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NHS Dentistry Backlog

Volume 712: debated on Tuesday 19 April 2022

The dental activity threshold has recently been raised to 95% of usual activity. That is another quarter-on-quarter increase to get us towards 100% of pre-pandemic activity. I fully recognise, though, that access to NHS dentistry before the pandemic was patchy and that the crux of the problem is the current NHS dental contract, so work is under way to reform that contract. As negotiations have started, I am limited in what further I can say, but I will update the House as soon as possible.

A number of my constituents are finding it impossible to access NHS dental care. They include Alison, one of my constituents who worked as a midwife in Ipswich Hospital for 40 years. Some of them have contacted 40 different practices and have not got anywhere. My understanding is that there has been a 30% drop in the number of dentists taking on NHS work in Suffolk. Will the Minister explain what local work is going on between the Department and the local NHS bodies to try to ensure that this issue is addressed?

My hon. Friend is quite right in his question and is campaigning hard to increase dental activity in his constituency. One of the key pieces of work is being done through Health Education England, which set out a range of recommendations in its “Advancing Dental Care” review. That will do a number of things, such as increase the skill mix and scope of practitioners across dental teams, and we may well require legislation to bring some of that work forward. Health Education England is also introducing more flexible routes into dental training and doing some workforce modelling to identify the parts of the country with the biggest gaps in provision, so that we can establish centres of dental development in those areas. I will look at Ipswich in particular.

My constituent contacted me to tell me that when she broke her canine and went to contact her NHS dentist, she found she had been kicked off the list and was facing a bill of £4,000, which she simply does not have, to have the work done privately. Will the Minister speak to some of the dental practices about the possibility of relaxing their rules on kicking people off their dental lists, especially as covid has meant that patients might have had legitimate reasons for missing appointments?

I am sorry to hear about the hon. Lady’s constituent’s experience. There is not actually a list system for dentists as there is for GPs, so patients can see any dentist when they have a dental issue. With that said, we have asked dental practices to update their availability for NHS patients on the website. This morning, I looked at the website to see what availability there was throughout the country and saw that many dentists still have not updated their availability, so I will ask officials—particularly in her constituency—to update the lists so that patients can access NHS dentistry more easily.

I join the Minister in thanking dentists and their associates for getting so much of the service back. Does she agree that in places such as the Arun parts of my constituency, where people cannot find a dentist and have not been able to for two or three years, there must be a way for people to get on a dentist’s list and get treated, and for dentists to be properly rewarded? Dentists and patients would be grateful for a change in the contract.

The Father of the House is quite right that the crux of the problem is that there is a shortage throughout the country not of dentists but of dentists taking on NHS work. The contract is the nub of the problem, which is why work is under way to reform it. We will shortly announce some short-term changes and some longer-term reforms, which will hopefully help my hon. Friend’s constituents.

Bearing in mind that dentists are now determined to turn their practices wholly private as they cannot make ends meet with NHS prices, will the Minister pledge to review NHS payments to stop the haemorrhaging of NHS dentistry provision?

The hon. Gentleman is correct that the units of dental activity payments are a perverse disincentive. Sometimes, when someone needs more extensive work, their dentist is paid the same as they would be for, say, one or two simple fillings. That is the nub of the problem and we are currently in negotiations on the matter.

My hon. Friend the Minister is right to talk about the contracts with dentists, but should she not also look at how dentistry is structured and the regional nature of the contracting? It sits outside our clinical commissioning groups, which reduces co-ordination and accountability in respect of something that is central to our health. Should this not change?

My right hon. Friend is right. Health Education England is addressing the overall system of where dentists are training and where the gaps in provision are filled in its “Advancing Dental Care” review. It is also working with commissioners at a local level to develop more opportunities in those places that we term dental deserts, where there is currently a lack of provision.

NHS dentistry is in crisis. Patients are stuck with either a never-ending wait for an NHS appointment or footing the bill for going private, which is simply not an option for most families suffering rising bills and taxes. With a third of the population experiencing untreated tooth decay, when will this Government, who have had 12 years to do so, finally come up with some practical solutions that put patients’ needs first, rather than the half-baked, unworkable ideas we have heard to date?

I am sorry to the hear that tone from the hon. Lady. We are working under Labour’s 2006 dental contract, and she may have missed that dentists were unable to offer any routine care during the pandemic over the last two years, which we have slowly worked up to 95% of usual activity. She may want to play politics with this issue, but perhaps she should speak to her Labour colleagues who run the NHS in Wales, where 6% of dental posts were lost last year. She should get her own side in order before lecturing this side of the House.

With the exception of the previous question, I do not think that anybody on either side of the House who has raised this issue is playing politics, because a pattern is emerging of a backlog and problems in accessing NHS dentistry. An increasing number of constituents are contacting me having gone to their NHS dentist with an acute dental problem only to be told either that NHS patients are no longer being seen or that they have fallen off the list, as the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) mentioned. How can Ministers help in the short term? I know the long-term answer is around the contract—I used to give that answer when I was in her seat—but will the Minister please meet me over a cup of tea so that we can try, as a starter for 10, get to the bottom of this?

I thank my hon. Friend for his question. We have had many cross-party meetings with colleagues about dentistry, with many raising constituency issues that we have followed up. He could speak to his local commissioners, because there can sometimes be local problems with the commissioning of dental services. However, now that we are moving towards 95% of usual activity—a significant change compared with last year— I hope that his constituents will be able to access services more easily.