NHS Dentists: South-West England

Neil O'Brien Excerpts

Wednesday 24th May 2023 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Ms Elliott. I congratulate my hon. Friend the Member for West Dorset (Chris Loder) on securing this incredibly important debate. Dentistry is the No. 1 issue that I am working on, and I reassure hon. Members that we are doing so at pace. We know that there are serious challenges across the country; hon. Friends and hon. Members are quite right about the scale of those challenges, which are particularly acute in the south-west.

I met the commissioners for dentistry in the south-west earlier this week. I met the professions separately, and I had further meetings about our dental plan earlier today. This is absolutely top-priority. I have been talking for some time to hon. Friends present and to south-west Members and others to generate the ideas that will go into the plan. They are the first in my mind when I think about those who are contributing important ideas to our dentistry plan, not just in their speeches today but in our conversations.

We have already started the process of reform, but it is only a start. We have created more UDA bands to reflect the fair cost of work and to incentivise NHS work. We introduced the first ever minimum UDA value to help to sustain practices where they are low, and—to address the point raised by my hon. Friend the Member for South Dorset (Richard Drax)—we have allowed dentists, for the first time, to deliver 110% of their UDAs, to encourage more activity from those who want to do more NHS dentistry. We have also started the process of making it easier for dentists to come and work in the UK. Just last month, legislation came into force that enables the General Dental Council to increase capacity for the overseas registration exam. I have also met the council to discuss how we can bust the backlog that built up during covid.

Plans for the centres for dental development are emerging around the country, which is very exciting and will address the issue that colleagues have mentioned about how to encourage dentists to train and then remain in the south-west and in other areas that find it more difficult to attract dentists. We have started to empower hygienists and therapists as well, exactly as my hon. Friend the Member for St Ives (Derek Thomas) proposes. We stand ready to go further. The reforms to split band 2 and the 110% option have been well received by the profession. They are being used: the proportion of the new band 2b that is being used is going up, which is already having some effect on delivery, although of course that effect is not high enough.

In data published by NHS England this week, the proportion of contracted units of dental activity delivered went up from 85% last March to 101% this March, and the number of NHS patients seen has gone up by about a fifth over the last year, so there is progress, but there is much more to do. We will go further in the forthcoming dental plan, which I hope will be out relatively shortly.

The reforms that I have talked about and the forthcoming dental plan draw on the ideas that Members across the House have put forward today. They will build on those initial banding changes, further improve that payment model and start to take us away from the 2006 contract, which everyone agrees is broken. Exactly as my hon. Friend the Member for West Dorset pointed out, that is the core of what we need to do.

We will also ensure further measures to improve access, particularly for new patients, look at how we address historical UDA variations that are not justified, improve transparency—I think my hon. Friend the Member for Torbay (Kevin Foster) made that point—and take further steps to grow the workforce, not least through the workforce plan, which we will publish very shortly. Fundamentally, we will do everything we can to make doing work for the NHS and NHS patients more attractive to dentists. At the same time—to answer the question that the Opposition Front Bencher, the hon. Member for Denton and Reddish (Andrew Gwynne), quite rightly asked—we will do more to encourage prevention as well.

The devolution of dentistry from the NHS regions to the individual integrated care boards at a more local level is an important improvement that we want to build on. It provides an opportunity for much closer integration with other local care services and much more accountability about what is being commissioned and delivered at the local level. People and MPs can go and see the person responsible for delivery in their area much more easily, and our dentistry plan will build on just that.

[Chris Loder]

I very much appreciate what the Minister is saying about the plan for dentistry going forward. The last time I brought up the issue was in July 2022, almost a year ago. We had these problems then, and we have them much worse now. Will the Minister share with us how some of these great initiatives, which I am pleased to hear about, will be expedited so that they can have the maximum effect as soon as possible for those who are most affected in the south-west?

[Neil O’Brien]

I feel the exact same sense of burning urgency that my hon. Friend feels. I hope our plan will be out very shortly.

[Richard Drax]

The Minister may be coming to this point, but can I ask him about the disincentives—the cap beyond which dentists do not get paid, and the money that is taken off them if they underspend? Is that issue going to be resolved?

[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.