Skip to main content

NHS: Dentistry

Volume 703: debated on Thursday 3 July 2008

asked Her Majesty’s Government:

What steps they are taking to maintain standards in NHS dentistry, in the light of dentists leaving the National Health Service.

My Lords, PCTs are reporting that plenty of dentists come forward when they tender new services. Although there was a fall in numbers in 2006, we still have 4,000 more NHS dentists than 10 years ago. We have made increasing access to dentistry a national priority for the NHS and we have increased this year’s funding by £209 million, taking our total spend to £2,081 million.

My Lords, I thank the noble Baroness for that reply. Does she acknowledge the difficulties that arise when, according to a recent health survey in York, 45 per cent of people in the city of York who wish to see a dentist when they need one cannot do so?

My Lords, in 2006 we introduced a legal duty on PCTs to provide dental services for those who need them. I know that access has been a problem in some areas and I am sorry that there has been a problem locally in York. However, as I have said, the extra £209 million put into dentistry this year should ease the situation. Indeed, we know that commissioning activity generally is up. Specifically, four new NHS dental practices have recently opened across North Yorkshire, and a total of 70,575 patients have been assigned to NHS dentists across the area. The PCT is working hard to solve the problem. But perhaps as fellow Yorkshire women, we might go back to the primary care trust to ask how it is progressing and what plans it has to solve this problem.

My Lords, I apologise to the House for my keenness in trying to get in, having failed to speak on a Statement last week. I hope that the noble Baroness is not implying that NHS dentists are not working to the highest possible standards. In view of the pledge of the Minister, the noble Lord, Lord Darzi, to provide high quality preventive care and his recognition that target-driven systems are not the way forward, will the noble Baroness re-examine the present system whereby all NHS dentists spend all of their time working to achieve treatment targets?

My Lords, my noble friend is, as ever, enthusiastic on behalf of dentists, and has put the emphasis on quality and prevention. For example, 12 year-old children in the UK have the best oral health in Europe. Although we are not reviewing the contractual system now in place, as part of the review being undertaken at the moment we will re-evaluate the new system to work out what is the best way forward, whether the system is working, and what steps are needed to ensure that local commissioning is taking us in the right direction for the future.

My Lords, does the noble Baroness agree that many dental conditions are more damaging to a patient’s health than many disorders now being treated at no cost in other parts of the health service? How long will we have to wait for the Government to sort out this muddle and ensure that crucial dental treatment is available to all under the health service?

My Lords, the noble Baroness is right to point out that preventive treatment is vital. The whole point of the new system is that we are, as it were, putting our money where our mouth is and giving the NHS an 11 per cent uplift. I apologise. I do not know whether it was a witty civil servant or an accident that put that in my brief. Putting budgets for the first time into the hands of the local NHS will help to bring forward the prevention that we all want.

My Lords, does my noble friend agree that in many respects concerning dentistry, prevention is better than cure? Will she clearly recommit the Government to the programme that is necessary for the fluoridation of water supplies in this country so that our dental health may be protected from birth and the demand for dental services will not be as great in the future as it is as present? I remind the House of my interest as president of the British Fluoridation Society.

My Lords, in the UK about 6 million people—10 per cent of the population—drink water that is either artificially fluoridated or has a natural level of fluoridation. This is an issue that local communities need to consider but, by way of illustration of the benefits, children in Sandwell, which has fluoridated water, have two and a half times fewer fillings than children in Bolton, an area of a similar social profile.

My Lords, have we not had this week a devastatingly condemning report on the state of dentistry in the National Health Service? This talk about prevention is all very well, but is it not clear that the report from the Commons states that people are not doing the repair work because the existing contract is a disincentive to do so? Can dentists be blamed because they are being forced to turn into private practitioners? When will the 2006 contract be reviewed to make it more practical in delivering dentistry to patients?

My Lords, the review is taking place at the moment and we will carefully consider the Health Select Committee report on dentistry in due course. We welcome the Select Committee’s support for the key elements of our dentistry reforms which are now being given to local primary care trusts for the first time. We are pleased that the committee agrees that this localised system is the way forward. The report of my noble friend Lord Darzi, High Quality Care for All, emphasised the importance of effective local commissioning in improving access to high-quality services across the NHS, including dentistry.

My Lords, recently there have been several questions about dentistry, including questions on the House of Commons report, all of which point to one issue: do we have a national shortage of dentists? If we have, who is responsible for maintaining the supply of dentists to the country?

My Lords, NHS dentistry is expanding and we are seeing a steady rise in the amount of services that are being commissioned. We are also increasing the number of dentists for the long term. We have increased the number of undergraduate training places by 25 per cent and have established two dental schools—one in Plymouth and one in Preston—which will open this autumn.

My Lords, is my noble friend aware that there are at least four dentists within an easy walk of where I stay in north London and that several of them have repaired my teeth extremely satisfactorily?

My Lords, will the Minister answer the previous question? Do we have a sufficient number of dentists at the moment or not?

My Lords, we made a fundamental and essential reform to the NHS dental contracts in 2006 and dentists have lost their ability to restrict the supply of NHS dental services. Much of the opposition comes from dentists and organisations in the private sector.