NHS Dentists: South-West England

Tim Farron Excerpts

Wednesday 24th May 2023 Westminster Hall

[Tim Farron (Westmorland and Lonsdale) (LD)]

It is a pleasure to serve under your chairmanship, Ms Elliot. I congratulate the hon. Member for West Dorset (Chris Loder) on securing an important debate and opening it very well. Access to NHS dentistry is becoming harder across the country, but, as we can sense from the contributions we have heard, especially so in rural communities such as those in Cornwall, Devon, Somerset, and Dorset, as well as in areas such as my own, in Cumbria.

Rural communities struggle more than others with access to dentistry because of pressures such as high housing costs and lower working-age populations, which mean there is a smaller dental workforce. Access to dental care in rural communities is also worse because we are dealing with sparsely populated areas and fewer economies of scale are available for the surgeries in question. There is the additional and crucial matter of the physical distances that people have to travel to receive treatment. Last week, I did a quick search and found that for a family in Coniston in my community the nearest available NHS dental place was in Hexham in Northumberland, which is a 160-mile round trip.

Every month it seems that we lose another NHS dental practice. I am sure that is the case for Members in every part of the country—from the contributions so far, especially in the south-west. I have recently lost a surgery in my community that saw 5,800 patients lose their NHS status overnight. The private plan that those patients were offered to replace those places would have cost a family of four £1,000 a year just to stay registered and on the books. With increasing prices, such as the rise in mortgage costs, rental costs, fuel duty and food—the cost of just living in any respect—how is that acceptable or affordable, given that that family, like everybody here, have already paid for their NHS dentistry through taxes?

People across our country have paid for a service, as my hon. Friend the Member for Tiverton and Honiton (Richard Foord) said, that the Government have not delivered. It is about not just the financial costs to families if they have to go private when an NHS dental service is no longer available but the physical pain, the anxiety and the sense of guilt, for parents, that their child is not seeing a dentist because they cannot afford to send them because NHS dentistry is not available. My hon. Friend the Member for Bath (Wera Hobhouse) talked about oral cancers and the fact that many dentists are the first to spot them and provide life-saving treatment.

For what it is worth, I do not blame the dentists, because I speak to so many of them. They are as angry as the rest of us, for many reasons. First, the Government take the public’s money but do not pass it on to the dentists. There is not enough money in the system, as the hon. Member for South Dorset (Richard Drax) wisely pointed out. That is true nationally, but it is also true surgery by surgery. Dentists tell me that it is often the case that the Government’s funding per unit of dental activity may be less than what a patient paid over the counter for their treatment. Dentists and patients, then, are both being ripped off.

A unit of dental activity payment, at the most basic level, could net perhaps £20 or £30 for a single examination. Diligent dentists seeking to do a good job might do three of those in an hour. Let us do the maths—that funding is not enough to pay to keep the lights and heating on, pay the rent and pay for staff salaries and materials. Many dentists feel that treating patients at a good standard therefore costs them and their practice more money, and that they have to subsidise the NHS. There are incentives to cut corners, to be on a treadmill, to rush through more patients and to do a job that the dentists themselves feel professionally dissatisfied with. As we have heard, good dentists who are committed to the NHS find that they cannot afford to stay, so they leave and it breaks their heart. That leaves thousands of our constituents without access to adequate, affordable dental care, which leads to more expensive, painful and damaging emergency hospital dental care further down the line.

There are many things that we can do as local MPs. I have written to my local surgeries to encourage them to take advantage of things that the integrated care system has offered to bring some back to the NHS, but unless there is radical reform of the system, good dentists will leave the NHS and thousands on thousands of our constituents will not be able to access the dental care that they have already paid for through their taxes for themselves and their children.