NHS Dentists: South-West England

Andrew Gwynne Excerpts

Wednesday 24th May 2023 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Ms Elliott. I thank the hon. Member for West Dorset (Chris Loder) for securing this really important debate and for the work that he does locally and here in Westminster to raise awareness of the issue. We have had a good, full debate. I thank my hon. Friends the Members for Bristol East (Kerry McCarthy) and for Plymouth, Sutton and Devonport (Luke Pollard) for their contributions, as well as the hon. Members for Torbay (Kevin Foster), for South Dorset (Richard Drax), for Newton Abbot (Anne Marie Morris), for Poole (Sir Robert Syms), for St Ives (Derek Thomas), for Bath (Wera Hobhouse), for Tiverton and Honiton (Richard Foord), and for Westmorland and Lonsdale (Tim Farron). That stretches the geography to the limits, but the hon. Member for Westmorland and Lonsdale has raised some very important points on behalf of his constituents and rural communities across England, not just in Cumbria.

Last week I responded to a debate on behalf of the shadow Health and Social Care team on dental services, but it was about the east of England. A couple of weeks before that I responded to a Backbench Business debate on NHS dentistry in the main Chamber. I do not raise those debates today to fill you in on my diary commitments over the past few weeks, Ms Elliott, but to highlight the strength of feeling across the House about the crisis we are currently experiencing in dental care.

We are all hearing from constituents who cannot access care, about parents trying to get their children seen and, in the most extreme cases, as we have heard today, patients attempting to perform dental treatments on themselves or on loved ones. So-called dentistry deserts are not being eradicated. Instead, they are multiplying, not least of all in the south-west, as we have heard today.

Last summer it was reported that out of 465 dentists across the south-west, just seven were accepting new patients. Indeed, we have heard more up-to-date statistics from Members during this debate. The number of NHS dentists practising across the south-west has fallen by more than 200, and in areas such as Exeter the current wait to get an NHS dentist is now two years. Behind the statistics are human beings who just want to be seen and to be treated, and we owe it to them to act. So my points to the Minister today will be familiar to him, and I fear that I will keep having to make them time and again until we see the Government’s dental plan.

My first point relates to the dental contract. As I have said before, it was the Labour Government who introduced the dental contract, but by the 2010 general election they had recognised that the contract needed to be substantially reformed. That was in our manifesto. The then Conservative Opposition agreed and it was in their election manifesto, too. The Government have been in power now for 13 years and change has moved at a glacial pace. In his response to the debate last week, the Minister said that he was under

“no illusion that there are significant challenges to address”,—[Official Report, 16 May 2023; Vol. 732, c. 353WH.]

but that those would be tackled in a forthcoming dental plan. Given the urgency of the situation, can the Minister provide an update on the development of the plan and when we can expect publication?

The hon. Member for West Dorset highlighted issues with unit costs being disincentives, and that was followed by other Members during this debate. It is true that dental costs have to be looked at on a per-unit basis because there are perverse incentives, but it would also be wrong to pretend that before the dental contract was introduced, there was a golden age of NHS dentistry. As I said last week, there is a reason why I have a mouthful of fillings and my children do not. It is not because I ate more sweets and did not brush my teeth as well as my children, but because of the then even more perverse incentives for dentists to drill and fill. They were paid for every filling that they put in so that people ended up with a mouthful of fillings whether they were needed or not. We need to strike a balance so that we get the public health needs and patients’ needs as well as a financial package that works for dentists to make a living.

On a similar note, can the Minister update us on the workforce plan? We have heard about that from hon. Members across the House today. We know that it has been produced and that it is on the Secretary of State’s desk. It is particularly pertinent, given that it was revealed earlier this week that the number of active NHS dentists in England is now at its lowest level in a decade, in spite of rising demand and in direct contradiction to claims made by the Prime Minister in Parliament.

Given that net Government spend on general dental practices in England has been cut by more than a third in the past decade and the number of NHS dental practices in England has fallen by more than 1,200, it is of little comfort to patients waiting in abject pain and misery to hear the Government say that a plan is coming. We urgently need to see the workforce plan published and implemented and reforms put in place that work for both patients and staff.

Labour knows we need to change if we are to secure the future of NHS dentistry. We want the NHS to become as much of a neighbourhood health service as it is a national health service. To do that, we will encourage joined-up services in the community that include dentistry. We want to see health professionals such as dentists working with family doctors as part of a neighbourhood team. That will not only help people get access to more care on their doorstep but prevent oral health problems before they become acute. It will also dismantle the two-tier system that has been allowed to develop, where those who can afford to pay receive treatment and those who cannot are left languishing. That is being further compounded by the way the cost of living crisis means some families are unable to afford even basic hygiene products. We are witnessing health inequalities widen in real time as a result, and that must not be allowed to continue.

What does the Minister plan to do to tackle oral health disparities and prioritise prevention? Will that work be part of his dental plan? I am sure this will not be the last dental debate I take part in on behalf of the shadow Health and Social Care team, but I sincerely hope that the next time I am face to face with the Minister in Westminster Hall or the main Chamber, we will have seen some long overdue progress.

It has been demonstrated during today’s debate that this need not be a partisan issue. It is in all our constituents’ interests that the Government crack on now and get improvements to dental care. We all want better dental care for our constituents and, as I said in the last debate and probably the one before that, addressing this crisis cannot wait until we have had a general election. In that vein and in closing, I urge the Minister to recognise that fact and get on with the job.