NHS Dentistry: South-west

Steve Race Excerpts

Tuesday 12th November 2024 Westminster Hall

[Steve Race (Exeter) (Lab)]

I am here to speak on behalf of Exeter residents about the parlous state of NHS dentistry in our city after 14 years of the Tory Government, who allowed NHS dentistry to fall into complete disrepair.

We have heard that the south-west is one of the most notorious dental deserts, but most troubling is the proportion of children who get to see a dentist. In Devon, it has dropped by a fifth, from about 61% of children in 2016 to 47% in 2024, well below the English average of 55%. The reality is truly shocking. Across the country, tooth decay is now the No. 1 reason why children are admitted to hospital, and more than 40,000 children in 2021-22 had teeth removed at hospitals across the UK. That is the case in Exeter too. The Royal Devon University Healthcare NHS foundation trust states in its annual accounts that tooth decay is still the most common reason for hospital admission in children aged between six and 10 years old. According to the oral health survey of five-year-old children, more than a fifth of children in Exeter—22%—have tooth decay by the time they are five.

I talked to one of my local primary schools in preparation for this debate, to get the views of its staff. They said that they know of multiple children who have had teeth removed due to a lack of dentistry and then had to miss school. Some children have joined reception with all of their teeth brown or blackened stumps. Children are missing school due to being in agony from toothache and having no dentist, and many families—and indeed teachers—are unable to find an NHS dentist that will take them on. It is truly shocking, and, as with many things, our primary schools do what they can to pick up the slack. This primary school already teaches children how to brush their teeth, and they do so each day in reception. Exeter’s NHS dentist crisis is not just having a detrimental impact on people’s teeth and health; it is having a detrimental impact on children’s education and on our economy. It is also having a detrimental impact on our local A&E department, which is already stretched to capacity. Tooth decay forced 740 patients to attend the emergency department between April 2022 and March 2023, according to NHS Digital data.

Comparing NHS regions, those in the south-west and south-east were least likely to have an NHS dentist and most likely to have a private one. Given that the cost of simply being accepted on to a private dentistry register can be upwards of £70 a month for a small family, before treatments are added in, this is clearly a cost of living issue for many.

As referenced already, the NHS dental budget across the south-west is underspent by more than £86 million in the financial year 2023-24. That is not due to any lack of demand, of course, but largely due to dental practices being unable to work under the current NHS contract, which simply does not cover the cost of treatment. We are asking dentists to deliver NHS services at a loss, which is clearly unsustainable.

Instead of seeking to provide flexibility in the dental contract, as I know some integrated care systems do across the country, Devon ICB simply reallocates that dental funding elsewhere in the budget, despite the fact that it is supposed to be ringfenced. That is causing us further issues in Devon, as the BDA informs me that dentists are leaving the NHS in droves. In Devon, we saw a 9% drop in the number of NHS dentists last year alone.

My residents welcome the Labour Government’s pledge to provide an extra 700,000 urgent dentists’ appointments and to reform the NHS dental contract, as part of a package of measures to rescue NHS dentistry. I know the Department is working at pace to roll out those extra, urgent dental appointments, and to pave the way for a new reformed dental contract.

I met the chair of the BDA recently to talk about Exeter specifically; he stressed that NHS dentists, who are stung by the many broken promises from the previous Government, need the Labour Government to deliver meaningful change, including a clear timeline for negotiations. I know the Government treat NHS dentistry extremely seriously—the Health Secretary made the BDA the first organisation he met after the election—and I was pleased to hear the Prime Minister say recently at Prime Minister’s questions that he would work as quickly as possible to end the current crisis. Given what I know and what we have heard today, for my constituents in Exeter that change cannot come soon enough.