NHS Dentistry

Debate between Lord Markham and Lord Young of Cookham

Monday 19th February 2024 Lords Chamber

[Lord Young of Cookham]

To ask His Majesty’s Government what assessment they have made of the availability of NHS dentistry.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

My Lords, since the pandemic this Government have taken decisive action to recover services. There are signs of recovery, with the amount of activity delivered and the number of patients seen increasing, but there is more to do. Our recently published plan to recover and reform NHS dentistry will make dental services faster, simpler and fairer for patients and will fund around 2.5 million additional appointments and more than 1.5 million additional courses of dental treatment.

[Lord Young of Cookham (Con)]

My Lords, I welcome the recent Statement but, with 80% of NHS dentists not accepting new patients and with 190 hospital operations every day removing rotten teeth from children, clearly a fresh initiative was needed. However, the dysfunctional, discredited 2006 dental contract, which is driving NHS dentists out of the business, and which was described by the Select Committee in another place as not fit for purpose, remains in place. When will it be reformed? Given that everyone has a right to register with a GP and if they cannot find one the ICB has to find one, why is there not an equivalent right to register with a dentist if dentistry is an integral part of the NHS?

[Lord Markham (Con)]

I thank my noble friend for raising this and declare my interest as my wife is a dentist, although she is not currently practising. It is accepted that we have made sensible improvements to the dental contract, but a fundamental longer-term overhaul is needed. In terms of the ability to get registered with a dentist, that is what the mobile trucks are all about. We realise that in certain areas it is difficult to get that registration. The idea is for mobile trucks to go into a neighbourhood where there is a particular shortage to resolve the problem.

NHS Dentistry: Recovery and Reform

Debate between Lord Markham and Lord Young of Cookham

Wednesday 7th February 2024 Lords Chamber

[Lord Young of Cookham (Con)]

My Lords, I felt that today’s Statement deserved a slightly warmer welcome than it has received so far, particularly from the noble Baroness. At a time of enormous pressure on public expenditure, more resources have been found to target the people in the areas who need dental treatment.

I shall raise an issue that has not been raised in exchanges so far. The single most effective public health measure that the Government could take to reduce tooth decay, particularly among children, is to add fluoride to the water supply in those parts of the country where it does not occur naturally. The Health and Care Act 2022 transferred the responsibility from local authorities to my noble friend’s department. Since then, until today, nothing has happened. I welcome the announcement that there will be consultation on extending fluoride to the areas in the north-east where tooth decay happens to be at its highest. Can my noble friend give some idea of the timescale of that consultation and whether there are any plans to extend fluoride to other parts of the country where it is urgently needed as a public health measure?

[Lord Markham (Con)]

I thank my noble friend. He is absolutely correct that the benefits of water fluoridation are well proven. The consultation for the north-east of England, which will bring in 1.6 million people to this, is starting very shortly. The idea behind that is that we can really try to get moving quite quickly on that. I was surprised to learn that the level of water fluoridation in England today is only at about 6 million people. I know that a lot of people think that their water supply has fluoridation, but there is obviously a long way to go on that. The 1.6 million in the north-east is a good extension to that, but there is a lot more that we plan to do in this space.

Smoking

Debate between Lord Markham and Lord Young of Cookham

Thursday 25th January 2024 Lords Chamber

[Lord Markham (Con)]

I thank the noble Lord. Actually, Khan recommended four major things to achieve that in his report Smokefree 2030. The first was to increase the anti-smoking spend that the noble Lord refers to. As part of this, we propose to increase that spend from £70 million to £140 million—so we are doing absolutely what the noble Lord suggests. The second was to increase the age of sale, which of course this legislation is all about. The third was to promote vaping to help quit smoking. Again, the legislation will do that. The fourth was to increase NHS prevention methods which, again, we will do from here. So it is very much a range of measures to stop people ever smoking but also to stop many who are currently smoking by helping them to quit.

[Lord Young of Cookham (Con)]

My Lords—

--- Later in debate ---

[Lord Young of Cookham (Con)]

Further to the Question from the noble Lord, Lord Rennard, the Government commissioned the independent Khan review, which concluded that the Government would miss their smoke-free target for England by several years unless an additional £125 million a year was spent on prevention. Given the pressure on public expenditure, the Khan review instead suggested a levy on the profits of the tobacco industry, based on the polluter pays principle. Does that proposal not commend itself to my noble friend?

[Lord Markham (Con)]

As I say, we have tried to answer the four major points that Khan put forward, including doubling the spend from £70 million a year to £140 million. The levy was the one thing that was not so much favoured; there was a lot of modelling done on it and the thought was that the net increase would be only about £25 million or so. That is why it was thought better to look at taxes on tobacco itself as a way of raising revenue, and generally introducing the four major methods that Khan recommended.

Adult Social Care

Debate between Lord Markham and Lord Young of Cookham

Wednesday 22nd November 2023 Lords Chamber

[Lord Markham (Con)]

I do not have the figures for those 12 years, but I will happily send them to the noble Lord.

[Lord Young of Cookham (Con)]

My Lords, further to the original Question from the right reverend Prelate, is not the real problem facing the care sector that of recruiting and retaining care workers, who can often earn much more in a local supermarket than in a nursing or residential home? What action are the Government taking to make this a more attractive profession for people to go into?

[Lord Markham (Con)]

My noble friend is correct; they are the bedrock and are valued, and it is important that we make them feel valued. As I said, we are reforming the process in order to give them a qualification, which means that that work in the social care setting will be transferable between positions. In addition, if they want to go further into the medical service, be it nursing or other areas, a modular qualification system will enable them to build towards that, so that they not only feel valued but are in a long-term career structure.

NHS Dental Contract

Debate between Lord Markham and Lord Young of Cookham

Thursday 1st December 2022 Lords Chamber

[Lord Young of Cookham]

To ask His Majesty’s Government what plans they have to review the NHS dental contract.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

In July, the department announced a package of improvements to the NHS dental system, which included reform of the 2006 contract to ensure that dentists are remunerated more fairly and patient access is improved, especially for those with higher oral health needs. Implementation of these changes is under way, and we recently laid legislation in Parliament to deliver them. We continue to work with NHS England and the dental sector on further reform, which we plan to announce in 2023.

[Lord Young of Cookham (Con)]

I am grateful to my noble friend for that reply and for the recent modifications to the contract. But does he agree that much more radical reform is needed to that contract, which was described as “not fit for purpose” by a Select Committee in another place, if we are to address the exodus of NHS dentists, encourage more to join, address the 91% of dental practices that no longer admit new adult patients and help areas of the country with no NHS dentists at all? When will we have the longer-term radical reform referred to the last time I asked this Question, in May?

[Lord Markham (Con)]

I thank my noble friend, and I declare an interest: my wife is a dentist, although she is not practising at the moment. This is one of those rare occasions when it is a case not of announcing new spend but of making sure that the £3 billion we spend is fully utilised. To answer the question directly, it is absolutely right that we need a radical package to make sure that dentists are contracting against their UDAs and finding working in this space worth while and profitable, so that we get the full use of that. I will happily come forward with further proposals, planned for 2023, on what we are going to do in this space.