Tories' toothless attack on Swinney's Malawi trip ignores reality of global crisis

It was student dentists that provoked the official opposition’s outrage. The First Minister met with some of Malawi’s first dental students and heard about plans to build a stand-alone dental school, funded by the World Bank – a salient point that seemed to miss the usually forensic Dr Sandesh Ghullane. Instead, The Tories shadow health secretary mustered up all the outrage he could to criticise Swinney’s African visit.

He said, "This is grandstanding at its worst from John Swinney. On the SNP's watch, Scotland has lost 300 dentists since 2020, recruitment is the worst it's ever been, and thousands of Scots have been left with no option but to raid their life savings and go private for treatment.

"Instead of addressing the dentistry crisis that his party created, John Swinney is spending his time and taxpayers' money playing the global statesman – even though foreign affairs are reserved to the UK Government”.

His carefully calculated attack was aimed at those Scots who believe that the Scottish Government, or indeed Westminster, should not spend any money on international aid. Many had taken to social media to express their anger at Swinney’s visit, accusing him of “virtue signalling” (and worse) while Scotland’s NHS dental services collapsed. At first glance, their palpable anger is understandable. Scotland's dentistry is in crisis. There are fewer dental students and a significant drop in the number of dentists providing NHS services, as more turn to private practice, leaving many Scots without an NHS dentist. Only recently, figures provided by NHS Dumfries and Galloway show that more than 45,000 people in the region no longer have access to NHS dental services.

I grew up in Whithorn, a small town (population 900) in Dumfries and Galloway. Our dentist, Mr Reid, had a surgery in the heart of the community where my mother would take my three siblings and I every six months for a “check-up” which usually resulted in at least one filling, without anaesthetic. The brutality of 1960s dentistry aside, free oral care was once an important part of our national health service, along with local GP services which offered home visits and community hospitals. Even the most vulnerable children in my primary school had access to the school dentist, who made regular visits to treat those whose parents couldn’t, or wouldn’t, regularly drag them along to see Mr Reid.

Today, the health of Scotland’s poorest children is at risk. The gap in dental participation rates between children from the most and least deprived areas has widened from 7 per cent in 2010 to 20 per cent in 2022. And Dr David Offord, a leading Edinburgh dentist, pointed out in a recent edition of the Scottish Dental Magazine, dentistry is vital to general health. He said, “This isn’t just about oral health. Untreated dental problems can lead to serious systemic health issues, emergency hospital admissions and, in extreme cases, life-threatening infections.”

So, Dr Ghullane is correct in his assertion that, under the SNP, Scotland’s dental services are in an ever-deepening crisis. He is wrong, however, to link our public health emergency with that of Malawi’s. Is Dr Ghullane really arguing the people of Malawi should be abandoned, left alone to cope with the climate emergency which rich economies are largely responsible for creating? Do the Scottish Tories really believe that the rules of the global economy – in particular fiscal and trade policies - are fair?

And does the average Scot think it is acceptable for a country with a population of 22 million people to have fewer than 50 dentists - as was the case in Malawi before a chance meeting in 2016 between the then head of Glasgow University’s Dental School and the Principal of the University of Malawi College of Medicine.

Professor Jeremy Bagg and Dr Mwapatsa Mipando hit it off immediately and, with a modest investment from the Scottish Government, established the country’s first dental degree programme. It was this first cohort of dental graduates that John Swinney met on Monday. The two men, now close personal friends as well as professional colleagues, worked with Malawi’s Ministry of Health and others to develop a national oral health policy for Malawi, which includes interventions for children based on the principles of Scotland's very successful Childsmile programme. And their work has recently attracted a £5 million grant from the World Bank to build a stand-alone dental school.

Today, Jeremy Bagg, now chair of the Scotland Malawi Partnership, will join his colleagues at the charity's annual general meeting in Glasgow's Strathclyde University, which has its own Malawi Millennium project. Scots and Malawians will share their experiences of working together to build a better, sustainable world, whether through raising money for girls' education or building a national oral health policy. They are not 'do-gooders' or naive, but they do understand, far better than Dr Ghullane appears to do, that it is unsustainable for one half of humanity to flourish while the other languishes in unimaginable poverty.

Government interventions matter, and Swinney is right to provide international aid - Scotland can afford it - but it is the people-to-people links characterised by the friendship between Jeremy Bagg and Dr Mwapatsa Mipando that will make the lasting difference. 'One world' may be a campaign cliche overused by aid activists, but it is a unarguable fact. We are one species sharing one planet, our very survival is dependent on us recognising our deep social, cultural and economic bonds. We ignore these at our peril.