NHS Dentistry: Bristol and the South-west

Debate between Ben Bradshaw and Darren Jones

Monday 24th January 2022 Commons Chamber

[Darren Jones]

I thank the hon. Member, because it sounds as if his constituents are suffering the same problem as mine. Many have rung eight, nine or 10 NHS service providers, to be told that they could be accepted only as a private fee-paying patient. Going private is simply not an option that many of my constituents can afford. Some have been left with no other choice and others have just not been able to see a dentist at all. Outside of emergency cases, it seems that dentistry in our country has become merely a private healthcare service, with all the unacceptable inequalities that that presents.

[Mr Ben Bradshaw (Exeter) (Lab)]

In many cases even emergency appointments are simply not available, given the number of people asking for them. The waiting time to get an NHS dentist in Exeter is currently two years. We have thousands and thousands of people in Devon as a whole with no access to an NHS dentist. They cannot afford to go private and they cannot get access, in pain, to emergency treatment. It is an absolute disgrace, and for the last eight years this Government have done nothing about it.

[Darren Jones]

I agree, and I thank my right hon. Friend for raising the case in Exeter, which seems similar to the many other cases we are hearing about this evening.

When I surveyed my constituents, 79% of those who responded said that they did not feel that they could access a timely dental care appointment when they needed it, while 60% had not had any form of dental treatment during the past year. Twenty five per cent. detailed that they had contacted 11 or more dental practices to try to register for NHS treatment but were unable to do so.

Information compiled by the Association of Dental Groups puts those conclusions in context. The ADG highlights that 43% of patients across Bristol alone were unable to book an appointment when they wanted to do so. That figure increases to over 50% of patients when considering the south-west altogether.

In its 2021 “Great British Oral Health Report”, mydentist found that those in the south-west who have had a dental appointment in the last year lived, on average, over 5 miles away from their closest surgery. More concerningly, those who had not had a dental appointment in the last 12 months were twice as likely than the national average to live over 30 miles away from their closest surgery. That seems to suggest that there is a correlation between someone’s proximity to an NHS dentist and the amount of time that has elapsed since their last appointment, adding geographical inequality to income inequality in the often privatised dental care system—no doubt a levelling-up priority for the Government.

This is a growing problem, with increasing numbers of NHS dentists closing and a shortage of dentists available to do the work. For those familiar with the south-west’s regional news, Thursday’s BBC “Spotlight” reported that the number of NHS dentists practising across the south-west had fallen by more than 200 between 2017 and 2021. Across the country, 45% of patients have been forced to pay for private care due to the closure of a local NHS dentist.

The good news is that there are several actions that the Minister can take to address these issues. First, the Government should consider measures to reverse the decline in the number of dentists offering NHS services. Research from mydentist shows that nearly 1,000 dentists ceased providing NHS treatment in 2020-21, and in response to a survey, 47% of the British Dental Association’s membership said that they were considering reducing the provision of NHS dentistry due to the pressures being faced. I understand that the Government have announced a south-west dental reform programme. I would be grateful if the Minister could provide some detail as to how it could be deployed to increase dentistry numbers.

Secondly, the Government should look again at how they recognise international dentistry qualifications. The overseas registration examination has only 500 places available annually in the UK. The ADG has recommended that part of the examination could be taken in the candidate’s home country as a way of reducing some of the pressures, and that the overall number of places available should be increased. Furthermore, both the ADG and mydentist have recommended that the Government take swift action to reduce the impact that Brexit will have on those who have received their training in the European Union but whose qualifications are not recognised in the UK, and therefore on the number of dentistry providers in the UK. At present, the Government have agreed to recognise dentistry qualifications achieved in the EU until the end of the year, but given that 22% of dentistry care and treatment is provided by dentists from the European economic area, it is vital that certainty about the future is provided to those dentists and their patients as soon as possible. It is ridiculous that Ministers would prevent EU dentists from being able to work in the UK. I would be grateful if the Minister could update the House on that particular issue.

Finally, and most importantly, the Government need to bring forward long overdue reforms to the NHS dental contract, which was established in 2006. Local dentists in Bristol North West have contacted me to highlight their frustration with the current contract, which prevents them from seeing NHS patients when they need to be seen. They have explained that they have been expected to meet higher patient targets due to local closures, despite the need for covid-19 safety measures and without the full payment usually required to see those extra patients. Those pressures are in addition to the backlog from the pandemic, with more than 350,000 dental appointments lost in Bristol alone between April 2020 and November 2021. Reforming the NHS dental contract is vital to solving the underlying issues with access to NHS dentistry, and I would welcome an update from the Minister on the status of that work.

In the round, NHS dentistry is broken and the problems are getting worse. The system works only for those with dental emergencies—and that is if they are lucky—while everyone else is left largely to pay private fees in a private dental system that costs significant sums of money. The closure of so many NHS dentists is adding geographical inequalities to the income inequalities created by the private sector-led dentistry system, and the shortage of dentists in the country is being exacerbated by a failure to recognise European Union dentists and an unwillingness to make it easier to welcome dentists from other countries around the world.

From my experience with Ministers and officials, I get the sense that dentistry in this country is now nothing more than an afterthought, placed in the “too difficult for Government action” box.

Immigration and Social Security Co-ordination (EU Withdrawal) Bill

Debate between Ben Bradshaw and Darren Jones

2nd reading: House of Commons & Money resolution: House of Commons & Programme motion: House of Commons & Ways and Means resolution: House of Commons
Monday 28th January 2019 Commons Chamber

[Darren Jones (Bristol North West) (Lab)]

I pay tribute to my right hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), who from a lifetime of experience is in the right place on this issue.

The nature of a country and the values that underpin it are often reflected in the rules of its immigration system. On that basis, the United Kingdom could be seen as hostile, expensive, often offensive and demeaning, and overly restrictive. That is not the type of country I wish to help to lead from this House. Our immigration system should be fair, both to those who wish to come here and those already here, and should strike a balance between rights, restrictions, contributions and rewards for those who wish to come and be a part of our great country.

At a time of rising populism, the Bill was an important opportunity for the Government to set the right tone, but on that measure they have failed, not least because the Bill is remarkably light on detail, instead giving Ministers wide powers to make up the rules as they see fit. It gives the House no insight into what they seek to do. It fails to recognise either the positive contribution migrants make to our country or the positive bottom line for UK plc; it fails to recognise the rights of British citizens living in the EU—in greater numbers than EU citizens in Britain; and it fails to recognise the different types of immigration, whether they be those who come because we need them, those who come to contribute, or those who come seeking asylum. Nothing in the Bill sets out what type of country we seek to become—what type of country we wish to be—and that is a grave missed opportunity.

The Bill offers little hope to people in Bristol North West, whether the hundreds of doctors, nurses and social care workers at Southmead Hospital, or the migrant labourers in Avonmouth working in our warehousing and logistics business, or the people I meet in my constituency surgery week in, week out, including, sadly, victims of modern slavery—I know the Government have done great work on that, and I pay tribute to them and look forward to the conclusions of the review of ways of strengthening the support victims receive—or its scientists, researchers and technology entrepreneurs.

A recent report by the Science and Technology Select Committee, on which I sit, noted that collaboration across disciplinary and geographical boundaries was the foundation of scientific and technological endeavour—one this country has a proud history of leading and no doubt wishes to lead in the future—but also highlighted the overly restrictive tier 1 visa system for exceptional talent and how difficult the tier 2 system made it for employees and employers who want and need to be here to come here. It also dealt with long and short-term stays for the purposes of research and collaboration on innovation. We are failing to be able to bring the best scientific teams and technological minds to our country at a time when we need them not only to fuel our own GDP and economic success but to secure our position in the world as a leader in science and innovation.

I have a few questions that I hope the Minister will respond to when she sums up, although some have been asked already. First, in respect of the many nurses and social care workers and other low-paid workers, including scientists and innovation and tech entrepreneurs in Bristol earning less than £30,000 a year, are the Government not confusing vital skills with pay, and pay with value? The value that many of our low-paid workers, whether in healthcare or other settings, add to my constituents is hugely valuable but may not be reflected in their pay. We should be saying in this country that we welcome their contribution to creating a fairer, more open and more tolerant society, but instead we are saying that they do not earn enough to have the right to be here.

Secondly, is it right that amendments to immigration policy should not be debated on the Floor of the House? I understand that the Government have given themselves this power in the Bill, but surely the Minister will today confirm that they will none the less bring those matters to the House, both for debate and in the interests of their own accountability. Thirdly, there has been some concern about EU citizens who reside in this country for valid reasons other than exercising their treaty rights and whether they will be protected as part of the transitional arrangements if we leave the EU. I hope the Minister will clarify that distinction. She says “when” we leave the EU. I am hopeful that we will not be doing so.

[Mr Ben Bradshaw (Exeter) (Lab)]

Hear, hear.

[Darren Jones]

I thank my right hon. Friend for that.

Fourthly, in response to the report by the Science and Technology Committee, which I recommend to all right hon. and hon. Members, I hope the Minister will say how she and her Department will seek to meet the requirements I mentioned in order that we might stay at the forefront of international collaboration on scientific endeavour.

Lastly, I assume the Government will not admit it, but this is a prime opportunity to set out what type of country we want to be, whether Brexit happens or not; to say to people around the world who Britain is and what their experience will be here; to say to people who live in this country what values we expect of our communities and what we will not condone and that xenophobia is not welcome, regardless of what people felt they could and could not say as a consequence of the leave campaign; to set out afresh a new, innovative, welcoming and fair immigration system that brings to life the values that supposedly represent the Treasury Bench’s intentions for this country. Instead, it is a failure on all the measures I have set out, so I will happily not be supporting the Bill this evening.