NHS Dentists
Debate between Stephen Kinnock and Adrian Ramsay(2 days, 2 hours ago)
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The Minister for Care (Stephen Kinnock)
I congratulate the hon. Member for North Down (Alex Easton) on securing this important debate. I thank him for his work to raise awareness of the challenges facing dental patients in his constituency and across the United Kingdom. It is vital that we work together, across the four nations of the United Kingdom, to tackle the long-standing problems that adults and children have been facing in accessing an NHS dentist when they need one. I also thank other hon. Members and hon. Friends for their powerful contributions to the debate. I know that access to dentistry is a matter of continuing concern for Members and their constituents.
The concerns Members have raised support the many testimonies I have heard directly from patients, dentists, members of the wider dental team, and their representatives. In July 2024, we inherited a dental system in crisis. That is evident in the adult oral health survey of 2023, which provides the first picture of adult oral health in England for more than a decade, and shows poor oral health in adults. Among adults with their own teeth, over two fifths—41%—showed evidence of obvious decay, 93% had some form of gum disease, and 19% had one or more potentially urgent dental conditions. This Government are determined to fix that.
Our 10-year health plan confirms our commitment to transforming NHS dentistry so that it is fit for future generations. We have established a platform for future success by reducing the NHS dentistry underspend from £392 million in 2023-24 to just £36 million. The decrease in underspend is leading to an increase in NHS dentistry, but I absolutely accept that there is still a long way to go. Over the past 18 months, the Government have made great strides in improving NHS dentistry, not just for patients but for the dental workforce delivering oral care to our nation. My immediate priority when taking up this ministerial post was to ensure that people who need an urgent dental appointment are prioritised and able to access the care that they need quickly. It is essential that we direct care towards those who need it most.
We all have a duty to reduce health inequalities, which are sorely felt in NHS dentistry. That is why, since last April, we have been making extra urgent dental appointments available to ensure that patients with urgent dental needs can get the treatment they require. Those extra appointments are available across the country, and are more heavily weighted towards the areas in which they are needed most. We are also incentivising high street dentists to offer further appointments in order to maximise availability for those in need of urgent care.
We recognise that access to NHS dental services remains a challenge in certain parts of the country. In addition to our urgent appointments, integrated care boards are recruiting dentists through the dental recruitment incentive scheme—known as the “golden hello” scheme. That initiative offers a financial incentive to encourage dentists to work in underserved areas for a minimum commitment of three years.
This Government have heard dentists’ concerns that they do not think the current dental contract is fit for purpose. Talks are under way, including with the British Dental Association, to scope our plans for potential changes. We remain open-minded and keen to consider how different payment models could best improve the delivery of care to dental patients. In reforming the dental contract, we want to focus on matching resources to need, improving access, promoting prevention and rewarding dentists fairly. We also want to enable the whole dental team to work to the top of their capabilities.
But reforming the dental contract is a significant challenge, and there are no quick fixes or easy answers. That is why in our 10-year health plan, we committed to fundamental reform of the dental contract by the end of this Parliament, with significant steps in 2026-27. Talks are under way with the British Dental Association, and we are making progress on these matters.
In addition to delivering fundamental contract reform over the longer term, we have already made significant progress through our 2026 reforms. We held a public consultation last summer on changes to the current NHS dental contract to address the pressing issues that dentists and dental teams said they were experiencing. The Government’s response, published in December, took account of the views of the dental sector as well as people with lived experience. Our reforms will utilise the existing dental contract to deliver the right care to the right people, while incentivising dentists to provide more NHS care. By prioritising patients with the greatest needs and making more efficient use of dentists’ time, the changes will ensure that the NHS dentistry budget delivers value for money for the taxpayer.
From 1 April, we will start to implement the reforms. For the first time, we are introducing provisions in the dental contract to embed urgent dental care appointments, making it easier for patients to access this care. We are increasing payments to dentists to deliver that care from £42 on average to £75 for that unit of dental activity. We are providing new treatment pathways for patients with complex treatment needs, paid at a set fee of around £250 or £700 depending on the pathway, while enabling and encouraging dentists to deliver more preventive care. These reforms will make full use of the existing dental contract, to ensure that patients receive the right care at the right time, while creating clear incentives for dentists to provide more NHS care. As I say, they will kick in from 1 April.
England has more than 38,000 registered dentists, of whom 10,700 are full-time equivalent general dentists delivering NHS care. As we take forward our reform programme to rebuild NHS dentistry, we are clear that strengthening the workforce is key to achieving our ambitions. This Government are committed to publishing a 10-year workforce plan to set out actions to create a workforce that is ready to deliver the transformed service set out in our overall 10-year health plan.
We are taking steps to increase the capacity of our dental workforce. As announced in our 10-year health plan, we will make it a requirement for newly qualified dentists to practise in the NHS for a minimum period. We intend that minimum period to be at least three years. That will mean more NHS dentists, more NHS appointments and better oral health.
Adrian Ramsay
I thank the Minister for highlighting the need for the dental workforce to be strengthened. We have a dental desert in East Anglia. The University of East Anglia stands ready to open a new dental school. It has permission from the General Dental Council but is awaiting the funded undergraduate dental places that will be needed to start training new dentists from 2027. Can the Minister set out how those places will be made available on the basis of regional need, so that dental deserts such as the east of England can start to build a sustainable dental workforce?
Oral Answers to Questions
Debate between Stephen Kinnock and Adrian Ramsay(6 months, 2 weeks ago)
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Adrian Ramsay (Waveney Valley) (Green)
Data published last week shows that despite the Government’s initial action, the proportion of dentists working in the NHS in Norfolk and Waveney continues to drop. I am pleased to hear about the Government’s work on the dental contract, but the Public Accounts Committee is clear that this will work only if it is backed by sustainable funding. I will give the Minister another chance to answer the question: will the Government ensure that the extra funding that has been put into the Department is actually reflected in extra funding for NHS dentistry?
Stephen Kinnock
One thing that I made clear to officials when I came into this post was that every penny that is allocated to NHS dentistry must be spent on NHS dentistry. We are in a crazy situation where demand for NHS dentistry is going through the roof, yet we have had underspends. That needs to stop. We will focus the spending on where it is most needed, including areas that are under-served, such as the hon. Gentleman’s constituency.
Oral Answers to Questions
Debate between Stephen Kinnock and Adrian Ramsay(7 months, 3 weeks ago)
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Stephen Kinnock
We have provided hospices in England with a record £100 million in capital funding, as my hon. Friend will know. ICBs are responsible for commissioning palliative and end-of-life care services, including hospices, to meet the needs of their local populations. NHS England has published statutory guidance to support that. I would of course be more than happy to meet my hon. Friend to discuss that further.
Adrian Ramsay (Waveney Valley) (Green)
The British Dental Association recently published analysis showing that the proportion of NHS funding spent on dentistry more than halved under the Conservatives, who failed to account for inflation and demand to the cost of £1 billion. It is no wonder that we have dental deserts across much of the country. Will the Secretary of State ensure that dentistry receives its fair share of funding from the new NHS funding allocated in the spending review?
Stephen Kinnock
The hon. Gentleman is absolutely right to point to the neglect and incompetence of the past 14 years. We are fighting to get NHS dentistry back to where it needs to be. An important first step, of course, is the 700,000 additional urgent appointments and supervised tooth-brushing programme, but long-term contract reform is what is needed, alongside the investment that will come through the spending review.
Dental Healthcare: East Anglia
Debate between Stephen Kinnock and Adrian Ramsay(1 year, 1 month ago)
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The Minister for Care (Stephen Kinnock)
It is a pleasure to serve under your chairship, Mr Dowd. I thank the hon. Member for Broadland and Fakenham (Jerome Mayhew) for securing this vital debate on dental healthcare provision in East Anglia, and I thank hon. Members on both sides of the House for their important interventions.
The debate follows hot on the heels of a debate on 3 September that my hon. Friend the Member for Norwich South (Clive Lewis) led on healthcare provision in the east of England. We know that huge swathes of the region are dental deserts. These areas are facing great pressures from challenges in the recruitment and retention of dentists, leaving patients struggling to access the NHS dental treatments that they need. As has been pointed out, it is a scandal—frankly, it is Dickensian—that the No. 1 reason for children aged five to nine to be admitted to hospital in our country in 2024 is to have rotten teeth removed.
Norfolk and Waveney integrated care board had 31.5 dentists per 100,000 of the population in 2023-24, which is the lowest number in England. That is why I have met with colleagues from the east of England, including the hon. Member for Broadland and Fakenham, to discuss the specific challenges in the region and to discuss the University of East Anglia’s plans to open a dental school. The UEA’s proposal to begin training dental students is very welcome news. As I said to all the colleagues I met recently, and to the hon. Gentleman at oral questions last month, the Government strongly encourage the UEA to continue its progress towards establishing a dental school by submitting its bid to the General Dental Council as rapidly as possible.
The independent Office for Students is another key player. It has statutory responsibility for allocating funded training places to dental schools. As the hon. Gentleman has pointed out, the OfS is independent from the Government. I cannot make specific commitments about allocating additional training places for future years, because to do so would be to cut across the independence of the OfS. The OfS makes decisions based on its own assessments, following guidance issued by Government. What I can say to the hon. Gentleman is that our guidance is influential, but I cannot guarantee its outcome.
The guidance for the 2026 academic year will be published in due course. Provided that the UEA meets those requirements, it would absolutely be considered for Government-funded dental training places. That would certainly help to retain local dentists in East Anglia. As a Member for a rural constituency, I absolutely understand how important that is to the hon. Gentleman and to the many other hon. Members present who represent his part of the country.
We also need a clear-headed diagnosis of where we are. It is beyond doubt that NHS dentistry was left in an appalling state of disrepair by the previous Government. As the Prime Minister said last week, the precious contract between the state and the British people has been broken. He rightly said that our public services are
“in crisis, unable to perform their basic functions”
and that they are
“unable to provide the timely care and dignity that Britain relies on”.
Almost five years on from the beginning of the pandemic, NHS dentistry has still not recovered to pre-pandemic levels. Only 40% of adults were seen by an NHS dentist in the 24 months to June this year, down from almost 50% before the pandemic. Although 34 million courses of dental treatment were delivered in England in 2023-24, that is down from almost 40 million courses five years ago. As I say, it is disgraceful that having rotten teeth removed is the single most common cause of hospital admissions for children aged five to nine, causing them untold pain and suffering and affecting their ability to sleep, speak and socialise.
On the subject of the general state of dentistry, I thank the National Audit Office for its recent investigation of the previous Government’s dental recovery plan. Its report lays out in black and white something that was already apparent to millions of people across the length and breadth of our country: the dental recovery plan that we inherited did not go far enough. We are reflecting on every line of the NAO report as part of our efforts to rebuild dentistry, get it back on its feet and make it fit to serve people of all ages. We have launched the largest ever national conversation to inform our 10-year plan to reform the NHS, and our workforce will play a central role, because they are key to unlocking improvements across our communities.
The golden hello scheme offers dentists £20,000 to work in underserved areas of the country for three years. The recruitment process is well under way, with posts being filled by dentists in those areas as we speak. As of 7 November, 64 posts had been advertised. Our manifesto pledged 700,000 more urgent dental appointments, and we are working to ensure that patients can start to access them as soon as possible. They will be targeted at the areas that need them most.
Strengthening the workforce is key to our ambitions, but for years dentistry has faced chronic workforce shortages. We have to be honest that bringing in the staff we need will take time. To rebuild dentistry in the long term and increase access to NHS dental care, we will reform the dental contract with a shift to focusing on prevention and the retention of NHS dentists. There are no perfect payment systems, and careful consideration needs to be given to any potential changes to the complex dental system, so that we deliver a system that is better for patients and the profession.
Adrian Ramsay
I thank the Minister for reiterating the Government’s commitment to reforming the dental contract. Please will he set out a timescale for that work commencing?
Stephen Kinnock
I was just going to say that we are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition to improve access for NHS dental patients. We are working on this as a matter of urgency. I cannot give a specific timeframe, but it is a top priority for the Department.