Access to GP Services and NHS Dentistry

Lilian Greenwood Excerpts

Tuesday 21st June 2022 Commons Chamber

[Wes Streeting]

I notice that the hon. Gentleman has played the old trick of selecting figures from a specific set of years, but nothing he has said contradicts the facts that I have outlined. In any case, the people of Wakefield will draw their own conclusions on Thursday when they go to vote. The fact is that the Government have had more than enough time to reform general practice in this country, and they have no one other than themselves to blame for the crisis we are in.

Since the Conservative party has been in government for the past 12 years, I thought I would take a trip down memory lane to remind us, the House and the British people exactly what they have been promising since they were first elected in 2010. The 2010 Conservative party manifesto promised that GP surgeries would be open 12 hours a day, seven days a week. The Government failed to deliver that—maybe they blame their coalition partners, although I do not think the Liberal Democrats would have disagreed with GP surgeries being open for that long—so they promised the same again in 2015. That time, they set themselves a deadline of 2020, and guess what? They missed that, too.

In 2015, they promised that everyone over the age of 75 would get a same-day appointment—another promise broken. They said they would hire 5,000 more GPs by 2020—another promise broken. In 2019, they promised 6,000 more GPs, but the Health Secretary has already admitted that he is on course to break that promise, too. They promised 50 million more GP appointments a year, but as the British people know from their experience, appointments are down. That is today’s Conservative party: over-promise and under-deliver, never take responsibility, and leave patients paying the price.

[Lilian Greenwood (Nottingham South) (Lab)]

This morning, one of my constituents contacted me to say she was standing outside her GP practice at 7.15 am in order to secure an appointment. She said that she was successful in securing an appointment, but a number of people who were also standing outside did not. Does my hon. Friend remember the Health Secretary promising that people would have to do that in order to secure a GP appointment?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. This is the problem: they overpromise and underdeliver. If they will not hear it from me, Mr Speaker, let us remind ourselves of what some of the Secretary of State’s colleagues have said. The hon. Member for South West Bedfordshire (Andrew Selous), who is in the Chamber, said in Prime Minister’s questions only last week:

“At one of my surgeries, which has double the recommended number of patients per GP, the bowel cancer diagnosis of a 51-year-old father of four was missed and is now terminal.”—[Official Report, 15 June 2022; Vol. 716, c. 283-4.]

Earlier this month, the hon. Member for Telford (Lucy Allan) read a letter from a constituent to the Health Secretary. It said:

“Trying to get basic healthcare is a joke in Telford. Maybe I would be better off in…a third-world country”.

If the Secretary of State is not going to listen to us, he should at least listen to his own side. Before Conservative Members leap to the defence of their Government’s record, they should probably go back and check the record to make sure that they had not agreed with us in the first place.

As for dentistry, 2,000 dentists quit the NHS last year, around 10% of all dentists employed in England. It is an exodus under the Government’s watch. Four million people cannot access NHS dental care and cannot afford to go private either.

--- Later in debate ---

[Sajid Javid]

My right hon. Friend’s point is important and well made, and I will look at the issue closely and get back to him, if I may.

As we have already heard today—but it is such an important point—the challenge for NHS dentistry predated the pandemic. It is not just about the number of dentists in England, but about the completely outdated contracts under which they are working, which were signed under a Labour Government. [Interruption.] Labour Members do not like it, but it is true. These contracts mean that we are operating almost with one hand tied behind our backs. They do not incentivise prevention, they hold back innovation, and they mean that hard-working families cannot get the dental services that they deserve. However, we will now be changing that; our work with the sector, along with the work of Health Education England on recruitment and retention, will be vital for the future.

[Lilian Greenwood]

Will the Secretary of State give way?

[Sajid Javid]

I will in a moment.

If there is one thing that unites all our work on primary care and dentistry, it is this. We are shifting to a new mode of operating—one that is about helping the whole population to stay healthy, not just about treating those who ask for help. We need to get to a place where we are healthier for longer, because freedom is hollow without our health.

Our new Health and Social Care Act 2022 is an important step in that ambition. Statutory integrated care systems will be responsible for the funding to support the health of their respective areas—not just treating people, but helping people to stay healthy in the first place. The Act also allows us to make safe and effective public health interventions such as water fluoridation, and we will set out further plans for that shortly.

Prevention, personalisation, people and performance: those will be our watchwords for modernising NHS services. They will sit at the heart of everything to come, from the health disparities White Paper to the update of the NHS long-term plan. While the Opposition continue to go off the rails, we remain firmly on track, laying down our plans to deliver a truly 21st-century offer for the profession and, most of all, for patients.

--- Later in debate ---

[Paul Blomfield (Sheffield Central) (Lab)]

A range of important issues has been raised by those on both Front Benches and in the interventions on them, but I want to focus specifically on NHS dentistry issues.

We have all had so many constituents contact us, and I would like to share a small selection of mine. One new resident to the city said:

“I moved to Sheffield earlier in the year. I am unable to register for an NHS dentist. I am being quoted waiting lists of eighteen months just for a check-up.”

Another wrote:

“My partner has been trying to get into a dentist for a check-up for around 18 months. We have rung every dentist within a 6-mile radius to be told they are not taking on NHS patients…and he will need to go private.”

One woman wrote to me:

“I have a MATB1 form entitling me to free dental care whilst I’m pregnant and for a year after birth. Unfortunately, I can’t use this as I can’t find an NHS dentist”.

A young mother told me:

“We’re told dental care is important and that we should get our children seen early and regularly. We moved to Sheffield in December 2020. I started to look for a dentist. I’ve been on a waiting list for a year with no progress.”

Another parent told me:

“Our son was referred for NHS orthodontic treatment by his dental practice in February 2019 at the age of 12. He has now been on the waiting list for 35 months and will turn 15 next month. He still has not had an initial assessment appointment.”

[Lilian Greenwood]

I thank my hon. Friend for giving way; the Secretary of State seemed to forget to do so. Does my hon. Friend share my concern that, even before the pandemic, the No. 1 reason for hospital admission among children aged five to nine was tooth decay? Is that not a shocking indictment of the failure to address health prevention and care for children and their teeth, and is it not a bit galling for the Secretary of State to suggest that this is the fault of the last Labour Government, when before the pandemic his Government had already been in power for 10 years?

[Paul Blomfield]

I thank my hon. Friend for that intervention, and she is absolutely right about how that highlights the crisis we are facing in NHS dentistry. That exists right across England, and it was interesting to hear comments from other nations, because significantly less is spent on dentistry in England than in Wales, Scotland or Northern Ireland. The Secretary of State blames everything on the contract, but the cuts to dentistry have been deeper than in the rest of the NHS, with spending a quarter less than it was in 2010, and I am not surprised that he made no mention of that.

Last Wednesday, I met our local dental committee to discuss the problem—dentists who are committed to their profession and to NHS provision, and who want a solution—and following our discussion, they commissioned a survey of waiting lists across the city. Some 37 practices responded, which is about half of the city’s providers, but only one practice could offer a waiting time shorter than a year. For 29% it was up to two years and for 32% more than two years. The most significant number was that 35% of practices were unable to add any patients to their waiting lists.

Across England, the number of dentists providing NHS services fell from 24,700 in 2019-20 to 21,500 now, which is a fall of 15% in just two years—