Dental Healthcare: East Anglia

Adrian Ramsay Excerpts

Wednesday 11th December 2024 Westminster Hall

[Jerome Mayhew]

I thank the hon. Gentleman for his intervention. There is a difference between milk teeth and grown-up teeth, as I will call them, although I know that is not the technical term. I hope that that assessment is wrong, but undoubtedly there will be problems. If there is a long-term lack of access to dentistry, it builds up problems, whether in the teeth or in the gums, both for children and for adults.

We can all talk about how we got here, and I can defend lots of very good things that the previous Administration did, but did we get everything right? No, we did not. What I am more interested in is how we can encourage the Government and work with them across the parties to solve the problem in the very near future.

I hope we have got to a reasonable analysis of why we are in this position. If it is substantially because of a lack of dental training facilities in the east of England, an obvious solution, although not the sole solution, would be a school of oral health at the University of East Anglia. The Minister knows that the UEA is ready to go. He knows that there is a building under construction and that a large amount of funding has been applied for, some of which has been already agreed. He knows that the UEA is making an application for registration with the General Dental Council and that it will be completed within the next six weeks at the latest.

That brings us to the crucial next step, which is the Office for Students. I recognise that the Minister is important and impotent at the same time. He is important because as the dental Minister he sets direction and gives impetus to change, but I accept that in some sense he is impotent because the Office for Students is an arm’s-length independent body. I hope he will take these requests in the light of my acknowledgment of his constraints, but it would be helpful for the UEA and the residents of our area to have his confirmation on the following three points.

First, can the Minister confirm whether additional dental training places will be made available by the Office for Students in 2025? It is a political decision how much funding the Government are prepared to put into the overall number of dental training places in the country in 2025. What is the pot that the Office for Students has to work with? Can he confirm that the number will be increased to take account of increased need?

Secondly, if that is the case, will there be a regional allocation within that global figure specifically for the east of England, given that the need is not national? There are regional variations, and in the east of England it is worst of all. There is precedent for that approach: recently, medical training places had a regional allocation, although I accept that historically it has not happened with dental places. It is an important point and would be of huge encouragement to our residents.

Thirdly, can the Minister give some indication of the timetable on which he and the Office for Students will work to process the 2025 allocations?

[Adrian Ramsay (Waveney Valley) (Green)]

I welcome the hon. Member’s comments. Indeed, the funding for the dentistry school at the University of East Anglia is a welcome step in addressing our chronic shortage of dentists in the region, but we need to ensure that there are strong incentives for those dentists both to stay locally and to stay within the NHS, which means meaningful contract reform to make it economic for dentists to practise in the NHS in the long term. In addition to his points, does the hon. Member agree that we need the Minister to set out the timescales for the Government’s pledge to review the dental contract?

--- Later in debate ---

[The Minister for Care (Stephen Kinnock)]

It is a pleasure to serve under your chairship, Mr Dowd. I thank the hon. Member for Broadland and Fakenham (Jerome Mayhew) for securing this vital debate on dental healthcare provision in East Anglia, and I thank hon. Members on both sides of the House for their important interventions.

The debate follows hot on the heels of a debate on 3 September that my hon. Friend the Member for Norwich South (Clive Lewis) led on healthcare provision in the east of England. We know that huge swathes of the region are dental deserts. These areas are facing great pressures from challenges in the recruitment and retention of dentists, leaving patients struggling to access the NHS dental treatments that they need. As has been pointed out, it is a scandal—frankly, it is Dickensian—that the No. 1 reason for children aged five to nine to be admitted to hospital in our country in 2024 is to have rotten teeth removed.

Norfolk and Waveney integrated care board had 31.5 dentists per 100,000 of the population in 2023-24, which is the lowest number in England. That is why I have met with colleagues from the east of England, including the hon. Member for Broadland and Fakenham, to discuss the specific challenges in the region and to discuss the University of East Anglia’s plans to open a dental school. The UEA’s proposal to begin training dental students is very welcome news. As I said to all the colleagues I met recently, and to the hon. Gentleman at oral questions last month, the Government strongly encourage the UEA to continue its progress towards establishing a dental school by submitting its bid to the General Dental Council as rapidly as possible.

The independent Office for Students is another key player. It has statutory responsibility for allocating funded training places to dental schools. As the hon. Gentleman has pointed out, the OfS is independent from the Government. I cannot make specific commitments about allocating additional training places for future years, because to do so would be to cut across the independence of the OfS. The OfS makes decisions based on its own assessments, following guidance issued by Government. What I can say to the hon. Gentleman is that our guidance is influential, but I cannot guarantee its outcome.

The guidance for the 2026 academic year will be published in due course. Provided that the UEA meets those requirements, it would absolutely be considered for Government-funded dental training places. That would certainly help to retain local dentists in East Anglia. As a Member for a rural constituency, I absolutely understand how important that is to the hon. Gentleman and to the many other hon. Members present who represent his part of the country.

We also need a clear-headed diagnosis of where we are. It is beyond doubt that NHS dentistry was left in an appalling state of disrepair by the previous Government. As the Prime Minister said last week, the precious contract between the state and the British people has been broken. He rightly said that our public services are

“in crisis, unable to perform their basic functions”

and that they are

“unable to provide the timely care and dignity that Britain relies on”.

Almost five years on from the beginning of the pandemic, NHS dentistry has still not recovered to pre-pandemic levels. Only 40% of adults were seen by an NHS dentist in the 24 months to June this year, down from almost 50% before the pandemic. Although 34 million courses of dental treatment were delivered in England in 2023-24, that is down from almost 40 million courses five years ago. As I say, it is disgraceful that having rotten teeth removed is the single most common cause of hospital admissions for children aged five to nine, causing them untold pain and suffering and affecting their ability to sleep, speak and socialise.

On the subject of the general state of dentistry, I thank the National Audit Office for its recent investigation of the previous Government’s dental recovery plan. Its report lays out in black and white something that was already apparent to millions of people across the length and breadth of our country: the dental recovery plan that we inherited did not go far enough. We are reflecting on every line of the NAO report as part of our efforts to rebuild dentistry, get it back on its feet and make it fit to serve people of all ages. We have launched the largest ever national conversation to inform our 10-year plan to reform the NHS, and our workforce will play a central role, because they are key to unlocking improvements across our communities.

The golden hello scheme offers dentists £20,000 to work in underserved areas of the country for three years. The recruitment process is well under way, with posts being filled by dentists in those areas as we speak. As of 7 November, 64 posts had been advertised. Our manifesto pledged 700,000 more urgent dental appointments, and we are working to ensure that patients can start to access them as soon as possible. They will be targeted at the areas that need them most.

Strengthening the workforce is key to our ambitions, but for years dentistry has faced chronic workforce shortages. We have to be honest that bringing in the staff we need will take time. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract with a shift to focusing on prevention and the retention of NHS dentists. There are no perfect payment systems, and careful consideration needs to be given to any potential changes to the complex dental system, so that we deliver a system that is better for patients and the profession.

[Adrian Ramsay]

I thank the Minister for reiterating the Government’s commitment to reforming the dental contract. Please will he set out a timescale for that work commencing?

[Stephen Kinnock]

I was just going to say that we are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients. We are working on this as a matter of urgency. I cannot give a specific timeframe, but it is a top priority for the Department.