Access to NHS Dentistry

Maria Miller Excerpts

Thursday 10th February 2022 Westminster Hall

[Mrs Maria Miller (Basingstoke) (Con)]

It is a great pleasure to serve under your chairmanship, Mr Efford. I thank my hon. Friend the Member for Waveney (Peter Aldous) for his leadership on the issue. I pay tribute to my everyone at my local dentist for the work that they do—the technicians, the hygienist and the staff in both the private and NHS practices. I particularly pay tribute to them for everything they tried to do during the pandemic, as mentioned by my hon. Friend the Member for North East Bedfordshire (Richard Fuller).

Let us be under no illusion about the importance of dental health. It is not some cosmetic thing. The science shows that the health of our teeth and gums is integral to our overall health. Gum disease is linked to strokes, diabetes and heart disease, so the health of our teeth really matters. The Government spend more than £3 billion a year on NHS dentistry, including around £500 million in my own region of the south-east. Why does it feel, from all the conversations we have had, that that part of our health system is a distant cousin in comparison with the rest of our community health services?

Certainly in my own part of North Hampshire, that came into stark relief during the pandemic, showing the systemic fault line in the dental system and how it is semi-detached from the rest of our local NHS services. Despite being one of the sectors of the NHS that is most experienced with infection control, it was effectively shut completely for almost three months, and for many more months measures were put in place to significantly reduce the number of patients that could be seen. There was almost no way of accessing support, despite the fact that many professionals were very willing to put it in place, including dentists from my own area who contacted me at the time.

There are three systemic issues that the Minister needs to touch on. We need to be clearer about the role of the NHS in providing dentistry. The hon. Member for Bradford South (Judith Cummins) touched on the importance of private and NHS provision, but let us not fudge it. We need a mixed economy in the sector if we are going to go forward. Although I agree with the Father of the House that there should always be an NHS option, we need a system that embraces both private and NHS services and enables them to work together.

The second issue is around NHS contracts, which we have heard a lot about in the debate. There are no incentives in the current contracts for prevention or continuity of care set out by the National Institute for Health and Care Excellence. There is no real requirement to develop a relationship with patients, which would be beneficial for the long term. Surely that has to change. Can the Minister update us on that?

When it comes to scrutiny and accountability, dentistry is simply not the same as the rest of the NHS. I asked my local regional commissioner in the south-east for some data about 10 days ago when the debate was announced. I still do not have any local data on waiting times for appointments. Why? Because it is not collected. That is appalling. We are spending £500 million in my region, but we are not collecting any data on waiting times. Commissioning the service at a distant, regional level not only failed us in the pandemic, but fails us on an ongoing basis. Will my hon. Friend the Minister, who is really diligent in her work, touch on that in her speech?

We have to see a way forward. The people who access NHS dentistry rate it really highly. We welcome the additional funds that the Government have put in place to provide catch-up, but even though my constituency has two of the three Hampshire dentists who provide those extra services, I am still seeing a spike in problems in accessing the extra dental appointments. I do not think we are out of the woods yet with the hangover from the pandemic.

We need more accountability. We need dentistry to be part of our local health system, we need regional commissioning to be a thing of the past and we need a contract that really works. The 2020 NAO report on the subject is really important, demonstrating that in some areas there are significant under-deliveries of contracted dental services, making it even harder for patients to get NHS services that the NHS is actually willing to pay for. Indeed, the NAO report estimated that almost 1,000 practices fell into that category, delivering up to 40% fewer dental units than they should be in some areas. Let us have a contract that means that people get what they need, that prevention is in place, and that there is continuity of care. Others have touched on the need for more dentists. We have significantly fewer dentists per head than Germany and France. I welcome the work that the Government are doing on that but we need more.

The short-term problems created by the pandemic have shown much more significant and fundamental problems in our dental services. Let us use this opportunity to capitalise on that understanding of where the problems lie and get change that will deliver, for the long term, better dental service for everybody in the private and NHS sectors.

--- Later in debate ---

[Mrs Miller]

Will the hon. Gentleman give way?

[Peter Dowd]

In a moment. I am happy to give way, but we were told earlier that we did not have much time.

I do not want to detract from the substance of the debate, but it would be remiss of me not to talk about the crisis in health and social care more generally. Specific recognition from the Government of a crisis in access to dental services would give me a bit more confidence that they have a handle on it. More importantly, it would give me confidence that they are actually going to do something substantive about it. I wait with bated breath.

[Mrs Miller]

Will the hon. Gentleman give way?

[Peter Dowd]

In a moment.

Any denial by the Minister that there is a problem is itself a part of the problem. I really do not want to hear any denials.

[Peter Dowd]

I am pleased that the hon. Gentleman raises that. The bottom line is this: look at the Public Accounts Committee documents. There are more to come out. If the hon. Gentleman wants to have a debate on fraud, I am more than happy to have one. Perhaps he can put in the application and I will come and speak to him about it.

[Mrs Miller]

What would the hon. Gentleman have done differently in 2006 when the current dental contract was put in place? Of course, at that point, he would have been able to influence the Labour Government.

[Peter Dowd]

I will come back to that in a minute. I am an optimist—hope springs eternal, as Alexander Pope said—and I hope the Minister will accept that there is a crisis. Perhaps then we can all move on, in a very collegiate way, as the hon. Member for Thirsk and Malton (Kevin Hollinrake) says, towards finding a solution, which he knows I am more than happy to do.