Dental Care: Durham

Neil O'Brien Excerpts

Wednesday 24th May 2023 Commons Chamber

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

Let me come directly to the questions asked by the hon. Member for City of Durham (Mary Kelly Foy). She called for a comprehensive dental reform plan. Yes, we will do that, and we will do it soon. She called for an overhaul of the 2006 contract. Yes, we will do that. Will we work with those at the BDA? Yes. In fact, I met them yesterday. We are keen to draw on their expertise.

I congratulate the hon. Lady on securing the time for this important debate. It is absolutely my top priority right now to work at pace to try to address the significant problems in dentistry. I am not here to say that there is no problem; I am here to try to fix the problem as quickly as possible. We could debate the figure on dental activity all day, but the bottom line is that it is not high enough and we need to get it higher. To come directly to her point about correcting the record and so on, the latest published figures show that there are 1,473 more dentists than there were in 2010—about 6.5% more.

[Mary Kelly Foy]

NHS dentists?

[Neil O’Brien]

NHS dentists, yes. Activity is definitely going up—about a fifth more patients were seen in the year ending March than in the year before that—but it is still too low. That is a point on which we absolutely agree.

We have started—only started—to reform the contract. We have introduced more bands for units of dental activity to better reflect the fair cost of work so that there is fairness for dentists, and to incentivise more NHS work. We introduced the first ever minimum UDA value to help sustain practices where UDA values are low. That has implications for under-delivery in some bits of the country.

We are for the first time allowing dentists to do 110% delivery of their UDAs so that those who want to do more NHS dentistry can do more, with a requirement to update their availability on the NHS website. We have also started the process of making it easier for dentists to come to work in the UK. Last month, we brought into force legislation enabling the General Dental Council to increase the capacity of the overseas registration exam. We are also working with local partners around the country who have various ideas about creating new centres for dental development so that, in areas that do not have a dental school, we can get more people to train and remain, and dentists flow to the bits of the country where there the need is most acute.

Some of those reforms are starting to have effects. It is good that the reforms to split band 2 have been reasonably well received, as has the 110% option. The splitting of band 2 is being used and the proportion of band 2bs is going up. As I say, activity is going up, which is encouraging, but it is not high enough and needs to be higher still. The reforms that we have talked about so far have just been a start. I am under no illusions about the significant challenges to address, not just in Durham but across the whole country.

The forthcoming dental plan will build on those initial steps to go further on improving the payment model and those initial banding changes, especially focusing on improving access for new patients, which is a particular problem. We want to consider how we address historical UDA valuations—they are stuck in time in 2006 and are, in some cases, unfair—and look fundamentally at how we make NHS work more attractive.

[Peter Gibson]

I thank the Minister for his engagement with me on dentistry in my constituency, and I welcome the reforms that he is talking about, but as he has just mentioned UDAs, could he say something about the disparity of UDA rates across a region? That disparity means that a large practice can concentrate its efforts in areas with higher UDA rates rather than in areas with lower UDA rates.

[Neil O’Brien]

My hon. Friend is quite right. Some of those disparities, which can occur from one end of the street to the other, are extremely hard to justify, hence the introduction of the minimum UDA rate and why we are looking at going further. He is completely correct. Funnily enough, as well as coming to improving access to treatment, I was just about to respond to his earlier point about prevention and his rather brilliant idea about what more we could do in schools. We are, following the conversations we have had, actively considering that.

I thank the hon. Member for City of Durham for her important work in securing this important debate.

[Mary Kelly Foy]

It feels as if the Minister is coming to the end of his speech, but I would really like him to correct the record. In my point of order yesterday, I said that the Prime Minister has on seven occasions said that there are 500 more NHS dentists, when there are in fact 700 fewer dentists. If the Minister has met the British Dental Association, it will have pointed that fact out to him. Could he please correct the record, or may I ask you, Madam Deputy Speaker, for advice on how we can encourage the Prime Minister to correct the record before the House rises tomorrow?

[Neil O’Brien]

I have already read out the statistics. I will not read them out again, and I do not think there is a need to correct the record. The statistics that the hon. Lady is drawing on are incomplete, because there is effectively a two-month lag between activity and the need to report that activity. Drawing on such incomplete information does not give the full picture, so I caution her against doing so.

First, I encourage the hon. Lady to wait for the official data in the usual way. Secondly, we are looking to improve that official data by, indeed, working with and responding to concerns raised by the BDA. I do not think that headcount is a sensible measure with the workforce. There are more people doing NHS work than there were in 2010. What we are really interested in is the total amount of activity, which is best measured by the total number of UDAs being delivered. As I have said, that total amount of activity is going up. In the last month for which we have data, it had gone up from 85% in March 2022 to about 101% in March 2023, but it is still not high enough. Although the trend is positive and dentists are doing more NHS work, the point of agreement here is that that needs to improve further.

[Mr Kevan Jones]

I am sorry, but the Minister cannot have it both ways. First, the population of this country has increased since 2010 and we need to measure the number of dentists against the size of the population. The other thing is that he can talk about UDAs, but if people are in an NHS dentist desert, as is the case in Durham, it does not matter if the number has gone up elsewhere. If people do not have access to a dentist, they do not have access to a dentist and therefore cannot be treated.

[Neil O’Brien]

That point is clearly correct, but that is not to disagree with anything that I have just said.

Rather than getting into the weeds—I have already read out the official statistics—let me try to end on a note of agreement. We absolutely want to take further steps to ensure that we increase access to NHS dentistry where it is lowest and, as well as improving the service for patients right across the country and improving preventive activity, we want to see particularly rapid improvement in those areas, perhaps including that of the hon. Member for City of Durham, that have not had the level of access that we would want over recent times.

Question put and agreed to.