NHS Dentistry in England

Peter Gibson Excerpts

Wednesday 22nd June 2022 Westminster Hall

[Peter Gibson (Darlington) (Con)]

It is a pleasure to serve under your chairmanship, Mr Stringer, and to follow the hon. Member for York Central (Rachael Maskell). I am pleased to report that my own dentist is in the hon. Lady’s constituency, and I have had excellent service from them for the past 25 years.

I congratulate my hon. Friend the Member for St Ives (Derek Thomas) on securing the debate. As we have heard, many Members across the House have had significant correspondence on this issue from constituents. Since the start of the year, I have been contacted by 26 constituents raising their difficulties in obtaining access to NHS dentistry. I therefore welcome the opportunity to discuss this important issue.

The problem of access to NHS dental services has sometimes been put down to a lack of adequate staff numbers. Across the Tees Valley CCG area over the last 11 years, the number of dentists carrying out NHS activity has remained static, at around 330. Moreover, issues with access to care have undoubtedly been compounded by the pandemic, with waiting times increasing significantly due to the infection control measures that were required to keep services going. However, those are not the main issues.

Instead, we must look at the shortcomings in the current system of dental contracts, which was introduced by Labour in 2006. Under that system, a dental provider agrees to provide a set number of units of dental activity from April until the following March, and the annual contract value is paid in 12 monthly instalments. Those units are not related to numbers of patients or the extent of the work that needs to be performed, and similar rates are paid for taking out one tooth or doing one filling and for doing extensive dental work.

Therefore, dental providers effectively end up being paid less money for more work, with it not being financially viable to provide NHS dental services. That results in providers not taking on NHS patients, or sometimes handing back NHS contracts and concentrating on private dental care. Furthermore, the nature of the employment of many associates—who are retained on a decreasing percentage share of the income they generate—further reduces the incentive for those coming up through the profession to remain doing NHS work. I understand from the Minister that the British Dental Association and NHS England are in discussions to reform the contract. I wish those negotiations well for the sake of all our constituents.

I would also like to focus on the fact that the main causes of tooth loss are decay and gum disease. Prevention is definitely better than cure. Improved dental hygiene gives a better chance of keeping teeth for life. I hope that any changes to the NHS contract include a shift to focus more on prevention and pre-emptive care in order to reduce demand for routine and urgent dental care.

I firmly believe we need a far greater focus on education in dental care. Early years foundation stage is a child’s first experience with oral health impacting on the rest of their life. Setting good dental hygiene standards and practices early on often leads to far less need for care in later life. Schools should do more to emphasise good dental health, and dentists should do more to educate parents on how they can set high standards for their children and on the vital role they play in normalising dental visits, putting their children at ease with the dentist, as a person they can trust.

I welcome the steps the Government have taken to try to deal with the backlog of NHS dental care, including the provision of £50 million to provide up to 350,000 additional dental appointments in England. It is welcome that that funding was targeted at those groups most in need of dental treatment, with children and people with learning disabilities, autism or severe mental health problems being prioritised. But I fear that that is not enough to ensure that everyone who needs to be seen can be.

This is a hugely important issue in Darlington, and one we cannot afford to get wrong. It is essential that those in the most need of care and those in the most deprived areas are prioritised. The current system is simply not working in that regard. I trust that the Minister has listened closely to the points I have raised, and recognises the importance of expediting the reform of NHS dentistry contracts and of focusing on preventive care, so that we can create a system that works for all.