Access to NHS Dentistry

Richard Fuller Excerpts

Thursday 10th February 2022 Westminster Hall

[Richard Fuller (North East Bedfordshire) (Con)]

It is a pleasure to serve under your chairmanship, Mr Efford, and to follow the hon. Member for Ealing, Southall (Mr Sharma), although I did not agree with the premise of his argument. I congratulate my hon. Friend the Member for Waveney (Peter Aldous) on securing this important debate. He and other hon. Members have mentioned a number of problems. I do not mean to reiterate any, but I will add one issue for consideration by the Minister: infrastructure first, and the pressure of additional housing development. House building in my constituency is at five times the national average. That is not only disruptive to our natural environment but means that people cannot access their GP, a school place or a dentist. Maybe she can address that.

I wanted to speak for a number of reasons. One thing I put on the record—many colleagues will have had this—is that a number of dentists contacted me through lockdown desperately wanting to serve and provide services. They found it exceptionally difficult to be able to do that. They literally knew that there was a growing problem, and they wanted to serve. I thank dentists in my constituency, as I am sure do all Members, for their efforts during the period of covid. In addition to infrastructure first, I would like to hear from the Minister specifically how we are going to address the difference between registration for a service and actually accessing a service. It seems that there is a problem in the contracting around that at the moment.

Where I perhaps disagree with the hon. Member for Ealing, Southall, who just left his place, is that I think we have to control taxpayer support for dentistry. Public finances are stretched and have been for considerable time—in my time as a Member of Parliament, both currently and during my time as the Member for Bedford. We have tried to deal with some aspects of excessive public expenditure. We have record debt. We have record levels of taxation. It is a fantasy for Members of Parliament to come here or to the Chamber time after time and say how wonderful it would be to spend more money on whatever is the topic of the day. In that way lies financial ruin. The Labour party has no answer to that. We need to find creative solutions to use existing levels of expenditure more wisely than currently.

On the way dentistry contracts work, as the British Dental Association and others have shown, there is plenty of scope for spending existing resources more efficiently and more effectively, by looking at a better form of contract than drill and fill or by looking at preventive dentistry, rather than reacting once problems have occurred. I was amazed to see—I do not know whether other colleagues have seen this; I am not sure I read it right—that one of the main reasons for young people ending up in A&E right now is tooth decay. How on earth did we get into that situation? There must be a better way for us to spend resources if that is the result those resources are having.

May I also make a point about recruiting people into dentistry? I supported Brexit and I support the Home Secretary’s points-based immigration system. What on earth are we doing to ensure that we have an adequate supply of people from across the world? My hon. Friend the Member for Waveney talked about people coming from the Commonwealth. I do not mind where they come from. I want the best and brightest to come to this country. How can we eliminate some of the restrictive practices to ensure that we make that an interesting and attractive option?

Finally, I will make a point about the contract. One issue in our health services is that most contracting is done, in essence, through what I would call production contracts between a producer and the state for how taxpayers’ money should be allocated. However, there are other ways to do that, such as by putting the power of the money with the consumer. We started to do that in elder care through personal budgets, and I know that the Opposition spokesperson, the hon. Member for Bristol South (Karin Smyth), has a lot of experience in care, so she might address that issue, too.

Can we find a new way to contract with our dentists that empowers consumers with the financial resources that are to be spent, so that they can choose where to use the money? They could have competitive pricing from dentists, rather than every particular production item in dentistry having a particular price, with all the frailties mentioned by my hon. Friend the Member for Worthing West (Sir Peter Bottomley), the Father of the House, with one filling versus the whole thing ending up at the same production price. If we empower people through the budget, that might be a better way to approach any change to our contracts, rather than just rehashing another producer contract for dentistry.