NHS Dentists: South-West England

Kerry McCarthy Excerpts

Wednesday 24th May 2023 Westminster Hall

[Kerry McCarthy (Bristol East) (Lab)]

It is a pleasure to see you in the Chair, Ms Elliot. I congratulate the hon. Member for West Dorset (Chris Loder) on securing the debate; the turnout shows why he felt compelled to do so.

Let me quickly outline the key problems that I see in my constituency. People who are not registered with an NHS dentist cannot get treatment now because almost all practices in the area are not accepting new patients. There are patients who are registered with a surgery but cannot get an appointment because there is no longer an NHS dentist working there. In my case, I left my NHS dentist because every time I had an appointment it was cancelled, because the practice was moving dentists around other surgeries in the chain where there was higher demand.

Practices are deregistering NHS patients—that is, removing them from the active patients record—if they have not seen the dentist within a set period of time, to make room for patients on the NHS waiting list. They are legally allowed to do that. Some practices are closing down, including the Bupa surgery in the constituency of my hon. Friend the Member for Bristol West (Thangam Debbonaire), which is used by a lot of my constituents and is about to close.

There is also an issue for pregnant women, who are entitled to free dentistry on the NHS yet cannot see a dentist at all. I have asked a number of parliamentary questions about that. Pregnant women are more likely to suffer particular dental issues and there is an increased risk of certain health complications if the dental problems worsen. An estimated 1 million pregnant dental care patients in England missed out on dental care between March 2020 and March 2022, and they are still finding it very difficult.

On the underlying issue of the shortage of dentists, they say they are not incentivised to work for the NHS. They intend to leave for better pay and working conditions in the private sector, or are considering going overseas. An estimated 2,000 dentists—10% of the workforce—left the NHS last year. As a consequence, patients in pain are being forced to seek private treatment because they cannot see a dentist. They have to wait for tooth problems to become emergencies before they can get urgent treatment at the University of Bristol Dental Hospital, which can offer only a certain number of emergency appointments per day.

Those who cannot afford a tooth extraction with a private dentist and cannot get an emergency NHS appointment are pulling out their own teeth in agony. Constituents have told me that that is a fact. Dentists are seeing more people with higher levels of dental need, because the wait for an NHS appointment means that a minor problem drastically worsens over time so that, in the end, they find they need to have their teeth removed. Some patients say that because they have not been able to get an appointment since lockdown, they have been kicked off the dentist’s records for not attending.

I would like to quote a few constituents. John says he was due a check-up in January 2023. It was cancelled and he was offered a new appointment for April 2023. That, too, was cancelled, and he has been told to phone again in November to make a new appointment. He has a refugee from Ukraine staying with him who managed to go back to Lviv for Christmas. She says she was almost as pleased about getting a dental appointment in Lviv as she was to see her family. John says:

“Dental care in a war zone is functioning better than”

it is in Bristol.

Another constituent, from St George, has not been able to register since she moved to Bristol a year and a half ago. A colleague of hers tripped and knocked out her front tooth. She had not been able to register with an NHS dentist and had to spend her entire £4,000 of savings on a visit to a private dentist.

Katy, another constituent, is halfway through her pregnancy and entitled to free dental care. She spent hours scrolling through lists of dentists, phoning all the ones that might take on NHS patients. She says:

“I cannot find a single dental practice which is accepting NHS patients.”

The final constituent I want to quote is a dental practice manager who says their practice is a little better able to attract and retain dentists because it holds a contract with a UDA—units of dental activity—rate of £30.92, which is well above the area average, which is £25.98. Even then, the practice has been able to fill only half of it NHS dentist vacancies. She says:

“Without long-term workforce planning and meaningful reform of the NHS General Dental Service contract, the system and those who rely on it most will continue to suffer.”

I have taken this issue up with the Government, NHS England and the local integrated care board. Generally, the Government recommend that people visit the NHS “Find a dentist” website. Local NHS services have been working hard to commission more urgent dental care appointments. They are also offering stabilisation sessions for those who do not have an NHS dentist, cannot afford to go private and need an urgent fix to a problem like a broken tooth or a damaged filling. But clearly this is not good enough.

I reiterate the point the hon. Member for West Dorset made. We need to work on retaining as well as recruiting NHS dentists and we need to reform the dental contract which, as he said, is simply not fit for purpose. Given the time, I will leave it to others to raise some of the other questions. I could talk for a very long time about the problems my constituents are suffering from.