Dentistry: Children

Debate between Baroness Manzoor and Lord Colwyn

Tuesday 15th January 2019 Lords Chamber

[Baroness Manzoor]

The noble Baroness is absolutely right: sugar is a leading cause of tooth decay and we must do more to tackle it. Indeed, the Government are doing that. We published the second chapter of our world-leading childhood obesity plan in 2018. This builds on the real progress that we have made since publication of chapter 1 in 2016. The key measures in chapter 2 include restricting promotion deals on sugary and fatty products, introducing further advertising restrictions, mandating calorie labelling in restaurants and ending the sale to children of energy drinks which may be high in sugar.

[Lord Colwyn (Con)]

My Lords, I am aware that the UDAs are not very popular with the dental profession. Can my noble friend update the House on the long-term plan for the NHS published earlier this month? A recent Written Answer revealed that only 108 practices are signed up to Starting Well. As far as I am aware, the scheme has received no new funding. I declare my interest as a retired dental surgeon and a fellow of the British Dental Association. Will the Government agree to examine the success of the tried and tested deals in Scotland and Wales and roll out a properly funded, universal oral health prevention programme to children across England?

[Baroness Manzoor]

I thank my noble friend for that question. NHS England’s Starting Well initiative is supporting dentists across England to see more children from a young age and form good oral health. Two hundred and thirteen practices in 13 identified areas are participating in the programme, of which 210 have preventive champions in place. In Hull, for the first time, each practice has identified a health visitor to work with it. In Ealing, early indications are that children who do not normally attend dental practices are reported to be doing so. However, it is early days. We are also looking at how we might put more preventive dental access into the dental contract, but that will take a little time.

The NHS

Debate between Baroness Manzoor and Lord Colwyn

Thursday 5th July 2018 Lords Chamber

[Lord Colwyn (Con)]

My Lords, I welcome the debate of the noble Lord, Lord Darzi. I must also declare my 40 years in the NHS and that I am a fellow of the British Dental Association.

In 1948, the nation’s dental health was in a worse state than that of defeated and occupied Germany; decay and gum disease were rife and more than three-quarters of the adult population had complete dentures. The creation of the NHS meant that, for the very first time, dental care was free at the point of use and the demand was overwhelming. By late 1948, more than 80% of practising dentists had signed up to work in the NHS and, in the first nine months of its existence, NHS dentists provided over 33 million artificial teeth, performed 4.5 million extractions and put in 4.2 million fillings. By 1951, the NHS started running out of money and so charges for dentures were introduced—the first charges of any kind for NHS treatment. This controversial move caused much debate and led to the resignation of Aneurin Bevan. Charges for other types of dental treatment soon followed and, to this day, dentistry remains the only part of the NHS that is not free at the point of use.

NHS dentistry today looks very different from the way it did 70 years ago. Modern technology means that dentistry today is relatively pain free compared with the dentistry of the past. Our nation’s oral health continues to improve and most of us keep at least some of our own teeth past the age of 85. Satisfaction with NHS dentistry is at a record high. Despite an estimated 10 million adults in the UK reporting dental anxiety and 6 million experiencing dental phobia, 85% of patients rate their NHS dental experience as positive.

We cannot, however, afford to be complacent. Although oral health on average is steadily improving for the general population, there are still unacceptable variations in outcomes, depending on where you live. Almost half of five-year-old children living in places such as Pendle, Rochdale or Burnley have tooth decay, but a mere 5% are affected in Waverley or Guildford. Tooth decay remains the leading reason for hospital admissions among young children, despite being almost entirely preventable—a scandal in 21st-century Britain. Increasingly, there are also problems with access to NHS dentistry in many areas. A recent BBC investigation revealed that only 52% of dental practices were able to accept new NHS patients. Almost half of all adults in England—a total of 21 million people—have not seen an NHS dentist for over two years.

The reasons for that can be traced back to two main problems: the lack of funding and a failed dental contract. NHS dentistry has been chronically underfunded in recent years. Nominal spending on dental services per capita fell from £41 in 2013 to £36 in 2017. This drop is even greater if we take into consideration inflation and the rising cost of dental materials. At the same time, patient charges in England have increased at an unprecedented pace—a 5% rise each year for the past three years. Data shows clearly that this fee makes many people delay going to the dentist until the problem has escalated, ultimately requiring more expensive treatment.

The second reason for problems with dental access and rising inequalities in England is the way that dentistry is commissioned. The failed NHS dental contract effectively sets quotas on the number of patients a dentist is able to see on the NHS.

[Baroness Manzoor]

I am so sorry. We are running late and have to go to the next speaker.

[Lord Colwyn]

I have only one more sentence. It has led to such low morale in the workforce that 58% of dentists are looking to leave the NHS in the next five years.