Dentistry: Access for Cancer Patients

Preet Kaur Gill Excerpts

Wednesday 17th April 2024 Westminster Hall

[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Mr Dowd.

I thank my hon. Friend the Member for Stretford and Urmston (Andrew Western) for securing the debate and for speaking so powerfully about how the dentistry access crisis affects cancer patients and survivors such as his constituent, Michele. I had the pleasure of meeting Michele with my hon. Friend earlier today, and it was eye-opening to hear the stories about what cancer patients and survivors face. I am delighted that Michele is here today. I thank her for all her campaigning and the support that she provides for those suffering pretty much what she had to go through.

I am afraid the state of NHS dentistry under this Government is Dickensian. Most of us might think that our teeth would be the least of our worries if we were diagnosed with cancer, and as we have heard, oral health is incredibly important. Many cancer patients, who previously had few or no dental issues, can experience the loss or crumbling of teeth, together with a host of other dental problems during or after treatment. Poor dental hygiene can lead to infections, which can interfere with a patient’s chemotherapy. Radiotherapy can cause acute complications for teeth and gums through tissue damage. In rare cases, extractions afterwards can result in bone necrosis, whereby the jawbone essentially dies.

It is therefore crucial that timely access to dentistry, including any required treatment and preventive advice, is provided before, during and after cancer therapy to maximise positive outcomes. The last thing that any cancer patient needs is to find that they cannot access a dentist when they need one. However, as the Minister knows, the current crisis in access to dentistry is shocking. After more than a decade of neglect, patients are desperately queueing round the block to see a dentist. Eight in 10 practices are not taking on new adult NHS patients and, as we have heard, one in 10 people have tried DIY dentistry. Some of the most vulnerable people in society, who need to get seen, are missing out.

I want to share with the Minister some of the stories that were shared with me before the debate. Michaela from Alresford said:

“I lost all my root canals and my teeth just started falling to bits on chemotherapy. I wasn’t able to see an NHS dentist and I couldn’t afford private. I’m awaiting treatment again for cancer (for the second time) and urgently need my teeth sorted before I have chemotherapy again, but I can’t get in to see a dentist.”

Carole from Shropshire said:

“I was with an NHS dentist but missed a check-up while going through chemo—was very ill. So got knocked off. I had problems when taking ibandronic tablets for bones, had to go for emergency treatment. NHS dentist in Shrewsbury 17 miles from home. This was two years ago—still not been able to register. Tried surrounding towns. I know I am not on my own. There are hundreds in the same situation as me.”

What does the Minister have to say to Carole and Michaela? Has the Department made any estimate of the impact of the access crisis on cancer patients and survivors?

As we heard today, according to research by Macmillan Cancer Support, four in five cancer patients are hit with an average cost of £570 a month as a result of their illness. If patients face oral health complications because of their treatment and they cannot be seen on the NHS, most will simply go without. A two-tier system, whereby those who can afford to go private and the rest go without, is obscene. How are the Government working to minimise the financial cost of cancer for patients and survivors? Those costs can knock back their health.

It was disappointing to hear from Michele that when she was diagnosed with breast cancer her doctor did not tell her about the impact her treatment could have on her oral health. I know the Minister accepts that such advice should be routine. The Department of Health and Social Care guidance for delivering better oral health states that cancer patients should receive appropriate care to manage and stabilise their oral health before treatment, but it appears that not all cancer patients are getting that support. I urge the Minister to address the matter and raise it when possible.

In my team, a parent of one of my staffers was diagnosed with throat cancer in 2020, but did not get his orthodontist appointment to have four teeth removed until a year after his treatment. Will the Minister comment on the fact that the latest estimates show that in February 2024 more than 325,000 patients were waiting for oral surgery in England? That is up by nearly 200,000 since 2015, almost a decade ago, which was the last time the NHS target was met. How many cancer patients’ treatments are delayed as a result?

There is also the dire issue of cancer diagnoses themselves. Oral cancer is now one of the fastest-growing types of cancer in the United Kingdom, with mortality rates up by 46% on a decade ago. It now kills more than 3,000 a year in the United Kingdom. But if diagnosed early, oral cancers have a survival rate of roughly 90%, compared with 50% if diagnosis is delayed. Given that dentists are often the first to spot the early signs of the disease, will the Minister say whether she has made any assessment of the contribution of the dentistry crisis to the appalling mortality figures?

As my hon. Friend the Member for Bolton South East (Yasmin Qureshi) said, the Health Secretary claimed in the Commons in February:

“There is £200 million on top of the £3 billion that we already spend on NHS dentistry in England.”—[Official Report, 7 February 2024; Vol. 745, c. 264.]

But that is not true. Notwithstanding the fact that £1 billion of that is covered by patient charges, not central Government, the Health Secretary also subsequently admitted that the money will come from existing budgets. So really it is only £200 million as part of the money that she might spend on NHS dentistry if the £400 million yearly underspend persists.

The Health Secretary also claimed:

“The Opposition’s ambitions reach only as far as 700,000 more appointments. Our plan will provide more than three times that number of appointments across the country—that is 2.5 million”.—[Official Report, 7 February 2024; Vol. 745, c. 255.]

But that is not true either, is it? It is not true because the Government’s scheme will run for only one year, while Labour’s plan would deliver both in the here and now and into the future. Perhaps the Health Secretary might correct the record on that, too.

My hon. Friend the Member for Stretford and Urmston shared his thoughts on how joining up services in hospital for cancer patients could address access to dentistry for very high-risk patients. NHS dentistry is dying a slow death under this Government, and the people who rely on NHS care cannot wait another five years for a Tory Government to decide that, this time, they really mean it and they will reform NHS dentistry for good. Labour’s fully funded plans would provide 700,000 more urgent appointments a year, supervised tooth-brushing schemes in areas of deprivation, and a targeted recruitment scheme in left-behind areas, all paid for by cracking down on tax dodgers. We would get on with the reform to the NHS dental contract that this Government have put off for 14 years. Cancer patients, new mothers, those in rural communities and millions of others are being failed every year that we let the decay in NHS dentistry continue.