Access to NHS Dentistry

Peter Dowd Excerpts

Thursday 10th February 2022 Westminster Hall

[Peter Dowd (Bootle) (Lab)]

I thank the hon. Member for Waveney (Peter Aldous) and my hon. Friend the Member for Bradford South (Judith Cummins) for raising this issue and for their tenacity. It is a pleasure to see you in the Chair, Ms Ali.

As many hon. Members have said, dentistry is not just about teeth; it is a vital component of our health. The hon. Member for North Devon (Selaine Saxby) shared a Shakespearian quote, and there is another one worth mentioning. In Shakespeare’s “As You Like It”, Jaques says:

“Sans teeth, sans eyes, sans taste, sans everything.”

If the Government carry on the way they are, it will be “sans dentists” as well. They need to get a grip of the situation.

The hon. Member for North East Bedfordshire (Richard Fuller) talked about the cash and the expenditure. I am happy to have a debate with him on this issue, and if he wants to secure a Westminster Hall debate on public expenditure, I will join him. I will give him an example of what he was talking about: the £10 billion-worth of covid-related fraud. That is equivalent to £153 for every person in his constituency—the best part of £50 million, which would be better spent on dental services in his constituency.

[Kevin Hollinrake]

Will the hon. Gentleman give way?

[Peter Dowd]

I am more than happy to come back to the hon. Gentleman in a moment.

Last week, I took part in a debate on the energy crisis. This week, I took part in debates on the crisis in children’s mental health services, the food insecurity crisis and the cost of living crisis. Today, it is about the access to dental services crisis. There is a bit of a theme beginning to develop here—it is about crisis, and all these crises are not isolated.

It is not as though the Government are having a run of bad luck through no fault of their own and have an otherwise impeccable record; there is something systemic and even endemic going on. I get a bit tired of the Government’s default approach to any deficit in policy application, and we have heard it a bit here: it is the CCGs, the NHS, the officials—it is everybody else’s fault bar the Government’s. They have to take responsibility.

[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.

[Kevin Hollinrake]

The hon. Gentleman is not making a particularly collegiate speech, but never mind. I have a lot of time for him. I do not know where the £10 billion fraud figure he throws out has come from. If it is about PPE, he should look at the facts behind that: £4.6 billion of that was write-down of current value versus value at the time of the pandemic. If we are going to debate in this place, it should at least represent the facts.

[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.

[Wera Hobhouse]

For the purpose of giving everybody a voice, would it not be most collegiate if we actually acknowledged that the dental contract was introduced under a Labour Government? It is important to address that, but it is also important to address the fact that the bottom line is public funding for a good service.

[Peter Dowd]

Frankly, the coalition, including the Liberal Democrat party, which the hon. Lady serves, could have sorted that problem out in the last 10 years, but they dithered, ducked and dived. Let us not go there. She is on dodgy ground in relation to that, I have to say.

Facts are stubborn, and here are a few. The Government have cut dental budgets by a third in real terms over the last decade. They are making a meal out of their recent time-limited £50 million injection into the service, or the so-called dental treatment blitz—a blitz that will barely blow the top off a toothpaste tube. I suspect that that £50 million—a veneer if ever there was one—is unlikely to be fully spent.

The bottom line is that we are in a crisis. The British Dental Association estimates that it will take £880 million a year to put things back to where they were in 2010—that is a fact, and it does not account for the huge impact of the pandemic. We also need to address the chronic underfunding and to have a clear commitment to ending the system based on units of dental activity that has been going on since 2011—it has been discussed today so I will not go into it any more. It has been over a decade, and the Government really need to get a grip of that.

In my constituency, 5% of dentists in South Sefton CCG stopped providing NHS services in the last two years. That vastly underestimates the loss of local provision, as most dentists tend to reduce the size of their NHS contract gradually before they quit the NHS completely. Across the country, 40 million NHS dental appointments have been lost since the pandemic. That is a whole year of dental provision. Without better support from the Government and, crucially, an end to the chronic underfunding, and without a clear commitment to and progress on contract reform, there is no way dentistry will be able to recover.

The covid alibi is beginning to wear a bit thin. This is all about pre-covid. Covid has exacerbated the situation, but pre-covid is also significant. Enormous backlogs began pre-covid. Let us get a grip of that. I ask hon. Members across the way to press the Minister and ask the Secretary of State and the Prime Minister—their colleagues—to listen to the facts, because, unless Members opposite can get that message across to an indurate Government, things can only get worse. No more excuses, no more prevarication, no more procrastination, no more pretext or self-exoneration—as I have heard today. The Government need to pull their finger out. We need action now. There is no excuse for letting the opportunity go by.

In closing, perhaps I can re-jig what Ian Fleming said to make a point about the Government’s lack of action in this crisis. He said:

“Once is happenstance. Twice is coincidence. Three times is enemy action.”

Which one does the Minister think it is? I cannot speak for the dental profession, but I think I know which one it is, and it is not one of the first two.