Reforms to NHS Dentistry

Debate between Jill Mortimer and Sharon Hodgson

Thursday 27th April 2023 Commons Chamber

[Jill Mortimer (Hartlepool) (Con)]

I, too, thank everyone involved in securing this important debate, including the hon. Member for Bradford South (Judith Cummins), who so eloquently laid out the terrible state of NHS dental services in this country today and the desperate need for reform of that terrible Labour 2006 contract, which, in effect, destroyed NHS dental services in the UK. That is why I welcome the general direction of the Government’s plans for NHS dental reform, as outlined in the statement on 19 July last year. It is a good start, but we must do more. We must take this opportunity to not only put NHS dentistry back on track after disruptions during covid, but ensure we create a long-term sustainable plan to enable good NHS dentistry for all who want it.

I wholeheartedly agreed with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), when she said that

“the contract is the nub of the problem; it is currently a perverse disincentive for dentists to take on NHS work.”—[Official Report, 14 June 2022; Vol. 716, c. 135.]

That contract is the primary structural issue in NHS dentistry at the moment and has been since 2006. I have spoken to a dentist who owns 17 NHS practices across England, including two in my constituency. They are struggling financially to keep those practices going, but are totally committed to providing NHS dental services to my constituents and so push on despite the difficult environment.

[Mrs Hodgson]

Will the hon. Lady give way?

[Jill Mortimer]

No, I want to make progress.

That dentist’s many problems include the unfair way UDA rates are calculated, which ironically disadvantages areas such as Hartlepool, which have severe health deprivation. That has knock-on effects on their ability to employ staff at competitive rates and leads to a reliance on expensive locum dentists, further stretching the viability of the business. Dentists find a way to make their practices work with access contracts, but the lack of certainty they face because of the difference in competences between different integrated care boards adds further issues. For example, under one ICB’s access contract they were provided with clarity for a two-year period, but under our ICB they were still waiting to hear at the end of the month whether a contract would be renewed four days later. Not only did the survival of the practice and the jobs of 30 staff depend on that contract, but the dental care of 20,000 patients also depended on it. Thankfully it was renewed, but it is unacceptable that the ICB provided them with no indication of whether the contract would be renewed so close to its end. No business can run like that.

For areas such as mine that have a desperate need of NHS dental services, we should be fully valuing and supporting good dentists like that to ensure the survival of their essential services. I urge the Minister to consider radical reform of the way in which NHS dental service contracts are remunerated, so that established NHS dentists continue to offer NHS services to new patients. I would also like to see changes to stop newly qualified dentists being tempted into private work. It costs the taxpayer a significant amount of money to train a dentist, but they are not then required to work in the NHS. It is only fair on working people who have subsidised these professionals to train in their chosen career to expect a degree of payback. I would therefore welcome the Minister looking into the possibility of a staggered mandatory amount of NHS work per year for the first few years after qualification.

Good dental care starts with good preventive care, and I want to see a day when everyone who wants it can access NHS dental services for all routine procedures and check-ups, not just emergencies, without the difficulties that my constituents are currently facing.