NHS Dentists: South-West England

Luke Pollard Excerpts

Wednesday 24th May 2023 Westminster Hall

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

It is rare for every single party in the south-west to agree, but we do all agree on this: NHS dentistry in the region is broken, and it is getting worse. There is a huge crisis facing NHS dentistry in Plymouth, and everyone who has tried to access a dentist in my city knows it. After 13 years of Tory government, it is getting harder and harder to see an NHS dentist. Many children in Plymouth are in pain at home, having never visited a dentist.

Hundreds of our kids are having their teeth removed under general anaesthetic at Derriford Hospital every year. Some patients, unable to afford private dental care, are resorting to pulling out their own teeth. NHS dentistry in Plymouth is an endangered species. For many, an NHS dentist appointment is already a mythical beast, spoken about only when prefaced with, “Do you remember when you could get one?” Ministers have broken NHS dentistry over the past 13 years. If they do not do something serious soon, we are not far away from the extinction of NHS dentistry in Plymouth.

I thank all the people who work in NHS dental surgeries and practices, from dentists, to hygienists, to receptionists—who often get the brunt of angry people unable to access an appointment—to trainees and students. Our NHS dental waiting list in Plymouth is now over seven years long. It has an estimated 22,000 people on it, and it is growing each and every day. That is 10% of our population. The Dental Access Centre at Seven Trees Court in Plymouth—the only emergency dental service in the city—handles demand that far exceeds the supply of appointments. It takes over 300 calls a day, but it has only 20 available slots.

We need a proper plan, not more half measures and sticking-plaster solutions. Last year, the Government announced a £50 million dentistry treatment blitz, which all hon. Members present will remember. Of the £4.76 million allocated to the south-west, the Department of Health and Social Care has clawed back £4 million. Our system is so deeply in crisis that we are unable to fulfil the contracts we already have, let alone the extra funding, because we are so short of staff to deliver them. Our NHS dental system is utterly broken.

Ministers have also failed to address the recruitment and retention crisis facing NHS dentistry nationwide, but especially in the south-west. As mentioned by the hon. Members for West Dorset (Chris Loder) and for Tiverton and Honiton (Richard Foord), the British Dental Association estimates that over half of all NHS dentists in the west country are likely to go fully private, and 75% say they are likely to reduce, or further reduce, the amount of NHS work taken this year. It is going to get worse. That is what I am hearing from the dentists.

A professional working in the sector wrote to me with an upsetting account of what it is really like to be in NHS dentistry. She said:

“As with many of my other colleagues, the state of NHS dentistry in Plymouth has broken my spirit. Our service is constantly slated by the public for not doing enough, and my colleagues are subjected to abuse via email and over the phone daily - despite us often going above and beyond what we are commissioned to do. It is not our service that is letting the people of Plymouth down but those in government.”

What on earth would incentivise someone to go to work and stay in NHS dentistry if that is their lived experience every single day?

The last Labour Government opened a new dental school in Plymouth, which is outstanding and superbly led. It is focused on social outcomes and excellent teaching, and it is rated as the best dental school in England. That is a Labour legacy that we can be proud of. However, NHS dentistry in our city is on its knees today, and responsibility for that lies firmly with the Government. Despite the heroic efforts of staff, if NHS dentistry were a hospital, it would be in special measures. That is why we need an emergency rescue plan.

There are ways out of this crisis. First, we need to reform the NHS contract. The changes announced to date are inadequate to address the systemic problems. We know what the solutions are. Let us get on with it. Secondly, we need a national plan for recruitment and retention. At the moment, there is no national plan to address that crisis. Thirdly, I want Ministers to increase the number of dental students in training, reversing the 10% cut from a few years ago. We do not have enough dentists in training to replace those who are leaving practice. The Minister could take an immediate step. The Peninsula Dental School in Plymouth wants to take on an additional dozen students for the next academic year. Please could he help it to do so by granting the funding?

Fourthly—this will be a game changer—we need to properly fund dental therapists. Dental therapists can do 80% of what a dentist can do, but they take only three years, not five, to train. Funding them could have a profound impact on rural and coastal areas across the west country. Finally, we need our fair share of funding. Per capita, the south-west receives less funding for dentistry than nearly every other region in the country. It is not fair. There is a solution to this crisis. Let us just get on with it.

--- Later in debate ---

[Neil O’Brien]

Absolutely. I mentioned that in the last financial year we brought in the 110% flexibility so that those who do want to go further and deliver more NHS care were able to do so. We are looking at continuing that and also making some further changes to make the system more flexible and give local commissioners more power, so we do not have these rigidities in the system leading to the absurd situation where there is both under-delivery and underspend, which is completely maddening to everyone.

Once again, I thank my hon. Friend the Member for West Dorset for raising this hugely important subject. I am sure all hon. Members will want to see the dentistry plan out as shortly as possible.

[Luke Pollard]

Could the Minister return to the question I raised about additional training places for dentists? We have a really good dental school in Plymouth that wants to take on more dental students. That could deliver a big impact for our region. Is that something that he is minded to look favourably on?

[Neil O’Brien]

We will set out our plans extremely shortly on the future of the workforce and on growing training places. I am sure we will look closely and with great interest at individual proposals such as the one that the hon. Member has just made.

Not just in the south-west, but in the entirety of England, we are looking to improve and build on the NHS service that is so vital to all of our constituents. It is a personal passion of mine, and we are working at pace on it. We know it needs to improve. We have had good ideas coming from Members across the House this afternoon, and we will try to put them in place as soon as we can.