacMillan might think I have, as both Uist and Barra hospital and the Western Isles Hospital hospital are solely the responsibility of the health board and it is not for councillors to make any decisions on their future.

“I have never discussed in any shape or form either the dental service in Uist or her call for an inquiry with Rhoda Grant. 

“As to the colour of my politics, Councillor MacMillan’s claims are equally questionable. I have registered for the last fifteen years as an independent councillor.”

Councillor Calum MacMillan has described NHS Western Isles plans to centralise dental care as a “diversionary tactic.”

Mrs Grant said: “Councillor MacMillan’s assertion would be laughable were it not such a serious issue in question.

“I have, from the outset in 2016, listened to the concerns being raised by constituents, by the Uist Locality Planning Group, by the Association of Community Councils, by a stakeholder event held in Lochboisdale, and by all local elected members serving when this proposal to centralise dental services was first aired.

“I have repeatedly made representation to the IJB, to NHS Western Isles, to the comhairle, to the previous Health Secretary, and to the First Minister.

“Health boards and local authorities throughout Scotland are having to make incredibly difficult decisions to fit with the reducing budgets they are being given and perhaps Councillor MacMillan, instead of throwing meaningless insults around, would do better focusing on bringing this to the attention of his colleagues in the Scottish Government, opposing jobs and services being taken out of local communities.

“This is an appalling decision, which flies in the face of local democracy, and constituents in Uist deserve to have their concerns heard, and heeded.”

Editorial: Time to ‘call-in’ the Uist dental plan

Despite the uproar, despite the universal opposition stretching from Eriskay to Berneray, both NHS Western Isles and Comhairle nan Eilean Siar are hellbent on making it harder to access dental treatment in the Uists.

Officially, it was something called the Integration Joint Board that made the announcement at the end of last month: all roads will soon lead to Balivanich. But the IJB began life as a creature of the big boys; it is staffed by officials from both public agencies. Is its independence nominal? It’s hard to be sure.

Whatever the limits of its power, it is a useful fig leaf to hide behind. The barrage of flak directed at this rotten decision to centralise a vital health service can be dodged by the likes of NHS Western Isles chief executive Gordon Jamieson. The plan to close three dental surgeries came from the IJB. At least that’s how it was sold to the public.

Before too long, everyone in the Uists will have to go to hospital in Balivanich if they need a filling or a tooth extracted. So much for the “professional concerns” comhairle chief executive Malcolm Burr has supposedly spent that last six months mulling over. At the end of September, he fell into line. Unanimity was required in order to proceed, and he delivered it.

One particular paragraph from the IJB decision paper is worth quoting in full: “Given his familiarity with the subject matter, the chief executive of NHS Western Isles was able to come to an early view about the best arrangements for the provision of dental services in Uist; but the chief executive of the comhairle, having no previous experience of these services, required more time to familiarise himself with the detail.”

This admission is revealing. Completely out of his depth, it took Mr Burr six months to swot up on the intricacies of closing three dental surgeries before wielding the axe. In doing so, he perhaps exposed the limits of integrating health and social care, which is the IJB’s raison d’etre. Put simply, it should not be the responsibility of someone with no background in health care to make a decision like this. 

Western Isles MSP Alasdair Allan has had a quiet word with Public Health Minister Joe Fitzpatrick about referring the matter to the Scottish Government

The IJB say there will be an “outreach” service aimed primarily at South Uist and Eriskay, the latter 35 miles away from Balivanich along single-track roads. What this pledge means, in dental terms, is still to be decided. Perhaps teeth can be extracted safely in the back of a van.

If the fruits of integration — a much-hyped national paradigm — are vandalism on this scale, then we suggest a rethink is in order.  The hybrid organisations driving the agenda don’t seem to be accountable to anyone, least of all the voters.

Speaking of which, we are glad to see that Western Isles MSP Alasdair Allan has had a quiet word with Public Health Minister Joe Fitzpatrick about referring the matter to the Scottish Government. Ultimately, it is Health Secretary Jeane Freeman who has the power to stop this. Hopefully, she’ll use it before Stornoway wrecks a system that has worked well for decades.

Main article by Peter Urpeth – Local Democracy Reporter.