NHS Dentistry

Anthony Mangnall Excerpts

Tuesday 9th January 2024 Commons Chamber

[Anthony Mangnall (Totnes) (Con)]

Will the hon. Gentleman give way?

[Wes Streeting]

I will, so that the hon. Gentleman can explain why that is the case.

[Anthony Mangnall]

Is there any greater landmine of a Labour legacy than the 2006 contract that it designed, which is pulling us down? Labour Members need look no further than their own designs on the NHS. We are sorting out their mess.

[Wes Streeting]

The sound you can hear, Mr Speaker, is the scraping of the barrel. How has the hon. Gentleman got the brass neck to stand up, after 14 years of his party in government, and say that a contract agreed in 2006 is the problem? If only the Conservatives had been in government for 14 years to sort it out.

Here is the other rub: we do not pretend that everything was perfect under the last Labour Government. In fact, reform of the NHS dentistry contract was in Labour’s 2010 manifesto, because we recognised that it needed to change. Had we been elected in 2010, we would have delivered. It was also in the Conservatives’ 2010 manifesto and 2015 manifesto. It was probably in the 2017 and 2019 manifestos, too, and they have not delivered. We have 14 years of Conservative failure. How dare the hon. Gentleman have the brass neck to stand up and blame someone else.

--- Later in debate ---

[Victoria Atkins]

I am grateful to the hon. Gentleman for raising that point, because according to the latest statistics available to me, 18.1 million adults were seen by an NHS dentist in the 24 months up to 30 June 2023. That is an increase of 10%, and what does it mean in reality? It means that over 1.7 million more adults were seen than in the previous year. I know that we are all concerned about the health of children; some 6.4 million children were seen by an NHS dentist in the 12 months up to 30 June 2023, an increase of 14%, which means, in real terms, an increase of 800,000 on the previous year.

I accept, of course, that there is more to do, and we will be setting that out in our dental recovery plan shortly, but this is not just about big numbers. [Interruption.] The hon. Gentleman asks when “shortly” will be. As he knows full well, “shortly” is a little shorter than “in due course” and a little longer than “imminently”.

We have introduced several simple and effective measures to improve the nation’s dental health. The Health and Care Act 2022 made it simpler to expand water fluoridation schemes, because raising the fluoride level to 1 mg per litre is a straightforward way to prevent tooth decay. It has proved effective in parts of England as well as Canada, the United States, Ireland and Australia, and the chief medical officer has concluded that there is “strong scientific evidence” that water fluoridation can drive down the “prevalence of tooth decay”.

[Anthony Mangnall]

I congratulate the Secretary of State on the progress that has been made, while, obviously, recognising that there is more to be done. I wonder if she will help me to ask the shadow Minister to correct the record. He said that in 2010 and 2015 Labour had a plan for dental practice, but there is no mention of that in the Labour manifestos. I will come back and correct that if necessary, but the hon. Gentleman is out there stating that Labour has had a plan for dental recovery since 2010, and that is not in those manifestos.

[Victoria Atkins]

My goodness me! My hon. Friend has identified a “cavity” in the shadow Minister’s so-called plans.

--- Later in debate ---

[Anthony Mangnall (Totnes) (Con)]

It is a pleasure to speak in the debate and to raise the issues that so many people face across the south-west and south Devon, many of whom are in immense pain. I will start by responding to some of the remarks made earlier in the debate. It is acceptable to make the point that the NHS contract from 2006 does not work and has not worked. It is acceptable to say that we tried to make it work, and we hit an enormous roadblock in the form of the pandemic, which has shown the system to be wanting. None of those are controversial statements to make.

Labour should not be outraged when we ask for their plans. Time and again, Labour Members go in front of the cameras and say they have a plan for this and that and everything we might possibly imagine, so we therefore should be able to ask them, given that this is their debate. They can laugh, as they are doing now, or smile about this, but it is a serious and legitimate question. If they are a Government in waiting, they should come up with proposals for a short-term solution to this issue.

The shadow Health Secretary, the hon. Member for Ilford North (Wes Streeting), decided to tell me that he and the Labour party have been talking about this issue since 2010. Indeed, he said it was in their manifestos in 2010 and 2015. I cannot find any record of it being in their manifestos. In fact, it is hard to actually see when the shadow Health Secretary even cared about this issue before his appointment, but I will leave that to others to make clear in the course of the debate.

My right hon. Friend the Secretary of State made perfectly clear the challenges we face. She made the point clearly that there have been some improvements, but no Conservative Member is complacent. We are all aware of this, because we speak to our constituents and look at our email inboxes. We are aware of the size of the trouble and problems being faced. It should be welcome that we are now pushing taxpayer-funded dentists who have been in training to work within the NHS at the end of their training. It should be welcome that there are 40% more dental training places and that we are looking at ways in which we can bring dentists from abroad, as well as creating training places right across the country. I welcome the report and comments by the Chair of the Health and Social Care Committee, my hon. Friend the Member for Winchester (Steve Brine).

All of that boils down to what we think the priorities of NHS dentistry should be. Simply put, having spoken to many dentists in my constituency, the priorities boil down to three areas: prevention, education and pain relief. [Interruption.] I do not think many people are looking to disagree on that point, but if the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) wants to disagree with me, she can. The point is that the pandemic has blown two of those priorities off course. The focus for the short term must be how we address pain relief. That is the issue we face today, and children and those of an older age are suffering from it across the country.

What are the short-term actions that we can take today? They have been mentioned by many Conservative Members. We can look at dental access centres and mobile units that can move across the country. We might think those are fantasy, but they are already in practice in some places in the country. Indeed, they have been raised by a number of dentists in my area of south Devon, who suggest that they are not just feasible but incredibly possible with the underspend that has not been utilised. We must unlock the money that has not been spent through NHS contracts. I am sure my hon. Friend the Member for North Devon (Selaine Saxby) will correct me if I am wrong, but I understand that some £50 million of underspend on NHS dentist contracts could be made available to help those on waiting lists.

As a number of Labour Members have said, we must allow dental therapists to play a larger role in helping treat people within the process and address their needs. As I have said, we must focus on pain relief as the priority. Reform of UDAs has to happen as quickly as possible. The time and geographical disparity means the system has been found wanting, and it is clear right across the country—whether in urban, rural or coastal community settings—that there are huge disparities in remuneration for a UDA. Rather than standing here and speaking about parliamentary candidates, it is probably more appropriate to think about the solutions that we can find to help those who are suffering so much.

I will give examples of what is going on in Devon. We have 17,000 more UDAs, which is welcome. We have a dental care stabilisation system. We have 406 extra appointments per week, which can be found through contacting 111. We have one of the finest dental training schools in the form of the Peninsula Dental School, located just outside Plymouth. It is working to help address the need and to support the Government in helping areas across the country. It is looking to help ensure that its trainees remain within the area after their training, to make the NHS as flexible as possible to the needs of those who need to use it.

We must have reform. Many of us on the Conservative Back Benches agree that we must have the reforms that have been promised before, because they are the hook that we can hang our hat on, and they will be the solution. If the Minister could look at the short-term solutions I have proposed and give a response, that would be welcome not just in my part of the country, but all across the country.