Reforms to NHS Dentistry

Peter Bottomley Excerpts

Thursday 27th April 2023 Commons Chamber

[Peter Aldous (Waveney) (Con)]

I thank the Backbench Business Committee for granting this debate. It is the third in a trilogy that the hon. Member for Bradford South (Judith Cummins) and I have secured, and that in itself tells a sad and sorry story. Complaints about access to NHS dentistry have been the No. 1 item in my inbox for getting on for two years and, while there is a particular challenge in Suffolk and Norfolk, I am conscious that this is very much a national crisis.

The fundamental causes of the collapse of NHS dentistry go back over 25 years, with a gradual withdrawal of funding by successive Governments and the poorly thought-through 2006 NHS contract. Covid was the final straw that brought the edifice crashing down. The challenge now in front of us is to put NHS dentistry on a secured long-term footing, but in a way that enables our constituents, many of whom are in acute agony, to see a dentist straight away.

[Sir Peter Bottomley (Worthing West) (Con)]

I thank my hon. Friend for his part in securing successive debates. On emergency dentistry, in my constituency people are asked to travel an hour and a half by public transport for emergency treatment. Great changes have happened in the last three months, but we must improve on that in the next three months so that that no longer happens.

[Peter Aldous]

I think we all have tales of constituents who have had to go a long way to see an NHS dentist, if they can find one at all. In Lowestoft, people have had to travel to Basildon, which is not straightforward by public transport.

The task of delivering the plan for NHS dentistry is on the shoulders of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien). From my perspective, the purpose of the debate is to be constructive and to provide him with ideas and suggestions that could be included in his plan. It should be ambitious, visionary and innovative, not just a sticking plaster to get us through the immediate crisis.

To achieve that, and to ensure that our constituents are able to see a truly local NHS dentist quickly, three immediate short-term challenges need to be addressed. First, the up to £500 million due to be clawed back into the main NHS budget should remain available exclusively for NHS dentistry this year. Secondly in the short term, there is a need to recruit more dentists from overseas to address the acute shortage of NHS dentists. I acknowledge the measures that the Government put in place, as the Minister set out in his answer to my question on Tuesday, but more needs to be done to eliminate the queue as quickly as possible. Thirdly in the short term, the 2006 NHS contract needs replacing, and we must move completely away from the discredited UDA system.

In the longer term, the ingredients for rebuilding NHS dentistry and transforming it into a system fit for the 21st century of which we can justifiably be proud, are as follows: first, as I mentioned, we need to put in place that new contract, and address the current contract’s fatal flaw. It should facilitate a focus on prevention and should motivate dentists and dental practitioners to work in rural and coastal areas such as Suffolk and Norfolk. Secondly, a long-term fair funding system should be put in place. I acknowledge that Governments do not like ringfencing, but NHS dentistry must be provided with an assurance that the funds are available to make the long-term strategic investment that ensures that service will be both resilient and robust.

Thirdly, the recruitment and retention arrangements need to be significantly improved. Dentistry must feature prominently in the Government’s forthcoming NHS and social care workforce plan. Many colleagues, including myself, have highlighted the need for dentistry schools in their areas. Locally, both the University of East Anglia and the University of Suffolk have come forward with proposals. In East Anglia, my sense is that a vacuum must be filled, but I am mindful that a strategic approach right across the country needs to be pursued on where dentistry schools are best located. I would be grateful if my hon. Friend the Minister could commit to carrying out such an assessment. In the meantime, I urge him to immediately support the University of Suffolk’s dental community interest company, which has the twin benefits of providing much needed NHS dental treatments and training in such areas as dental therapy and hygiene.

There is also a need to improve the accountability and transparency of NHS dentistry. The move to integrated care boards that happened throughout much of the country on 1 April, including locally with the Norfolk and Waveney integrated care board, is very much a step in the right direction. In our local area it is taking steps to put in place a long-term plan and to ensure proper representation from dentists.

Finally, at the heart of any health strategy must be prevention. Such an approach will help spare people from hours of agony and ultimately impose less of a burden on the public purse. I will briefly outline three possible strands to intervention. First, the Government must press ahead with plans to fluoridate the water supply. All the evidence is that that will bring significant results. Secondly, we must come up with a strategy for promoting better oral healthcare for children. In 2021, with support from local councillors, Lowestoft Rising provided free toothbrushes and toothpaste to the under-sevens. The take-up was high and the feedback was extremely positive, and it recommended that such products should be exempted from VAT. I urge my hon. Friend the Minister to promote that policy with the Treasury. Thirdly, as we have heard, we must not forget the elderly, particularly those in care homes, and that must be covered in the new dental contract.

In conclusion, the emergence of dental deserts across the country, which are now joining up to create an area of Saharan proportions, is a crisis that must be tackled head-on with proper funding, root-and-branch reform and bold and imaginative policies. My sense and my hope is that the Minister is up for the challenge, and I look forward to the publication of the Government’s NHS dentistry plan. As I have said, this is the third Backbench Business Committee debate that the hon. Member for Bradford South and I have secured, and I hope that a fourth will not be necessary.