NHS Dentistry

Peter Gibson Excerpts

Tuesday 9th January 2024 Commons Chamber

[Wes Streeting]

I totally agree. The tragedy is that if we look at the system as a whole and think about the pressure the whole system is under, and if we got NHS dentistry right, we would not only be saving patients untold pain, but saving the NHS money. As Lucy Rigby, Labour’s candidate in Northampton North, reported to me, in 2022 tooth decay forced 625 of her local patients to A&E—worse for them and more expensive for the taxpayer.

If Tory Members disagree with charging non-doms their fair share, maybe they could explain in their own contributions why they disagree. I am sure that their constituents would love to hear their defence of the non-doms, and we would be happy to give them space on Labour leaflets to quote their arguments back at them and let the public decide. I would particularly like to know why the Prime Minister is so wedded to this tax break for the wealthiest.

While Tory Members are set to oppose Labour’s rescue motion today, I understand that our plan on supervised toothbrushing for three to five-year-olds has received an endorsement from an unlikely source. On his podcast, former Conservative Chancellor George Osborne said:

“That really is the nanny-state in action.”

Coming from the Chancellor who introduced a sugar tax, I am sure George meant that as a compliment. Of course, Conservative Members may not see it the same way, just as they do not agree with Labour’s proposal to phase out smoking for children. Don’t worry, we have the Prime Minister’s back on that one; it is, after all, our proposal. But I ask those who attack our plan as nanny-state, what is the alternative? If a child cannot see a dentist and their parents will not do the responsible thing and make sure they clean their teeth, then should we just shrug our shoulders and do nothing while children’s teeth rot?

The problem for the small-statists on the Conservative Benches is this. Too many children today are not cleaning their teeth. Their teeth are rotting and they end up having them pulled out in hospital, which is worse for them and more expensive for the taxpayer. Last year, the NHS spent £80 million on tooth extraction. Toothbrushing in schools would cost a fraction of that, yet the Conservatives choose to waste taxpayers’ money, burning through taxpayers’ cash on the altar of ideological dogma and putting children through unnecessary misery, because it fits their confused ideology.

That is the irony of the Conservative party. Tories say that they believe in a small state and low taxes, yet they have left our country with the highest tax burden since the 1950s. The NHS receives £169 billion a year, yet it is going through the biggest crisis in its history. Because they do not understand that prevention is better than cure. Because they have refused to undertake meaningful reform. Because they treat taxpayers’ money with utter carelessness and contempt. And so they have left us with an NHS that gets to people too late, delivering worse care for patients at greater cost to the taxpayer. We are paying more and getting less. That is Tory Britain. No wonder Tory candidates are so worried.

Before this debate, I happened on a letter on Facebook from the hon. Member for Darlington (Peter Gibson) who is, happily, in his place. First he talks about the state of dentistry in his constituency—we obviously agree with him there—and then he says:

“I was shocked to learn at the end of last year that little to no progress has been made by the Health Board in our region who are responsible for commissioning this service to you.”

Let us assume it was in anticipation of Labour’s motion, which he is going to vote against because the Whip has been cracked. He goes on to say:

“I have today written to the Chief Executive following on from the meetings I had last year, and will be raising this issue in today’s dentistry debate in the House of Commons.”

What that is, and what voters will see it for, is just one of what will no doubt be countless examples of Tory MPs and Tory Ministers, after 14 years of their failure and mismanagement, pointing the finger of blame at someone else, hoping that voters in Darlington and elsewhere will blame local NHS managers and local NHS commissioners for 14 years of failure. If it is really the case that his integrated care board is to blame for why people in Darlington cannot get a dentist, why are people struggling in Newcastle-under-Lyme? Why are they struggling in Northampton North? Why are they struggling in Shipley? Why are they struggling in Filton and Bradley Stoke? Why are they struggling in Worthing West, Stroud, Stevenage, Great Yarmouth, Truro and Falmouth, Blackpool South, Stockton South and every other constituency in the country? Stop blaming other people for your Government’s failures.

[Peter Gibson (Darlington) (Con)]

I am very grateful to the hon. Gentleman for giving way and I appreciate that he gave me notice that he was going to mention my constituency. What he failed to do in his contribution was read out the letter in full. He has also not anticipated the full content of my speech, which highlights all the work I have been doing in my constituency to tackle the failure by the ICB to deliver the missing contract.

[Wes Streeting]

I could quote the full letter, but it does not help the hon. Gentleman. He misses the fundamental point. This is not just a failure in Darlington. This is not just a problem in the north-east of England. It is the south-west of England, it is the south-east of England, it is the west midlands, it is the east midlands, it is the north-west, it is Cumbria—it is right across the country. In fact, even in London, my city, which has the best NHS dentistry provision in the country—so much for levelling up—dentistry is still in a poor condition. That is why people in Darlington are looking to Labour and, I hope, Lola McEvoy, to take responsibility, show some leadership, back good Labour policies and rescue NHS dentistry in Darlington. The general election cannot come soon enough.

The choice is clear. Under the Tories, NHS dentistry is dying a slow death. The only chance for survival is change with Labour. Labour’s plan will deliver: 700,000 more dental appointments a year for those most in need; new dentists recruited to dental deserts where there is not a single dentist taking on new patients; toothbrushing in primary school for three to five year-olds to promote good health and prevent demand on the NHS; and reform of the dental contract after 14 years of failure, so that once again every patient who needs a dentist can get one. Politics is about choices. Labour chooses to rescue NHS dentistry, not give the wealthiest a tax break. Labour’s plan is fully costed, fully funded, and will make a real difference to people across the country. The Tories have left our country toothless. Labour will give our country its smile back and give its NHS back, too.

--- Later in debate ---

[Peter Gibson (Darlington) (Con)]

I wish to put on the record at the outset my thanks to my hon. Friend the Member for Harborough (Neil O’Brien) for his work on dentistry. I also thank the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), for her early engagement with colleagues on this topic just days into her new role.

My constituency office has received enquiries from almost 200 residents who have been unable to access NHS dentistry services, despite the fact that there are many dentists in our town. The current NHS contract for dentistry stems from Labour’s reforms of 2006, and has increasingly shown itself to be lacking. The regime of payments based on units of dental activity has been unfair to dentists from the start, and, due to insufficient commissioning in areas of greatest need, it has been unfair to patients too.

Last year, a practice based at Firthmoor community centre in Darlington handed back its NHS contract as it was unable to be economically viable while being paid a mere £23.50 for a UDA. After struggling to recruit a new dentist, the owner of the practice, who also operates in other parts of the north-east and is paid almost £40 for a UDA in leafy parts of Newcastle, took the very sad but entirely understandable decision to close their Darlington branch. No business can recruit and employ staff when the money coming in does not cover the operating costs, never mind make a profit. NHS England, which did the commissioning prior to April 2023, offered to increase the UDA rate to nearly £30, but frankly, that was too little, too late.

When the North East and North Cumbria integrated care board took over responsibility for dentistry in April last year, I was filled with fresh hope that a resolution for the situation in Darlington would be found. I was assured that emergency provision would be expanded and additional commissioning would be provided at a higher UDA to further expand provision in Darlington. Imagine my dismay and disappointment when, in late November, I learned that little, if anything, had been done—literally nothing. There then followed numerous meetings, conversations and communications as I became increasingly angry that I had effectively been misled and my constituents were still being under-provided for. I am grateful to the hon. Member for Ilford North (Wes Streeting) for kindly highlighting my work on this topic as a constituency MP, in contrast to his time prior to his current role, when he mentioned dentistry not once.

Our ICBs do not even have to have a dentist on their boards. It has become clear to me that only by our lobbying, pushing and raising this in the media will our ICBs actually turn their attention away from their own internal bureaucracy and focus on the job of providing the services that they have an obligation to commission. I welcome that the Government will bring forward a dental recovery plan, which really cannot come soon enough. In the meantime, I urge the Minister to give our ICBs a boot up the backside and get them to pull their finger out. When things are as bad as they are, their underspend on dentistry is utterly shocking.

While I am on my feet, I have a few suggestions for the Minister. I have shared them directly with her before, but it would be good to get them on the record. We need more dental training. Will she consider the addition of a dental school to Teesside University, alongside its excellent dental technician training facilities? I welcome that we will oblige our new dentists, whose training comes at massive public cost, to spend a period of time providing public services before they go fully private. Dentists should be required to publish their fees and charges for NHS, private and insurance-backed work, so that patients can make clear and informed choices. We also need to see greater provision of mobile dentists visiting schools, particularly in areas of higher deprivation.

We need to see much more progress on this issue. We need to go further and faster, and I am quite sure that my right hon. Friend the Minister is the right person to do just that.

--- Later in debate ---

[Peter Gibson]

The hon. Lady and I share the same integrated care board. If this is to do with austerity, why has she not engaged with our local ICB to ask it about the underspend and the provision in her constituency?

[Mary Kelly Foy]

I do speak to the ICB whenever I need to and it has told me, as I am about to say, that our welfare state, of which the NHS is a part, has been hollowed out. The system is wrong. Austerity has caused these problems: it is not the pandemic; it happened many years before then.

Supporters of austerity often say they do not want to burden future generations with debt, but austerity and preventive healthcare are incompatible; we cannot have both. The healthcare problems this Government have caused our constituents—issues that could have been prevented with funding and investment—will now be more expensive to resolve down the line. Conservative Members have saddled future generations with poorer health, poorer opportunities and ultimately a poorer country, and it is time for them to go.

--- Later in debate ---

[Ashley Dalton (West Lancashire) (Lab)]

I am grateful for the opportunity to speak in this debate, because inability to gain access to an NHS dentist is an issue plaguing my constituents.

In 2024 Tory Britain, the opening of additional NHS dentistry practices is national news, with reports of people queuing on high streets just for the chance to be seen by a dentist. This is a Britain where a call to an NHS dentist to inquire about registering as a new patient is met with laughter down the phone. That is not hyperbole or hearsay: it is what I heard when I tried to register my 88-year-old mother and myself with a new NHS dentist. My dad does not need one: he had his teeth taken out for his 21st birthday, because—my hon. Friend the Member for Wallasey (Dame Angela Eagle) made this point—it was cheaper and easier. It is shocking that we seem to be back in that situation today. In 2024, it is easier to get your hands on Taylor Swift tickets than to get an NHS dental appointment.

For the benefit of the hon. Member for North Devon (Selaine Saxby), who is no longer in her place, my constituency is a rural one, and it is a beauty. However, for many of my constituents, living in a rural constituency makes accessing vital services nothing short of stress-inducing. The presence of the new Labour Members, my hon. Friends the Members for Selby and Ainsty (Keir Mather) and for Mid Bedfordshire (Alistair Strathern), would point to the idea that people in rural communities do believe that Labour has got a grip on what rural communities need; and our colleagues the candidate in Hexham, Joe Morris, and the candidate in Carlisle, Julie Minns, are also telling me that their local people, and hopefully future constituents, believe that Labour has a grip on what is needed in rural communities.

When services are not available in Burscough, in my constituency, it is not as simple as phoning the next practice down the road, or the one just over from that. It means travelling to Skelmersdale, to Southport, to Liverpool. One of my constituents has contacted every practice in our constituency and beyond, from Ormskirk to Blackpool, and is unable to register anywhere as an NHS patient—and Blackpool is 50 miles away, a four-hour round trip by public transport. Another parent in my constituency has been unable to register either of their children, both of whom have additional needs, with an NHS practice.

Another recent arrival to Skem cannot register any of his family members as an NHS patient. I took up his case with the ICB—I am sure that the hon. Member for Darlington (Peter Gibson), who is still in his place, would approve. The ICB told me the shocking truth that Government funding of NHS dentistry is only sufficient to enable around 50% of the population to access routine dental care. So where is the funding for the other half? What are the other 50% of our constituents meant to do?

[Peter Gibson]

The hon. Lady is obviously in a different ICB area from mine and I am not privy to the detail in respect of her ICB’s underspend, but it would be wonderful to know whether her ICB does in fact have an underspend.

[Ashley Dalton]

I thank the hon. Gentleman for leading up conveniently to my next point. The issue is that the ICB is actually bringing back more money than ever before from our dentists, and the local NHS dentist in Burscough is telling me that that is because they cannot recruit dentists or hygienists or other dental professionals in order to meet their target. They would love to do it; they cannot. The hon. Member for Darlington also talked about choice, but it is no choice when the only choice is private or nowt—and that is what my constituents are looking at.

If only the problem stopped at dentistry. The inability to access a dentist and regular check-ups leads to people having to visit their GP for knock-on health issues, or they are in so much pain that they are forced to end up at an already stretched A&E. Under this Government, the state of NHS dentistry services has ended up as dismal. A member of the public who contacted Healthwatch Lancashire recently, reported that they were in so much pain that they were feeling suicidal.

The public know that they cannot trust the Tories with NHS dentistry, and the alternative with Labour is clear. Prevention is by far the most effective way to improve patient outcomes across the NHS, and there is no better way to prevent than to educate. We have heard that a Labour Government will introduce supervised toothbrushing in schools for three to five-year-olds, giving children the best chance to avoid tooth decay altogether; 700,000 more urgent appointments for the most serious treatments such as fillings and root canals; and will incentivise dentists to work in areas where they are needed most. That is music to the ears of residents in rural areas such as mine. Even better than that, it is all paid for, by ensuring that the people who make Britain their home pay their taxes here, abolishing the non-dom tax status once and for all.

Toothache is nothing compared with the hurt of another five years of this Government’s inaction on dentistry. It is time they called a general election to make way for a Government with a plan to fix our nation’s teeth.