Access to GP Services and NHS Dentistry

Rebecca Long Bailey Excerpts

Tuesday 21st June 2022 Commons Chamber

[Rebecca Long Bailey (Salford and Eccles) (Lab)]

According to the Association of Dental Groups, only a third of adults and half of children in England have access to an NHS dentist. As we have heard, the top reason for children being admitted to hospital is tooth extraction. It is 2022, not 1922. Back in 1947, when the NHS and NHS dental services were brought about by the then Labour Government, many of us naively thought that they would be around for ever, that we would always be able to access those services when we needed them. Unfortunately, we now see the return to the poverty-linked ill health that we saw in the 1940s.

As MPs, we hear heartbreaking stories. There was the Salford man with a badly infected tooth who could barely afford to live, let alone pay for private dental treatment. He could not find an NHS dentist who would take him on. He said to me that, had it not been for the fact that he was on anticoagulants, he would have pulled his own teeth out with a pair of pliers. There was the Salford woman with countless abscesses all over her jaw, and no money to go private. She was in acute pain and putting her life at risk from a spreading infection. She had been trying to get on an NHS waiting list for a dentist for over five years. There was also the Salford mother living on the breadline, yet forced to borrow and scrape together the money to go private. She told me that she had to pay £100 just to get on a dentist’s list. There are thousands of stories like this.

Recently, I asked the Government what data they held on the number of people trying to access an NHS dentist in Salford, such as the stories I had heard from my constituents. The Government confirmed that they held no data for my constituency or even across Greater Manchester. Frankly, that is staggering.

So what is at the heart of the decline of NHS dentistry? The British Dental Association details that chronic underfunding and the current NHS dental contract are to blame for long-standing problems with burnout, recruitment and retention in NHS dental services.

On funding, in real terms, net Government spend on general dental practice in England was cut by over a quarter between 2010 and 2020. The £50 million that the Government have announced—as we have already heard today, it is difficult to access that at the best of times—will not even touch the sides given the amount of funding cut from NHS dentistry.

On the contract, the system in effect sets quotas for the number of patients a dentist can see on the NHS and caps the number of dental procedures they can perform in any given year. If a dentist delivers more than they have been commissioned to—say, to try to help a desperate patient in need of urgent care—that dentist is in effect punished. Not only are they not remunerated for the extra work done, but they have to bear the cost themselves of any materials used, laboratory work and other overheads.

It is no wonder that morale among NHS dentists is now at an all-time low, and we are facing an exodus of dentists from the NHS. We are seeing NHS dentistry deserts popping up all over the country, where constituents such as mine in Salford can only dream of trying to get on an NHS dentist’s patient list. Around 3,000 dentists in England have stopped providing NHS services since the start of the pandemic. Staggeringly, for every dentist quitting the NHS entirely, 10 are reducing their NHS commitment by 25% on average, and 75%—75%—of dentists plan to reduce the amount of NHS work they do next year.

It is clear that we face a dental crisis and that the Government must urgently address it. There are a number of actions that I hope the Minister will take. First, they must reform the NHS dental contract with a decisive break from units of dental activity, a greater focus on prevention and the removal of perverse incentives.

Secondly, the Government must provide adequate levels of protected NHS dental funding to ensure investment in new and existing NHS dental services, and they must guarantee the long-term sustainability of NHS dentistry for all who need it.

Thirdly, NHS dentistry must be given the status it deserves. That means sitting right at the heart of local NHS commissioning, rather than being treated as an afterthought—a luxury service, as it were, which is how many seem to perceive it.

Finally, the Government must build and properly fund historic public health commitments to prevention. As we have heard—from Conservative Members, actually—this is a crisis in NHS dentistry, but many of the factors that contribute to this crisis are directly related to poverty, people’s diets and the amount of money they have to spend as a family on oral health and hygiene.

We are in the midst of a cost of living crisis as well as a dental crisis, and the Government need to be doing far more to support families to make sure that they have enough to live on and a decent range of food that provides them with the nutrition they need in order to have healthy teeth. We naively thought that poverty-related ill health, rotting teeth and gum disease had been consigned to the history books when NHS dentistry was established in 1948, but this Government wind the clock back day after day and those afflictions are now back with a vengeance. NHS dentistry hangs by a thread. The Government have a moral duty to stop the rot today because rotting teeth come from a rotting Government. I hope that the Minister will change my mind.