Access to Dentistry: Somerset

Richard Foord Excerpts

Tuesday 1st April 2025 Westminster Hall

[Anna Sabine (Frome and East Somerset) (LD)]

I beg to move,

That this House has considered access to dentistry in Somerset.

It is a pleasure to serve under your chairmanship, Mr Stuart. My grandfather might not have been a toolmaker, but he was dentist. He worked near Slough, and as a child I loved visits to the dentist because we got to play in the electric chair and dissolve bright pink mouthwash tablets in plastic cups, and we always got a Lambrusco and lemonade afterwards, which was of course entirely appropriate.

That regularity of dental treatment means that, at 45, I am lucky enough to have no fillings at all, and I am not particularly scared of dentists. Many children growing up today in my constituency of Frome and East Somerset are not so lucky: one in five children in Somerset has tooth decay by the time they are five. Although we know that difficulty in accessing an NHS dentist is a nationwide challenge, data reveals that the south-west is particularly neglected. The most recent Office for National Statistics data shows that it has the worst access problems of all regions in England, with 99% of people without a dentist failing to secure the NHS treatment they needed in the last month.

Furthermore, only 32% of adults in Somerset saw an NHS dentist in the two years to June 2024, which is much lower than the national average of 40%. The picture for children in Somerset is equally shocking: only 42% were seen by a dentist in the year to June 2024, well below the national average of 55%, and way below pre-covid averages.

[Richard Foord (Honiton and Sidmouth) (LD)]

My hon. Friend’s point about the south-west is absolutely right. Some 217 visits per 100,000 to accident and emergency are for dental-related issues, compared with 154 for the next highest region. So the south-west is a real outlier, and not in a good way. Does my hon. Friend think that that is having a detrimental effect on hospitals and A&E?

[Anna Sabine]

Yes, I absolutely agree, and I will talk later about how poor access to dentistry impacts other parts of the health sector.

Yesterday, I was lucky enough to visit a local primary school in Frome, along with a friend who is a dentist. We started with an assembly about the many superpowers the mouth has, in which I was delighted to be given the leading role of saliva. Then we moved on to taking two reception classes through a supervised toothbrushing session. The school is part of the Government’s supervised toothbrushing scheme, an initiative I welcome. Sadly, of the 30 children in the room, 10 did not have consent for the toothbrushing—some because forms had not been returned, and some because there was a parental objection to the activity or to the use of fluoride. To ensure that they did not feel left out, my dentist friend played a game where they counted their teeth instead. She said that, based on what she could see from that game, that group of 10 children had 50 obviously decayed teeth, and one child had at least 10 teeth that would need to be removed under general anaesthetic. Those children were four and five years old. Although the scheme overall is to be welcomed, I hope consideration will be given to having an opt-out rather than an opt-in, to ensure that the children who most need the scheme are actually benefiting.

Somerset used to be well above the national average on access to dentistry. As recently as 2018, 55% of adults were seen by an NHS dentist in a two-year period, compared with 50% nationally.

--- Later in debate ---

[Stephen Kinnock]

I absolutely agree. Two big things need to happen. First, the General Dental Council needs to do more to get more exams in place for those very well-qualified dentists. Of course, they have to pass the British exam. We cannot have people practising in Britain who have not passed that exam, but the availability of the exam has been too limited and that needs to change. The other thing is provisional registration. Some work can be done to expedite the registration of an international dentist, but more needs to be done on that as well. I will meet the head of the General Dental Council shortly, and I will convey those messages to him.

Recruitment and retention issues are not limited to dentists; there are difficulties across the whole dental team, including dental nurses, hygienists, therapists and technicians. In the past five years, there has been a 15% reduction in courses of dental treatment being delivered across England, and 28% of adults in England—a staggering 13 million people—have an unmet need for NHS dentistry. As a result, we hear too many stories about people who are unable to access the care they need, and some horrific accounts of DIY dentistry that nobody should have to resort to.

Dentistry rightly receives a lot of attention because of its dismal state, and I am grateful to the National Audit Office and Public Accounts Committee for their interest in the previous Government’s dentistry recovery plan. It is evident that the plan did not go far enough.

[Richard Foord]

The Minister talks about the previous Government’s dental recovery plan, and part of that was to impose a firmer ringfence on dentistry spending so that there was not an underspend that was reallocated elsewhere. The previous Government tasked NHS England with collecting monthly returns from ICBs to establish spending as against the allocation. Now that NHS England is being scrapped, will we still see that monitoring of ICBs to ensure that the spending matches the allocation?

[Stephen Kinnock]

I take the hon. Gentleman’s point about the ringfence, but in a way, ringfencing addresses the symptoms, rather than the cause, of the problem. The fundamental cause of the problem is the amateurish way in which the previous Government set up the NHS dentistry contract so that it does not incentivise dentists to do NHS work. That is what leads them to drift off. In a sense, we can do all the ringfencing we like, but if the workforce that we need is not incentivised to do the work that we need them to do, we are going to have that problem, because they vote with their feet. That is why the radical overhaul of the dentistry contract is the key point. However, I agree with the hon. Gentleman that once we have got a contract that works, we must ensure that every penny that is committed to NHS dentistry is spent on NHS dentistry, rather than the absurd situation that we have now, in which we constantly have underspends in the NHS dentistry contract while demand for NHS dentistry goes through the roof. It is a truly bizarre situation.

I return to the subject of the dentistry recovery plan. The new patient premium, introduced by the previous Government, aimed to increase the number of new patients seen, but that has not happened. In reality, since the introduction of the previous Government’s plan, there has been a 3% reduction in the number of treatments delivered to new patients. It is clear to this Government that stronger action is needed, and we are prepared to act to stop the decay.