Skip to main content

NHS: Dentistry

Volume 695: debated on Thursday 18 October 2007

asked Her Majesty’s Government:

Whether they intend to review the present National Health Service dental contract.

My Lords, the department keeps the new dental system under continuous review through the Implementation Review Group. That key stakeholder group, chaired by the Chief Dental Officer, includes representatives of the dental profession, citizens’ organisations and the NHS.

My Lords, I sympathise with the Minister over that reply, because the Government have such an appalling record on dentistry. I have two points to put to her. One is that she did not reply in the debate last week when asked whether the Government intended to phase out NHS dentistry altogether. The other is that recent government responses in the media have said that everyone has access to emergency treatment, but that does not at all accord with the reports we are getting. How and where is this emergency treatment available to patients, and how and where do they find out about it?

My Lords, that was a lot of questions. I shall answer them all. The Government are not going to phase out NHS dentistry. We have a fine record in relation to dentists. I abhor the sensationalist treatment of this subject by the press this week. Nine out of 10 dentists signed the contract, and a survey showed that 93 per cent of patients were happy with their dental treatment. There are more dentists now than there were in 1997, and we have increased exponentially the number of dentists in training. That is a very fine record.

My Lords, what guidance has gone from the Chief Dental Officer to GPs and accident and emergency departments for managing dental emergencies out of hours? Will the Minister assure the House that there is dental provision for those patients undergoing chemotherapy and other treatments where a dental infection, if not rapidly and expertly treated, could prove fatal?

My Lords, I do not know the exact guidance that has been given to GPs and accident and emergency services, but I will get back to the noble Baroness in writing about that. If a person needs emergency treatment, they can go to the PCTs and demand such treatment. That is their right. They can find a list of dentists on the NHS Direct website, but I know that that is still difficult for some people and we are looking for new ways of communicating information to people so they know where to find their emergency dentists.

I acknowledge that it is extremely important that patients undergoing chemotherapy have access to dentists whenever necessary. I am sure that that is happening, but if it is not, perhaps the noble Baroness will tell me in writing.

My Lords, since the noble Lord, Lord Darzi, has taken his seat on the Front Bench I have had two encouraging Answers to Questions about dentistry. Despite the assurances made by the Minister, other Ministers and the Prime Minister, there is no doubt that out there the profession and patients are not happy with the situation. Will the Minister ask the noble Lord, Lord Darzi, to have a look at the dental contract as part of his general inquiries into the NHS?

My Lords, my noble friend Lord Darzi is doing a fine job. I do not think that he is looking at dental services in his current review, but that may change. The dental contract is not within his remit at present, but it may be in future. As I explained earlier, many more patients are satisfied than we are given credit for, but I recognise that it is an enormous problem if someone who needs treatment cannot find an NHS dentist in their area. However, in areas such as Cumbria, where people were unable to find NHS dentists previously, we have provided an extra 62,000 places. Similar increases are being seen throughout the country. In response to the noble Lord’s point about the dental profession, I respectfully point out that professions never like change.

My Lords, the Minister will be aware of the CAB report, which came out earlier this year, about inequalities in access to dentistry in different areas. Will the department plot the incidence of people seeking emergency treatment against known inequalities in basic provision? One can see a pattern where emergencies will arise in areas where people cannot get routine access to basic dental care. Will the Government analyse that as part of their review of the contract?

My Lords, that would seem a sensible way forward if it is not being done at present, but in areas where great inequality in access and difficulty in getting NHS dental care have existed, we are doing our utmost to work with PCTs to ensure that there are improved dental services. However, I shall take back to the department the issue that the noble Baroness raised.

My Lords, how does the health of children’s teeth in the United Kingdom compare with that in other European countries? If she cannot give me an answer immediately, will she put it in the Library?

My Lords, I do not have the relevant statistics, but when I looked into this question, I was delighted to learn that our children have the healthiest teeth in the European Union. That is largely to do with the fine toothpastes that we use, but, in some areas, it is to do also with fluoridation. In Birmingham and Sandwell, where statistics for health are poor, children have excellent teeth. We are therefore very much in favour of fluoridation.

My Lords, has the Minister seen this week’s report by the Commission for Patient and Public Involvement in Health, which surveyed 5,200 patients and 750 dentists over several months? If she has, why do the Government continue to think that the present dental contract is not in need of review when a quarter of patients have been forced to pay for a private dentist because their local dentist does not accept NHS patients, 35 per cent have stopped using dental care because it is too difficult or expensive to get it on the NHS, and 6 per cent have treated themselves by using pliers to remove their teeth, because they were unable to get professional treatment on the NHS? Does she think that that is an acceptable situation?

My Lords, the situation as outlined by the noble Earl is not acceptable, but if one looks closely at the survey, the situation is much brighter than he portrayed. There is absolutely no reason for anyone to resort to self-treatment. The cases that were outlined by the media this week were absolutely sensationalist; there are very few such cases. Ninety-three per cent of the patients who were surveyed said that they were content with their dental treatment.