NHS Dentists: South-West England

Richard Drax Excerpts

Wednesday 24th May 2023 Westminster Hall

[Richard Drax (South Dorset) (Con)]

It is a pleasure to serve under your chairmanship, Ms Elliott. I congratulate my hon. Friend the Member for West Dorset (Chris Loder) on securing this excellent debate. He, like me, has been concerned about this issue for some time. As he said, NHS dentistry left NHS England on 1 April, so dentistry in our area has now been delegated to NHS Dorset integrated care board, with which we have close connections and work a lot. It has been in place for only a short time and is already looking carefully at this major issue. I hope my hon. Friend and I can get the desired result.

At risk of spouting too many statistics, I think it is worth noting that in my seat of South Dorset there are only 10 dental practices, in Swanage, Weymouth and Portland. None of them is NHS, one is now private, and none was accepting new NHS patients when contacted by Healthwatch six months ago. There are only two surgeries in Swanage. My constituents write to me regularly on this issue, and I am ashamed to say that I did not realise how shocking the situation was until we started to look into it. The figures are shocking, and I hope the Minister will respond today not least on the contract issue, which every Member has mentioned, because this has to change. It simply is not working.

Let me share what four of constituents wrote to me. One said:

“It’s impossible to find a dentist in Weymouth”.

Another wrote:

“I haven’t had a dental checkup in person for two years due to covid”.

A third said:

“Our appointment has been cancelled again and now, our dentist is retiring early”.

And another wrote:

“After telephoning 14 practices ranging from Portland to Poole, Blandford, Sherborne and Wareham in Dorset through to Castle Cary in Somerset, I was met with 12 straight negative replies and 2 offers of being placed on very slow moving waiting lists or private treatment offers”.

That is completely unacceptable.

The hon. Member for Bath (Wera Hobhouse) mentioned that children are being affected, and how right she is. I heard in a telephone call today that 300 children in Dorset have been waiting for months not for dental treatment but to go to Dorset County Hospital to be knocked out by general anaesthetic because their problems are so severe. Because of the pandemic and the backlog, they are waiting in pain. These are children. That is really, really shocking.

Healthwatch also looked at the situation in wider Dorset. I hope Members will forgive me for giving more statistics, but they are quite interesting. Of the 95 practices in Dorset, two have gone out of business, 13 did not reply and 78 responded. Of those, no dentists are taking on new adult patients; two have closed since last year; 17 are now entirely private; 18 accepted new child NHS patients; seven accepted patients with additional needs; 23 have waiting lists, although some did not know how long; 50% have waiting lists longer than 12 months; Purbeck is particularly short of dentists; 75% of registered patients are still receiving routine check-ups, which is good; and most private practices would accept urgent referrals from NHS 111.

The British Dental Association has said—and I agree, from what I am learning—that NHS dentistry is facing an “existential threat”. It shocked me to discover that before the pandemic there were only sufficient funds for dentistry to look after 50% of the population—even before the pandemic, only half the population had their teeth looked after. That is extraordinary. Some 11 million—almost one in four—adults are not having their needs met, and 10% of the £3 billion budget is set to be returned to the NHS this year, not because of lack of demand but because practices are unable to fulfil contractual commitments. Burnout and issues with retention and recruitment are causing a lack of dentists.

As I understand it, the contract, which has been touched on, is based—I hope I have this right—on a quota system, and dentists are penalised if they overperform. They are penalised if they underperform, and their funds are taken away. They are penalised if they take on patients with high needs, because they get paid the same for treating patients with fewer needs. This really is a serious issue, and I very much hope that the Minister can respond, not least on the issue with the contract.

--- Later in debate ---

[Neil O’Brien]

I feel the exact same sense of burning urgency that my hon. Friend feels. I hope our plan will be out very shortly.

[Richard Drax]

The Minister may be coming to this point, but can I ask him about the disincentives—the cap beyond which dentists do not get paid, and the money that is taken off them if they underspend? Is that issue going to be resolved?

[Neil O’Brien]

Absolutely. I mentioned that in the last financial year we brought in the 110% flexibility so that those who do want to go further and deliver more NHS care were able to do so. We are looking at continuing that and also making some further changes to make the system more flexible and give local commissioners more power, so we do not have these rigidities in the system leading to the absurd situation where there is both under-delivery and underspend, which is completely maddening to everyone.

Once again, I thank my hon. Friend the Member for West Dorset for raising this hugely important subject. I am sure all hon. Members will want to see the dentistry plan out as shortly as possible.