NHS Dentistry in England

Anthony Mangnall Excerpts

Wednesday 22nd June 2022 Westminster Hall

[Anthony Mangnall (Totnes) (Con)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I will be very brief because many points have already been made, but I want to try and give a further south-west example of the problems that we face, particularly in rural and coastal communities. The problem is sizeable and the requirement to respond to it is urgent. As has been said by so many colleagues from across the House, we must grip the issue now. If we let it slide, it will get worse and worse, and the backlog will get bigger and bigger.

The hon. Member for Sheffield Central (Paul Blomfield) was right to say that, like buses, it is good to have two debates on this. I was sorry not to be able to make my comments known yesterday. I was particularly struck by some of the positive developments that have come out of the Department, most notably that urgent care is back to pre-pandemic levels. There are also 700 centres for urgent care, £50 million has been made available to encourage 350,000 extra appointments, and there is an urge and a push to upskill dental nurses, assistants and technicians. Those are all very welcome steps.

I do not mean to be critical of the Government, because the Minister, who has responded to my letters, has spoken to me at length on the issues that we face in south Devon. There are a few outstanding issues that I hope she might be able to take on board. I hope she might also be willing to listen to some of the suggestions that colleagues and I are making.

One the five areas where I see a significant problem, which has already been raised, is children not getting access to dentists. On pensioners, countless constituents have contacted me who cannot get access to the very necessary dentistry services that they require. We must find a way to address that, for children and pensioners alike. We can find a way through this. The problem in my patch is that dentists are not taking on new patients. In fact, to give a concentrated example, there is one practice within 15 miles of Totnes that is accepting patients, and in that instance it is only children. I understand that the practice is already oversubscribed and therefore unable to see people in a reasonable timeframe. This is a real problem that, as others have said, is becoming exacerbated as time goes by.

My next point is about urgent dental care centres. I have heard about 700 of them being set up across the country, but I am not aware of one that is dealing with my constituents. In fact, when people use the hotline to even contact the NHS to discuss it, they cannot get through. I have constituents in considerable pain contacting the helpline and not being able to even get through to convey their point. That needs to be addressed. It is bad enough not being able to see a dentist; it is perhaps even worse not being able to talk to someone about the help one needs. It is also reflected in why we see so many people ending up in A&E with problems with their teeth. Addressing this issue would help the A&E numbers.

The Minister, as ever, is assiduous in responding to our correspondence. I hope she will not take this the wrong way, but she responded to one of my letters that it may be helpful to know that patients are registered with a dental practice only for the course of their treatment, meaning there are no geographical restrictions on which practice a patient may attend. She has been to south Devon, I am sure. If she has not, she is very welcome—it could not be a better time to visit over the summer. Our geography is very difficult at the best of times. We do not have rail lines—they were all ripped up in the 1950s. Our bus services have been cut back. There are no major routes even between the major towns in my constituency and the hospitals—I think of Dartmouth and Kingsbridge.

If we do not have the transport system to help people to get to those practices, the geography matters a great deal. We need to focus on a response for the rural and coastal communities, because they are at a significant disadvantage, as my right hon. Friends the Members for Ashford (Damian Green) and for South Holland and The Deepings (Sir John Hayes) said.

The £50 million made available is welcome, but the percentage awarded to the south-west is 9%, which, if my maths is good enough—probably not as good as my hon. Friend the Member for St Ives (Derek Thomas)—is £4,762,000. That will not be enough to deal with the sizeable issues in what is classed as the south-west, which is Somerset, Dorset, Devon and Cornwall.

I said I would not speak for long, but I have a few points that I hope the Minister will take on board. I hope we can find a solution on the basis of cross-party consensus and co-operation and of the urgent need to address this issue. Evidently, we need more dentists. There is no doubt about that. Training takes time. It is great that we are looking at how to retrain people, but what steps are we taking to encourage the creation and set-up of dentist schools across the country?

People want to train and work in this country. The NHS is a draw to medical students around the world. We should be able to train them here and encourage them to work in our system, at least for a certain amount of time. What steps are being taken to recognise the equivalent level of qualification that might be found in other countries to encourage them to come to this country?

I have mentioned it three times, but for added effect I will make the point again: we need a robust response for rural and coastal areas. Is the Minister willing to meet all coastal and rural MPs, on a cross-party basis, who have an issue with dentistry to discuss this issue? It is significant that, from Cornwall to elsewhere in the country, we all make similar points about how we are disadvantaged. That is no disrespect to the hon. Members for York Central (Rachael Maskell) and for Sheffield Central, but I hope the Minister will take that on board, because it is becoming more urgent.

Contract renegotiation has already been mentioned. We need more details on that, and it has to be sped up. Nobody wants us to sit here pointing the finger—I accept that Labour brought in this terrible decision in 2006; there we are, I have pointed it—but what we want is a solution. We can find a solution. If yesterday’s debate and this debate are anything to go by, there are sensible options being put forward. The time to act is now. Too many people have been in significant pain for too long.

--- Later in debate ---

[Feryal Clark (Enfield North) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank the hon. Member for St Ives (Derek Thomas) for securing this important debate and praise hon. Members for their powerful contributions, which contained a lot of personal experiences setting out just how dire the situation is across the country.

Here we are again. The problem with NHS dentistry has come up time and again over recent months. No matter how much the Minister wants to bury her head in the sand, issues with access to NHS dentistry are just not going away. The situation is a national scandal, as recognised by Members from across the House, by the sector and by our constituents, whose heartbreaking cases continue to fill our postbags. One cannot help but feel emotional at the immense pain people are having to live with.

Shamefully, we know that children are particularly badly affected. Half of all children in England have no access to an NHS dentist, with 78 children under 11 going to A&E every single day for a tooth extraction. The hon. Member for St Ives described a family with three children, none of whom had ever seen a dentist, with one child only seen because they had to go to A&E. In Wakefield, a fifth of children suffer from tooth decay before the age of three. This is not just unacceptable; it is a downright disgrace.

In yesterday’s debate, the Minister held her hands up and recognised the problem in primary care. Frankly, I was delighted to finally hear something akin to humility from the Minister on access to NHS dentistry. However, just as it seemed we would make some meaningful progress, the same old script was rolled out and the blame was laid at the door of the Labour party. I put it to the Minister yesterday, and do so again today, that her party has been in government for 12 years. When Labour was in government and saw that the contract was not working, we committed to reforming it, as set out by my hon. Friend the Member for Sheffield Central (Paul Blomfield), and put that in our 2010 manifesto, just as this Government did in theirs.

[Anthony Mangnall]

How does the hon. Lady explain the Labour performance in Wales, where dental practices are going down and the system is not being addressed? It is clear that the Labour party has no suggestions.

[Feryal Clark]

I thank the hon. Gentleman for his intervention. If he wants to know about Labour’s performance on the NHS, he should look at the performance of the Labour Government between 1997 and 2010. Waiting times went from 18 months to 18 weeks.

--- Later in debate ---

[Maria Caulfield]

The negotiations started back in March and there have been a number of meetings with the BDA. The BDA has been sent final recommendations, but we have not yet heard back, so I encourage the BDA to respond.

I will touch on a number of other issues that have been raised, the first of which is overseas dentists. For obvious reasons, no overseas registration examinations took place during the pandemic, creating a backlog of over 800 overseas dentists waiting to take their exams. Exams restarted earlier this year, and extra sessions are being held to get through that backlog of dentists so that we can get them into the system and working as dentists as quickly as possible.

We have also been working with the General Dental Council, which is the regulator, on recognition of overseas qualifications. The GDC did a consultation on regulation and recognition of overseas dentists, which I think closed on 5 or 6 May. We are waiting to hear the feedback from that consultation, but we are happy to lay regulations in this place—if necessary, we can do so by the end of the year—to give the GDC the power to mutually recognise overseas dentists according to its judgment. It is not for the Government to mutually recognise qualifications; it is for the regulator. However, we are happy to give the GDC the power to do so, and we look forward to its feedback on the consultation it undertook, because our overseas dentists are a rich source of the talent and skill that we need.

When it comes to getting more dentists into certain parts of the country—obviously, one of those areas is the south-west, whether that is Cornwall, Devon or Plymouth —significant work is going on. I met with Health Education England this morning to look at how we can set up centres for dental development. Those centres are different from dental schools, which are often very expensive and take a long time to set up, and, as was said during the debate, there are not always dentists available locally to supervise the training. Centres for dental development can be much more flexible and meet existing local needs while also looking at what needs could develop.

As such, we will be working up a programme, looking at what we can do in those specific parts of the country with the greatest need. In Norfolk, I recently met a group of local MPs and representatives from the local university and the local enterprise partnerships, all of whom are willing to work together to make that happen. I am going to Portsmouth on Monday, to Gosport, to see exactly the same thing—dentists coming together to come up with local solutions that will make a difference.

[Anthony Mangnall]

I am grateful to the Minister for giving way, and I thank her for those words. Far from burying her head in the sand, she is putting her head above the parapet. That is most welcome. As mentioned by my right hon. Friends the Members for Ashford (Damian Green) and for South Holland and The Deepings (Sir John Hayes), there is clearly significant data that highlights the worst affected areas. Given that the data is there, could we expedite that roundtable meeting as quickly as possible?