Dental Services: East of England

Neil O'Brien Excerpts

Tuesday 16th May 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)]

I start by thanking my hon. Friend the Member for South Norfolk (Mr Bacon) for securing this important debate. It was reminder of what a brilliant speaker he is. Dentistry is the number one issue that I am working on; I have had two meetings on it already today. It is something that we are working on at pace. I know there are challenges accessing dentistry across the country, and recently there have been particular issues in my hon. Friend’s constituency. We are committed to tackling those issues, not only in the east of England but right across the country.

My hon. Friends are quite right about the scale of the challenges, which are particularly acute in the east of England. Colleagues who are here today, and others from the east of England, are first in my mind when I think about those who are contributing ideas to our forthcoming dentistry plan. My hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) talked about how we get students to do more for NHS dentistry. My hon. Friend the Member for South West Bedfordshire (Andrew Selous) talked about how we must encourage preventative work, particularly for children—I completely agree with him.

My hon. Friend the Member for Waveney (Peter Aldous) talked about the challenge of under-delivery, the need to have proper rewards for complex types of treatment and how we incentivise dentists to move to areas such as the east of England. Those are all things that we are working on. My hon. Friend the Member for Broadland (Jerome Mayhew) talked about the unjustified variations in coverage and investment around the country, frozen in time by the 2006 contract. He also talked about the imbalances in training in different parts of the country. I was glad to hear various hon. Friends and Members talk about the importance of fluoridation. Across last year, we legislated to enable that to make progress for the first time since the 1960s.

My hon. Friend the Member for Boston and Skegness (Matt Warman) talked about how we must bust the backlog at the GDC. I met the GDC again yesterday to work on that. He also talked about the importance of accountability and greater transparency. Again, that is something that we are working on now. It would be remiss of me not to mention my hon. Friend the Member for North Norfolk (Duncan Baker), although the rules of this place do not allow him to speak in this debate. Hon. Friends from the east of England will not be surprised to hear that he, as the son of a dentist, is playing a leading role in pressing us forward to move even more quickly on dentistry.

My hon. Friend the Member for South Norfolk talked about fundamental reforms of the NHS dental contract. He is correct that we need to go further, but we have started to reform the contract for the first time since 2006, with the package of changes that we brought in last July. Those are an important first step in addressing some of the challenges facing the sector. We know, of course, that we need to go further. Those initial reforms have been received well by the profession and are starting to have a positive impact.

We created more UDA bands to better reflect the fair cost of work and incentivise NHS work. We introduced the first ever minimum UDA value to help to sustain practices where UDA vales are particularly low—the east of England is a good example of a place where that is the case. We allowed dentists to deliver 110% of their UDAs for the first time, to encourage more activity from those who want to do more. We made it a requirement for dentists to keep their availability for NHS patients up to date on the NHS website, which is an issue that a number of hon. Members have mentioned.

We also started the process of making it easier for dentists to come to work in the UK, and last month there came into force legislation that enables the General Dental Council to increase the capacity of the overseas registration exam, as hon. Friends have argued for in this debate. As some people have mentioned already, plans for a centre for dental development in Ipswich are advancing, and further plans are emerging elsewhere, including in Norfolk. We are also doing longer-term preventive work on expanding fluoridation; changing the law last year was part of that, and we also secured funding to expand fluoridation first across the north-east, subject to consultation later this year.

The reforms to split band 2 have been welcomed by the profession, as has the introduction of the 110% option. I am pleased to say that the proportion of the new band 2Bs is increasing and dentists are using the new flexibilities we introduced to prioritise those with higher needs. In terms of delivery, the number of patients seen in the year to March is up by nearly a fifth on a year earlier, but we must go further, and the changes we have made are just the start—I am under absolutely no illusion that there are significant challenges to address. The reforms that I have talked about and the forthcoming dental plan will draw on the ideas that hon. Members have put forward in this debate and offline. They will build on those initial banding changes and improve the payment model; ensure that we continue to improve access, particularly for new patients; look at how we address historical UDA variations; and look to make NHS work more attractive to ensure that NHS dentists are incentivised to deliver more NHS care.

The delegation, or devolution, of dentistry from NHS regions to ICBs, which various hon. Members have pointed out, is an improvement. It provides an opportunity for much closer integration with other local care services and much more accountability and transparency. People can much more easily go to see the person responsible for delivery in their area, and our dentistry plan will build on that.

I thank my hon. Friend the Member for South Norfolk for securing this important debate. I hope he is reassured that we have started to reform NHS dentistry and to improve services not just in the east of England, but in all areas. We will continue to build on those reforms in our plan for dentistry, on which we are working at pace.