Dental Services: East of England

Andrew Gwynne Excerpts

Tuesday 16th May 2023 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

As ever, it is a pleasure to serve under your chairmanship, Sir Mark. I commend the hon. Member for South Norfolk (Mr Bacon) for securing this important debate and for setting out some really important points not just for the people of the east of the England—although it has been impressed on me in the course of the debate that there is a specific issue that is pertinent to that area—but for the whole of England, because dentistry is nowhere near where we would want it to be in any part of the country, notwithstanding the differences in regional funding and access that we have heard about.

We have had a really good, thorough debate, and there has been consensus across the Chamber on the state of NHS dentistry. I thank the hon. Members for South Norfolk, for South West Bedfordshire (Andrew Selous), for Broadland (Jerome Mayhew), for Waveney (Peter Aldous) and for Boston and Skegness (Matt Warman) for the veritable tour of the east of England and south Lincolnshire that I have been sent on. I am well aware that south Lincolnshire is not in the east of England, although it is close to it and uses lots of public services within it. That is not least because my wife is from Bourne, in Lincolnshire, so I know how the area connects into Cambridgeshire and beyond.

I want to mention the hon. Member for North Norfolk (Duncan Baker), because he will have constituency issues that he would have dearly loved to raise in the debate. Having been a parliamentary private secretary myself, I know that they must be seen and not heard—it is one of the curses of the job. The great part of the job is getting to work with wonderful Ministers and being able to lobby them behind the scenes on all these issues. The downside is that constituents do not see the benefit of their MP most of the time. In addition, I thought the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) made some really important interventions.

It has been said already that we have been here before. I recently participated on behalf of the shadow health and social care team in a Backbench Business debate, which the hon. Member for South Norfolk co-sponsored. I spoke about people having to remove their own teeth, patients waiting over three years to access dental care, and individuals becoming addicted to painkillers because they cannot get treatment. I could go on and on with examples, but they all point to a simple fact: NHS dentistry is in crisis and is not working for the people who need to access treatment now. We have all heard from constituents at a loss about what to do, who are waiting day in, day out in utter agony and crying out for action on NHS dentistry.

As the hon. Member for South Norfolk made clear, the problem is particularly acute in the east of England. In 2022 no dentists were registering new patients in the whole of Suffolk, Norfolk or Cambridgeshire. In Norfolk, and indeed Waveney, there are only 38 NHS dentists per 100,000 people. It is little wonder that we hear stories of DIY tooth extraction, of Norwich hospital treating more people than ever before for opiate addiction and, in some parts of Norfolk, of 40% of under-fives suffering from dental decay.

We cannot go on like this—nationally, across England or in the east of England. Over the last decade, net spend on dental practices in England has been cut by over a third, with 2,000 NHS dentists quitting in 2021 alone. It is not just about this Government; there have been issues for a long period of time, and those have been compounded over a long period of time.

The hon. Member for South Norfolk and others mentioned the 2006 dental contract. As I pointed out in the Chamber in the Backbench Business debate, there was consensus on the effects of the 2006 contract by the 2010 general election.

The last Labour Government recognised that the dental contract needed reforming and pledged to do so in their election manifesto of 2010. So too did the Conservative party in its election manifesto in 2010. It would be remiss of me not to make this point, as the hon. Gentleman indicated I would: you guys have had 13 years to fix that dental contract. It is of deep frustration that in a decade and three years, that has not happened.

I have said this before: there was not a golden era of NHS dentistry before the 2006 contract. The hon. Member for South Norfolk mentioned that before 2006, dentists were paid for each treatment. That worked in the interests of dentists, but not always in the interests of patients. I have also said this before: there is a reason why my mouth is full of metal—crowns and fillings—and it is not because I ate more sweets than my children did or because I brushed my teeth less well. It is because dentists were incentivised to maximise the amount of work they did because that is how they got paid—drill and fill—and that was not always in the interests of public health or the patient.

It was not a bad thing that the Labour Government sought to make changes to bring NHS dentistry more in line with private dentistry, where the emphasis was on prevention rather than on drilling and filling, but it did not work—I make no bones about it. That contract needed to be reformed.

In a similar vein, there is still no sight of the NHS workforce plan—I say that at every opportunity when I face this Minister or others in his Department. We know it currently resides on the Secretary of State’s desk, despite the fact that 90% of dental practices with a high NHS commitment still find it difficult to recruit a dentist, so the key question to the Minister is: what does he plan to do to address the crisis in dental care across England? How do the Government plan to tackle the dental deserts that are causing misery to millions of people, particularly in the east of England? I would also appreciate an update on why the Government are yet to publish the workforce plan in full and when we can expect its release.

It is also important that the Minister recognises the extreme health inequalities that are widening to record levels. Children living in the poorest parts of England are around three and a half times more likely to have rotten teeth removed than those in more affluent areas. That problem is set to get much worse, with families unable to access basic oral hygiene products because of the cost of living crisis. I was very interested to hear of the project in the constituency of the hon. Member for Waveney. Such projects can make a big difference for a small amount of cash at a very local level.

What steps is the Minister planning to take to address the growing inequalities, and what assessment has he made of the continued impact of the cost of living crisis on families who are unable to access oral hygiene products? Labour Members have been clear since 2010 that tackling the crisis in dentistry has to be an absolute priority for any incoming Government, and I include the possibility of an incoming Labour Government. We have a big job of work to do across the whole NHS.

I understand the predicament that the current Government are in, but the previous Labour Government brought waiting lists down across the NHS from 18 months to 18 weeks, and we will do the same again. We want to secure the future of NHS dentistry, and we would provide the staff, equipment and modern technology needed to ensure patients get the care they deserve.

The hon. Member for South Norfolk was absolutely right: if the Government do not move on this territory, the Labour party is there. We have set out how we will pay for the next generation of doctors, nurses, healthcare workers and dentists, with our workforce investment paid for by abolishing the non-dom tax status. We can begin to chip away at the dreadful oral health inequalities that we see across England. We will train 5,000 new health visitors who work closely with families to promote and prevent ill health. We already know that health visitors have the potential to improve dental attendance and oral health in the families who are least likely to engage with dental services—a role that cannot be overlooked.

People in the east of England and across the nation deserve much better NHS dental services than they are getting. Slowly but surely, we are seeing the creation of the two-tier system that the hon. Member for South Norfolk set out in his opening remarks, where those who are able to pay are receiving essential care, and those who are not are languishing in utter agony, unable to find an NHS dentist. The next Labour Government stand ready and waiting to act to rebuild NHS dentistry. Until then, I urge this Government to get to work. Too many people are suffering, and the current state of crisis must not be allowed to become the new normal.