Dentist Industry and NHS Backlogs

Bob Seely Excerpts

Monday 7th February 2022 Commons Chamber

[Bob Seely (Isle of Wight) (Con)]

It is always a pleasure to follow my hon. Friend the Member for Clacton (Giles Watling). I thank my hon. Friend the Member for Warrington South (Andy Carter) for securing this debate on an important subject both for the country as a whole and for my constituents, because we are one of the coastal, rural communities badly affected by the lack of NHS dentists. Islanders are facing a serious dentistry issue. I have raised this with the previous Minister and the Secretary of State on a number of occasions. Frankly, it is now almost impossible to find an NHS dentist on the Island if you do not already have one. Some Islanders have written to me about having to go into the mainland as far as Surrey. That stretches a family budget, because we have some of the most expensive ferries on the planet, so it is a painful decision.

As my hon. Friend the Member for Clacton said, 85% of dental practices across the country are closed to new patients, and seven out of 10 people find it difficult to access an NHS dentist. This does not only have immediate consequences such as toothache but is dangerous, because there will be a significant rise in oral cancer cases, which are increasing in the UK. In 2020, 2,700 Brits lost their lives to mouth cancer. The lack of dental appointments means that we will not be able to spot those cancers early on, so those figures are likely to increase. We had a case on the Isle of Wight of somebody who was sadly diagnosed late and then misdiagnosed, who now has untreatable cancer. We also know there is a correlation between gum disease and heart disease. There is no doubt that a significant knock on will feed through from the lack of appointments.

Dental practices were clearly facing challenges before covid, and it is, in part, a workforce challenge. The British Dental Association has found that 75% of dental practices are struggling to fill vacancies, on which I will make some suggestions shortly. More than half of NHS dentists under the age of 35 are thinking of leaving the NHS in the next five years, which is a potentially serious and significant problem that will only make the issues more acute. It is one reason why areas such as Clacton and the Isle of Wight are significantly suffering from a lack of NHS dentists.

I will not take up too much time, because so much has been said so eloquently by my hon. Friend the Member for Warrington South, but I conclude with some constructive suggestions. It would be great if the Minister could address some of them. If she cannot, and I understand that I am bouncing her into this, I would be grateful if she could write to me. I wrote to the Secretary of State on this issue a couple of months ago, and I know the Department is very busy, but I have yet to receive a reply.

First, we should introduce a section 60 order to increase the General Dental Council’s discretion on recognising overseas dental qualifications. Secondly, we should develop a 12-month UK adaptation course for experienced, qualified overseas dentists to gain GDC recognition. Thirdly, we should maintain the mutual recognition of professional qualifications with European economic area countries indefinitely, and we should extend it to overseas territories, potentially as part of future free trade agreements.

Fourthly, and this is potentially the most important, we should fund a catch-up programme of overseas registration exams to make up for missed opportunities during the pandemic, with a view to recruiting 1,000 additional dentists within 12 months. This could specifically target the Indian subcontinent, which, according to all the dentists and dental experts I speak to, produces a very high standard of dentists and overproduces the number of dentists it needs. We are not talking about depriving another country of its dentists; we are talking about getting a job lot of 1,000 subcontinent dentists who speak English and who are very well trained. Some of them will be eager to work in this country, and we will get them here now.

Fifthly, we should introduce an expedited six-month performers’ list validation by experience programme for candidates with more than 1,500 hours of dental experience. Finally, we should accelerate changes to dental therapists’ scope of practice to allow courses of treatment without prescription from a dentist.

Others have spoken eloquently about the need to change the contract, so I am focusing on how, in the short and medium term, we can dramatically increase the number of dentists in this country. All these ideas were suggested to me by the Association of Dental Groups because, like others I have spoken to about this, it thinks they could be brought in relatively quickly and could have a reasonable, and potentially significant, impact in the next 12 months.

These are not unreasonable requests and, as we all have in this debate, I stress that the NHS was established on three significant and unalienable principles: that it meets the needs of everyone; that it is free at the point of delivery; and that it is based on clinical need, not the ability to pay. Certainly with NHS dentistry, we are struggling. We see that not only in kids’ and adults’ teeth being untreated but in serious diseases not being recognised as a result, potentially costing us far more not only in lives but in the money spent when cases come in as an NHS emergency, rather than as dental treatment that should be part and parcel of everyone’s rights in this country.

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[Maria Caulfield]

I take my hon. Friend’s point of view, but during the pandemic there has been significant support that many other sectors did not get. That is not to detract from the problems that dentists are facing, however, and no one is a bigger supporter of dentists than I.

I will just move on to some of the other points that my hon. Friend raised. We are not up to 100% of pre-pandemic activity simply because of covid, and that is taking a toll on access to NHS dentistry. A number of patients have waited and waited during the pandemic and now need urgent care, and we are seeing that reflected in A&E attendance and in surgical elective lists, because patients have got to a stage where they need surgery to rectify some of their problems.

I fully take on board many of the issues that have been raised in the debate this evening, but I reassure colleagues that we are trying to support dentistry as much as possible. NHS England is providing local commissioners with help and support to direct patients to where there is availability. It may have been my hon. Friend who mentioned this, but dentists have been asked recently to update their information on the NHS website that records where NHS dentists are, so that we can direct patients to those surgeries that are taking patients. Dentists have also been asked to operate a cancellation list, so that, should someone pull out, the next person on the list is proactively contacted to be offered that appointment. It is difficult for patients to navigate the system and find out where NHS dentists are.

Members may be aware—I hope they are—that just a few days ago, a one-off additional £50 million was secured for NHS dental services, the first pot of money that they have received in a long time. It is specifically focused on this financial year, so it has to be spent by April. It is targeted at those NHS dental teams to ask them what availability they have in increasing capacity, so that those waiting for treatment can start to access some of it. My hon. Friend’s area in the north-west has been allocated £7.3 million to be spent by April. NHS England is working at pace with local commissioners to deliver that and to try to tackle some of the backlog.

The difference between that funding and the contract is that the rates of pay are significantly different, and we are seeing huge uptake from dentists who are keen to do NHS work when they are rewarded accordingly. That additional £50 million will secure up to 350,000 additional dental appointments and will be targeted at those in most urgent need of dental treatments, whether it is oral pain, disease or infections, to help them get the care they need. Children, who a couple of Members mentioned, are being prioritised, as are other vulnerable groups. We are seeing some take-up of that offer, and I hope that shortly we will be able to update colleagues on where exactly that take-up has happened and the difference it has made in accessing NHS dental provision.

I will move on to some of the longer-term dental issues, which have been eloquently set out this evening.

[Bob Seely]

I do not want to interrupt my hon. Friend as she goes on to these important long-term structural issues. There were a bunch of short-term ideas to get dentists into this country in the next year or two to help with the immediate crisis and the lack of NHS dentists. Can she assure us that she and her Department are looking at some of those options, rather than looking purely at the long term?