NHS Dentistry: South-west

Tom Hayes Excerpts

Tuesday 12th November 2024 Westminster Hall

[Tom Hayes (Bournemouth East) (Lab)]

My constituent Jonathon Carr-Brown recently went to his dentist for a routine check-up. Dr King seated him in the dentist’s chair, as he had done many times before, and felt his throat, as he had done many times before. Unlike those other times, Dr King found something: he found a lump. After that visit to Bournemouth dental centre and further investigations, a tumour was identified.

I saw Jonathon at the weekend. He had just completed a course of chemotherapy, because his dentist had helped to spot cancer. He was doing well: he was a little tired following his treatment, but he was not too tired to talk passionately about the importance of dentistry within our wider healthcare and about how more lives could be saved with the right changes by our Labour Government.

Jonathon’s story shows the potential of so many things, including co-location, the promise of innovation and the possibilities of integration. Imagine if Jonathon had been able to go up the corridor to get diagnosed even faster and receive the right kind of support even faster. Jonathon’s story shows the power of prevention. There are so many people in Bournemouth East who are struggling to get the routine appointments that could spot problems and fix them sooner.

Of course we need more appointments and of course we need more workers, but we also need a rethink of who does what. In my constituency, as elsewhere, I know the potential for local hygienists and therapists to use the full scope of their practice, and indeed for Bournemouth to pilot a new model of therapy-led practices, with dentists covering only the work that sits outside scope.

I would welcome investment in the training and development of an oral health team who could learn by doing, providing clinical and preventive services to people who need them. Right now, Health Sciences University in Boscombe could help to increase local people’s access to oral health care by training even more professionals for the future and getting support to people who need it, bringing down the waiting list while also training people up and particularly providing outreach in areas of deprivation.

There are so many areas of policy that we could focus on. I would love to talk at length about the reform of the dental contract, but in the hope that colleagues will do so, I will focus instead on the importance of empowering people by giving them accurate and clear information about NHS dentistry.

The NHS app and the nhs.uk website are managed by NHS Digital and the NHS Business Services Authority—I said “NHS” quite a lot there. It is the responsibility of NHS contractors to update for their specific provision. That means that there is no kind of oversight or meaningful guarantee of accuracy of information.

In April, before the general election, my team rang around all the surgeries in Bournemouth that were offering spaces to new NHS patients. They discovered that many had not updated their details, sometimes for years. Since then, there have been a small number of updates, perhaps prompted by my team’s calls. However, most of the surgeries that were recently showing as not having updated their details were private. They were only offering private appointments and seemed baffled to be rung by somebody looking for NHS care.

It is not just that time-poor people who are desperate for dental care might be accessing incorrect information. It struck me and my team that people could be ringing surgeries listed on NHS platforms for NHS care—they are not listed as private dental providers. When those people are unable to access NHS care, they may be so desperate for any kind of care that they will buy into private dental provision.

When we checked it out with the NHS, it had no way of determining whether patients commit to private dental provision, or what service members of the public may be offered. We were told that although so many private surgeries were not listed as private on the website and digital platforms, the NHS could not comment on the advertising of private dental providers. In April, under the Conservative Government, we discovered that there were no new NHS places available in a dental surgery in Bournemouth. Things have improved slightly since then, but only slightly.

We need to improve the accuracy of the information that we provide to our public by putting in place the right mechanisms. We need to strengthen our digital platforms to ensure that citizens can book appointments, get personalised notifications to book routine check-ups and compare waiting times and patient satisfaction scores.

Lastly, we need a digital health record as a single source of truth about someone’s health. That information is fragmented across pharmacies, GP surgeries, dental practices, hospitals and people’s phones. How much better would it be to bring that information together so that someone’s medical record is in hand and complete when they are seen? That would allow them to be seen by the right person at the right time in the right setting.

Our NHS was founded on the principle that health should not depend on wealth. However, people who can pay are paying. The use of private healthcare will continue to rocket, perhaps even through unintended encouragement on NHS platforms, unless we co-locate, innovate and integrate.

A healthy population will unlock a stronger Britain. I look forward to supporting the Government in their efforts to change our NHS and our NHS dentistry, so that they can survive and serve our public.

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Mr Vickers. I congratulate the hon. Member for Honiton and Sidmouth (Richard Foord) on securing a debate on this important subject, starting at the significant time of two-thirty—I thought that was particularly skilled of him. [Laughter.] I thought you would like that one, Mr Vickers.

Nobody should have painful teeth and nobody should have difficulty accessing an NHS dentist. Lincolnshire, which is home to my constituency, suffers similar challenges with access to NHS dentistry; indeed, I led an Adjournment debate on the topic in October 2021. It has been pointed out that the number of dentists is not the issue; in fact, we have more dentists per capita than we did 10 years ago. Rather, dentists are either in the wrong place—concentrated in urban rather than rural and coastal areas—or they do not perform NHS work, for a variety of reasons. That leads to the underspend that has been described.

There has been some progress, with 500 more practices accepting NHS patients as a result of the dental recovery plan, and 6 million more dental treatment processes completed in 2023 than in 2021-22. One thing that helped with that was the patient premium for new patients, who are more likely than repeat patients to have a problem with their teeth that requires treatment. They are also more expensive for dentists to treat, so the current contract disincentivises the seeing of new patients. The patient premium is funded until April 2025. Will the Minister say whether he plans to continue it beyond that date? Another help has been the golden hello of up to £20,000 for dentists working in underserved areas, including the south-west, the midlands and East Anglia. Will the Minister say whether that scheme will continue?

A number of hon. Members have mentioned a long-term workforce plan. There are already additional dental training places in the south-west, but, as my hon. Friend the Member for South West Devon (Rebecca Smith) pointed out, there can be challenges in the way the training is organised, which means that people do not stay in the local area—although more do stay than if they had been trained elsewhere. Will the Minister look in detail at the problems my hon. Friend raised?

Ultimately, we have more dentists than ever before, but private dentistry is much more lucrative than NHS dentistry, and the NHS contract is complicated, offers disincentives and needs reform. The previous Government began reforming the 2006 contract by increasing the UDA rate to £28 as a minimum. The Labour party had a manifesto promise to negotiate with the BDA. Will the Minister confirm if negotiations have started and, if they have not, when he expects them to start?

[Tom Hayes]

I have just been rereading the 2010 Conservative manifesto—a delightful read. On page 47, it promises full dental contract reform. I then looked at comments by Conservative Ministers in 2024, when they promised to “consider” dental contract reform. Can the hon. Lady explain why no meaningful reform happened over those 14 years of Conservative government?