Reforms to NHS Dentistry

Esther McVey Excerpts

Thursday 27th April 2023 Commons Chamber

[Esther McVey (Tatton) (Con)]

I congratulate the hon. Member for Bradford South (Judith Cummins) and my hon. Friend the Member for Waveney (Peter Aldous) on securing the debate. Together they have acted like a veritable tag team, securing debate after debate, this being the third.

The problem we are discussing is obviously not getting better, and it is not going away. It is clear from what we have heard from Members today that it is becoming a bigger issue in our casework, and that is certainly my experience. I have taken some desperate phone calls from constituents, and have been shocked by what I have heard. It has led me to get on the phone straight away to beg dentists nearby to see some of those constituents. One, an elderly resident of Wilmslow, was losing his teeth and had abscesses. He needed to have his teeth removed and dentures fitted, but he could not find a dentist. When he rang the emergency dentist, there was a recording saying “No appointments”, and then the phone was just ringing out. He was pointed in the direction of a practice in Buxton, but found that it was no longer taking NHS patients, and one in Northwich which had a two-year waiting list. Other constituents who thought that they were fortunate enough to have an NHS dentist found that the Mobberley Road practice in Knutsford was no longer taking NHS patients either, and that they were no longer registered there.

Healthwatch, the independent statutory body, says that this is the No. 1 issue raised with it by NHS patients, and that four out of 10 people who contact it say that they are having difficulty accessing dental care, which is exactly what I am hearing from my constituents. The system is bad and decaying, and has been for some time. Lockdown made things significantly worse. With dentists shut down for the first few months of the pandemic, 50 million appointments were lost, and 3,000 dentists stopped providing NHS dentistry because the restrictions through lockdown made it financially unviable for practices, meaning NHS dentists are disappearing at a rate of knots. Some 90% of practices are closed to new patients, 80% will not even accept children, and in 37% of local authorities there are no practices accepting new adult NHS patients. Reform needs to be radical.

Tatton dentists have reached out to me and told me the current payment system of units of dental activity, introduced by a Labour Government back in 2006, has never worked and subsequent tinkering has not worked either. The Minister will probably know how it works, but others might not: a check-up with X-rays counts as one unit; adding a filling or several could count as another two units; and providing a full set of dentures is seven. It does not pay: the formula does not work, which means that dentists lose money, particularly when treating the neediest patients—those who really need their care and attention. Those figures never have stacked up and tweaks will not make a difference. In a nutshell, the business case is broken and a new one needs to be brought forward.

NHS dentistry is not attractive; we need to make it appealing. Interestingly, the number of qualified dentists is at an all-time high, but the number doing NHS work has fallen significantly. Last year, a British Dental Association poll found that 45% of dentists in England were doing an average of 25% less NHS work since the start of the pandemic. The poll also shows that 75% of dentists are thinking of reducing their NHS commitment this year, with almost half considering either a change of career, early retirement or turning fully private.

Bupa, which provides both NHS and private services, recently reinforced these figures, stating that it intends to merge or sell 85 of its 450 practices across the UK because of rising running costs and lack of dentists willing to deliver NHS care. This means nearly half a million more patients could lose their dentist.

Making NHS dentistry appealing is, therefore, a matter of high importance. Some suggestions have been handed to me and I will put them forward—and I know the Minister will be coming forward with bold plans. One suggestion was getting rid of student debt for newly trained dentists; might we remove that if they move into NHS provision? Also, what extra funding will be given and how will we move away from units of dental activity? We all want this to work; it is vital that it works and I certainly do not want to be taking calls from desperate constituents who need urgent dental medical care.