Access to NHS Dentistry

Duncan Baker Excerpts

Thursday 10th February 2022 Westminster Hall

[Peter Aldous]

I am very grateful that the hon. Gentleman intervened on me, because Birmingham is the model of how to do this. As a Birmingham MP, it is right that he highlights that, and I thank him for it.

[Duncan Baker (North Norfolk) (Con)]

As I will set out in my speech, my father was an NHS dentist for 23 years. He trained a long time ago in Manchester, and he told me that the advent of sugary foods and drinks had had an enormously detrimental effect on children’s teeth over the years. The one thing we can do to solve that problem is fluoridation of our waterstream. It has made such a difference, and I thank the hon. Member for Birmingham, Perry Barr (Mr Mahmood) for raising that point.

[Peter Aldous]

I am grateful to my hon. Friend for re-emphasising that.

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[Duncan Baker (North Norfolk) (Con)]

I echo other hon. Members in thanking my hon. Friend the Member for Waveney (Peter Aldous) and the hon. Member for Bradford South (Judith Cummins) for bringing this debate forward. My hon. Friend is a good friend and has been a real champion in bringing these debates to this Chamber and other places on many occasions, and I thank him for all the work he has done.

As I said in my intervention, I might have a bit of a vested interest in this topic given that my father was an NHS dentist for 34 years. As a retired dentist, he is probably sitting at home with a cup of tea watching this debate, so I shall try to say some nice things about him. He worked in the constituency of my hon. Friend the Member for Broadland (Jerome Mayhew), who is my neighbour in north Norfolk. The facts from when he retired 10 years ago are still prevalent today. In fact, it is arguable that the problems he encountered back then are now even worse. That is a sad state of affairs.

It is fair to say that we have a crisis in dentistry—-we certainly do in my constituency. Not a week goes by when I do not receive casework from people who are in pain or who simply cannot get an appointment with an NHS dentist and cannot afford to go private.

There are acute problems in certain parts of the country. We have heard from hon. Members from all over the country today, but the south-west and East Anglia are well known to have some of the worst problems. The fact is, we simply cannot get dentists to come and work in some of these rural locations.

The Minister wants to have answers, not always problem, and I would echo my hon. Friend the Member for North West Norfolk (James Wild), who said that a dental training college in our part of the country would be very worth while. Alongside the Norwich Medical School, such a college would create jobs and opportunities and filter those into our part of the country. There is nowhere in the east of England to train dentists at the moment. We are crying out for some kind of provision to help us. Why can we not make it a requirement for newly qualified NHS dentists to have to do a year of training in an area of high need before they pass with flying colours?

I also echo what was said by my hon. Friend the Member for South West Bedfordshire (Andrew Selous). He is absolutely right: it is not simply that we cannot get dentists into the country or that we are not training enough. Many will call for dentists to be trained or imported from other countries to ease the crisis, but the truth is that we do not simply have a shortage. Of course, we can make it easier for dentists coming across from India to have their qualifications recognised so that they can perform their work straightaway. We do need to streamline that process. However, that is not at the heart of the issue.

The simple facts are that the General Dental Council found that almost 2,000 more dentists are registered now than in 2018. The problem is that those dentists—just like my father, who retired 10 years ago—have simply had enough and do not want to work in the NHS any more. We have to establish why that is and address that as a key problem.

Of course, we could talk about many different areas. My hon. Friend the Member for Waveney listed five, and I will not go over those again. I will focus on one issue that we have heard a lot about today. I am not going to apologise for calling it the dreadful UDA contract. It was bad a decade ago and it is still bad today.

Almost 1,000 dentists quit the NHS in the last year alone, and the motivation to do so, as has been said, is not purely financial. Those dentists, like my father, are doctors; they care about patients’ health. They want to spend time with their patients and treat them properly. The bureaucracy of getting points for giving out prizes is not the right way to deal with people. Dentists are not being treated with care. They do not want to be chasing these dental activity targets—that is highly stressful and demoralising. The delays in the contract reforms are leading to their motivation plummeting and going through the floor. That is why they are turning away. The lack of urgency in helping them is the real root cause of the problem.

Let me put that into some kind of context. In the Norfolk and Waveney CCG area, which also covers the constituency of my hon. Friend the Member for Waveney, we lost 40 NHS dentists between 2018-19 and 2020-21—a 9% drop in just two years. If we carry on at that rate, we will be in an absolutely shocking predicament. We therefore need to make a decision, and I heard what my hon. Friend the Member for North East Bedfordshire (Richard Fuller) said earlier. However, NHS dentistry is not free—that is a myth. We need to make a decision: either we will continue with this decline, effectively privatising dentistry and sending it down the opticians route, or we need to urgently get on and reform the dentistry provisions in the contracts we keep talking about. There is a simple reason why: we cannot do this to our children, our elderly, our vulnerable and people on low incomes. They are the ones who need access to good dentistry, and it is not acceptable in the 21st century, and in a modern country, that they cannot get help and support from this service.

Less than 25% of children in Norfolk saw an NHS dentist in the year to June 2021, and that is significantly lower than the national average of 33%. Imagine if it was your child who had excruciating pain and could not get to see a dentist. That goes back to what I said earlier: this is a particular problem in East Anglia.

I know that the Minister is keen on reforming the system and that negotiations are under way, but I urge her to grab this issue with huge vigour. The number of Members sitting here this afternoon—on a Thursday, and when we are waiting to get away for the recess—shows just how important this is for so many of our constituents up and down the country.

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[Duncan Baker]

And a good golf course.

[Jerome Mayhew]

It also has a good golf course—I thank my hon. Friend and neighbour. It is genuinely a really gorgeous town, so why is it that it cannot attract anyone to take on the NHS dentistry contract that is available? As my hon. Friends have pointed out, one of the reasons is that we have no training facility—not just in Norfolk or Suffolk, or even in Cambridgeshire or Bedfordshire; the nearest is in London. People have to go up to Birmingham or to London.

When we are trying to persuade young dentists to set out on their professional life in a certain place, moving to a rural or small town is not automatically attractive to them. We have to encourage people via training, and we know from our experience with the medical provision at the University of East Anglia and the Norfolk medical training in Norwich that someone is much more likely to stick around afterwards in the place where they train, because they have established relationships, they have contacts in the community—and, frankly, they know what great places Fakenham and other parts of Broadland are. One of the primary reasons I wanted to speak today was to encourage the Minister to consider the provision of a dental training facility in the east of England.

I will leave it to others who are much more professional than I am to comment on how we properly reform the 2006 NHS contract, save for saying that we need to treat dentists with respect. It is not all about money; it is about how we treat people. And please can we have some training in Norfolk?