NHS Dentistry

Steve Brine Excerpts

Tuesday 9th January 2024 Commons Chamber

[Steve Brine (Winchester) (Con)]

Last July, the Health and Social Care Committee, which I chair, published an important report on NHS dentistry, and I urge colleagues to read it if they have not already done so—it has been mentioned a few times. That inquiry was more necessary than ever, and I would argue that the issues our constituents face in accessing an NHS dentist now are a greater challenge for my Front-Bench colleagues than the much higher-profile health promise to “cut the waiting list” that features in the Prime Minister’s five pledges. I say that because every Member faces this challenge. The Secretary of State’s amendment rightly references the pandemic and the massive impact it has had on dentistry; to ignore that is to ignore basic facts. Our Committee concluded that NHS dentistry is facing a crisis of access—no understatement—resulting in a decline in oral health.

Our report was described by the British Dental Association as

“an instruction manual to save NHS dentistry.”

Based on the evidence—I stress the word evidence—received by the cross-party Committee, it sets out what the Government should do to address the crisis. I thank the Secretary of State for coming before the Committee just before Christmas and for ensuring that we received a formal response to our report, albeit a few weeks later than I would have liked.

The motion proposed by the Labour party today contains some reasonable parts: it is obvious that some people are resorting to DIY dentistry and it is a fact that some people are attending A&E because of dental challenges. The Opposition talk about the provision of 700,000 urgent appointments a year, but I cannot support the motion because I hear no detail or explanation about how that will be done, who the dentists are who will fulfil all those appointments or where they will happen. The Opposition talk about recruiting new dentists to the areas that are most in need but, as the Secretary of State said in her opening remarks, we are increasing dentistry training places by 40% as part of the NHS long-term workforce plan, which is the biggest expansion of places on record. That is important and should be recognised, as it was from the Government Dispatch Box.

When giving evidence to the Select Committee’s inquiry, the then Parliamentary Under-Secretary, my hon. Friend the Member for Harborough (Neil O’Brien), described the Government’s ambition for NHS dentistry, saying:

“We do want everyone who needs one to be able to access an NHS dentist—absolutely”

The Committee welcomed that ambition but, if I am honest, we were surprised by it. In their most optimistic reading of the reality on the ground, what leads the new ministerial team to believe that that is deliverable? When she sums up, will the Minister repeat that ambition, as her predecessor did?

Do not get me wrong, Madam Deputy Speaker: I absolutely believe that everyone should be able to access an NHS dentist when they need one, wherever they live, but given the reality of where we are now, I question whether that is possible. In our report, we asked the Government to set out how they intend to realise that ambition and the timeline for delivery as a matter of urgency. They accepted the recommendation, but the detail, as we have heard, is still lacking. Now is the time, please.

Let me touch on the dental contract. It is right to recognise that action has been taken. Some initial changes were made to the dental contract in July 2022, and we had assurances of fundamental reform from the then Minister, and again from his successor as Minister responsible for dentistry, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), who is on the Treasury Bench.

My Committee believes that a fundamentally reformed contract must be implemented at the earliest possible stage. It has to represent a full move away from the current system of units of dental activity—UDAs—in favour of a weighted capitation-based system that provides financial incentives for seeing new patients and those with greater dental need, and in turn prioritises prevention and person-centred care. Failure to do so risks more dentists stopping NHS work, or not starting it, and exacerbating the issues that my constituents are experiencing with accessing care.

As I have said in the House before, my dentist recently gave up NHS work, which was a big, emotional decision for her. Any reform to the contracts now is too late for her. The Opposition and the Government have to work out how they are going to get people to come back to NHS dentistry, and reform the contract to stop more people accessing the exit door.

It is not just about contract reform: workplace reform is greatly important. We did not get significant acknowledgement of the lack of accurate data about the dental workforce in our report, so will Ministers revisit that? There were many other recommendations that I do not have time to go into today, but the report is available, as is the Government’s response.

The Secretary of State has made a good start and said she has begun to lay the foundations of change. I am encouraged by that but, to my Committee’s continued frustration, there is still no date for the publication of the dental recovery plan. If we do not solve this crisis, we will continue to hear about it in the House and from constituents. The crisis places additional pressures on already stretched services. Today is too late for dentists who are thinking of leaving and for patients who have run out of options. We need a short-term set of actions for constituents who are suffering pain today, and we need a fully reformed dental recovery plan hot on its heels. There cannot be any further delay.