NHS Dentistry: Recovery and Reform

Victoria Atkins Excerpts

Wednesday 7th February 2024 Commons Chamber

[The Secretary of State for Health and Social Care (Victoria Atkins)]

With your permission, Mr Speaker, I would like to make a statement on our plan to recover and reform NHS dentistry. First, though, on behalf of the entire House and my Department, I send our very best wishes to His Majesty the King. His decision to share his diagnosis will be welcomed by anyone whose life has been touched by cancer, and I know that we are all very much looking forward to seeing him make a speedy recovery and resume his public duties.

Thanks to a once-in-a-generation pandemic, 7 million patients across England did not come forward for appointments with NHS dentists between 2020 and 2022. Since then, we have taken decisive action to recover services: we have made reforms to the dental contract, so that practices are paid more fairly for caring for NHS patients with more complex needs; and we have made sure that dentists update the NHS website regularly so that the public know that they are taking on new patients. That has delivered results, with more than 1 million more people seeing an NHS dentist last year than in the year before. However, we know that too many, particularly those living in rural or coastal communities, are still struggling to find appointments. This recovery plan will put that right by making NHS dental care faster, simpler, and fairer for patients and staff. It is built on three key pillars, which I will address in turn.

First, we will help anyone who needs to see an NHS dentist to do so, wherever they live and whatever their background. To do this, we must incentivise dentists across the country to care for more NHS patients. That is why I am delighted to tell the House that for the coming year, we are offering dentists two new payments on top of their usual payments for care—£15 for every check-up they perform on NHS patients who have not been seen over the past two years, and £50 for every new NHS patient they treat who has not been seen over the same period—because we know that patients who do not have a relationship with a dentist find it harder to get care. That is not a long-term ambition: our new patient premium will be available from next month.

We are also increasing the minimum payment that dentists receive for delivering NHS treatments, which will support practices with the lowest unit of dental activity rates to provide more NHS care. However, we know that in many of our rural, remote and isolated communities, dentists themselves are in short supply. That is why starting this year, up to 240 dentists will receive golden hello payments worth up to £20,000 when they commit themselves to working in one of those areas for at least three years. These dentists will give patients the care they need faster, make dental provision fairer and tackle health inequalities.

We are also delivering dentistry to our most remote regions without delay. This year, we will deploy dental vans to more isolated, rural and coastal areas. Staffed by NHS dentists, they will offer check-ups and simple treatments such as fillings. This model has been a tried and tested success across many regions. For example, last year in Cornwall, a mobile van visited five harbours, treating more than 100 fishermen and their families. We will be rolling out up to 15 vans across Devon, Gloucestershire, Somerset, Norfolk, Suffolk, Lincolnshire, Cambridgeshire, Dorset, Cornwall, North Yorkshire and Northamptonshire. This move has been welcomed by Healthwatch, the Nuffield Trust and the College of General Dentistry. We will let patients know when vans will be in their area, so they can get the care they need faster.

These reforms will empower NHS dentists to treat more than 1 million people and deliver 2.5 million more appointments. As the chief executive of National Voices, a group of major health and care charities, said:

“This extra money…should help thousands of people who have been unable to see a dentist in the last two years to get the care they need.”

These reforms are just the beginning. This recovery plan will also drive forward reforms to make NHS dentistry sustainable for our children and our grandchildren.

That brings me to the second pillar: growing and upskilling our workforce for the long term. Our long-term workforce plan, the first in NHS history, gives us strong foundations on which to build. By 2031, training places for dentists will increase by 40%—forty per cent—and places for dental hygienists and therapists, who can perform simple tasks such as fillings, will also rise by 40%. More dentists and more dental therapists will mean more care for NHS patients.

I am delighted to tell the House today that we are going further in three key ways. First, we will consult on a tie-in to NHS work for dentistry graduates, because right now too many are choosing to deliver private work over valuable NHS care. More than 35,000 dentists in England are registered with the General Dental Council, but last year almost a third worked exclusively in the private sector. Training these dentists is a significant investment for taxpayers, and they rightly expect it to result in the strongest possible NHS care. That is why, this spring, we will launch a consultation on a tie-in for graduate dentists and how this could deliver more NHS care and better value for taxpayers.

Secondly, we will take full advantage of our dental professionals’ skills. Today, even though they have the right training, without written direction from a dentist dental therapists cannot do things such as administer antibiotics. This year, we will change this, making life simpler for dentists and making care faster for patients. As the president of the College of General Dentistry has said, the

“use of the full range of skills of all team members will enable the delivery of more care and make NHS dentistry more attractive to dental professionals.”

Thirdly, we will recruit more international dentists to the NHS. We have a plan to do this by working with the General Dental Council to get more international dentists taking exams and to get them on to the register sooner, and to explore the creation of a new provisional registration status so that, under the supervision of a dentist who is already on the register, highly skilled international dentists can start treating patients sooner, rather than working as hygienists while they are waiting to join the register.

I turn now to our plan’s third pillar, which is prioritising prevention and giving children a healthy smile for life. This begins by supporting parents to give their children the best possible start. That is why family hubs up and down the country will offer parents-to-be expert advice on looking after their baby’s teeth and gums. As those babies grow up, we will support parents and nurseries in making sure that before every child starts primary school, brushing their teeth is part of their routine.

The evidence is clear: the earlier good habits are built, the longer they will last. Seeing a dentist regularly is vital for children’s health, but since the pandemic, too many have been unable to do that. That is why this year we are taking care directly to children. We will deploy mobile dental teams to schools in areas with a shortage of NHS dentists. They will apply a preventive fluoride varnish to more than 165,000 reception-age children’s teeth, strengthening them early and preventing decay. Our Smile for Life programme has already been endorsed by the College of General Dentistry.

Six million people in England already benefit from water fluoridation. In order to go further in protecting children’s teeth, we will consult on strengthening more of our country’s water with fluoride. Again, the evidence is clear: in some of the most deprived parts of England, enhancing fluoride levels could reduce by up to 56% the number of teeth that are extracted because of decay. That is why, through the Health and Care Act 2022, we have made it simpler to add fluoride to more of our water supply. As a first step, this year we will launch a consultation on expanding water fluoridation across the north-east—an expansion that would give 1.6 million more people access to water that strengthens their teeth, preventing tooth decay and tackling inequality.

This is our Government’s plan to recover and reform dental care: dental training places up by 40%; 2.5 million more appointments; dental vans treating more patients; more dentists in remote areas; more dentists taking on NHS patients; better support for families and better care for children; patient access up and inequity coming down. It will make life simpler for staff, and treatment faster and fairer for patients and staff. We have taken the difficult decisions, and we have now delivered a long-term plan to make dental care faster, simpler, and fairer for people across the country. We are going to get on with the job and put our plan into action, and I commend this statement to the House.

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[Wes Streeting]

Don’t worry, Mr Speaker: I will come back to the Parliamentary Private Secretary shortly. Tooth decay is the No.1 reason for children aged six to 10 being admitted to hospital. Unbelievably, there have been reports of Ukrainian refugees booking dentist appointments back home and returning for treatment, because it is easier to fly to a war-torn country than it is to see an NHS dentist in England. Well, at least one Government policy is getting flights off the ground—and it is certainly not the Government’s Rwanda scheme failure.

Let us look at the human consequences of this Conservative tragedy. Labour’s candidate in Great Yarmouth, Keir Cozens, told me about Jeanette, a young woman in her 30s who has struggled with gum and mouth problems all her life. She used to be able to get treatment; now she cannot find an NHS dentist in all of Norfolk to take her. She cannot afford to go private. It hurts to smile, it hurts to laugh, and the pain is so great that Jeanette does not go out anymore. Just this week, she resorted to trying to remove her tooth herself. That is not right for anyone of any age, but Jeanette should be in the prime of her life. Will the Secretary of State apologise to Jeanette and the millions like her for what the Conservatives have done to NHS dentistry?

After 14 years of neglect, cuts and incompetence, the Government have today announced a policy of more appointments, recruiting dentists to the areas most in need and toothbrushing for children. It sounds awfully familiar. They are adopting much of Labour’s rescue plan for dentistry. Does that not show that the Conservatives are out of ideas of their own, and are looking to Labour to fix the mess they have made? I say: next time Conservative Ministers say that Labour does not have a plan, or that Labour’s plan is not credible, don’t believe a word of it.

There are some differences between our two parties’ approaches. Labour is pledging an extra 700,000 urgent and emergency appointments, which are additional to the appointments announced today. Can the Health Secretary confirm that the Government’s plan does not provide any additional emergency support? Labour proposed supervised early-years toothbrushing, and Conservative MPs accused it of being “nanny state”. Does the Health Secretary stand by that label, or does she now support children under five being supported in brushing their teeth?

The key difference is that we recognise that our plan is a rescue plan, and that to put NHS dentistry back on its feet, immediate reform of the dental contract is needed. Without that, the Government’s plan is doomed to fail. Do not just take my word for it; the British Dental Association has said that the plan will not stop the exodus of dentists from the NHS, will not provide a dentist for every patient who needs one, and will not put an end to this crisis.

I come to the Parliamentary Private Secretary, the hon. Member for North Norfolk (Duncan Baker), and the miserable script that the Whips are spreading out on the Table. If Labour’s contract is to blame, why have the Government not reformed it in 14 years, and why are they not reforming it now? In 2010, the Conservatives promised in their election manifesto to reform the dental contract. They are bringing back not just Lord Cameron, but his broken promises. People have been desperately trying to get dental care for years, but there was nothing from the Conservative party. Now that we are in an election year, the Conservatives are trying to kick the can down the road, and are scrambling for a plan. They only discover their heart when they fear in their heart for their political futures, and the consequences have been seen: queues around the block in Bristol.

Finally, the Secretary of State is promising reform after 2025 and after the next general election. Who is she trying to kid? After 2025, the Conservatives will be gone, and if they are not, NHS dentistry will be. How many more chances do they expect? How many more broken promises will there be? We had 2010, 2015, 2017 and 2019. Their time is up, and it is time for Labour to deliver the change that this country needs.

[Victoria Atkins]

I tried to help the hon. Gentleman by giving him an advance copy of my speech yesterday, yet that was his speech. This Government are focused on delivering for patients. Perhaps I can help him understand the difference between the Opposition’s proposals and the Government’s fully funded dental recovery plan. The Opposition’s ambitions reach only as far as 700,000 more appointments. Our plan will provide more than three times that number of appointments across the country—that is 2.5 million, to help him with his maths. We are offering golden hellos to 240 dentists who will work in hard-to-reach and under-served areas; their proposals cover only 200. They have no plan for training more dentists; we set out in the long-term workforce plan last year, and again in the dental recovery plan, that we will increase training places for dentists by 40% by 2031.

Then we have the centrepiece of the Opposition’s proposals: making teachers swap their textbooks for toothbrushes—an idea that is hated by teachers and that patronises parents. We believe that most parents do a great job of looking after their children. I know that the Labour party does not agree with that; the hon. Gentleman called our children short and fat on a media round. We believe that most parents do a great job, and that is why we support pregnant mums-to-be, and support parents in family hubs and nurseries. We will not wait until reception class, by which time children have already got their teeth.

I want to dwell on the experience of anybody living under Labour in Labour-run Wales. Health services in Wales are devolved, and the Leader of the Opposition has called Wales “the blueprint” for how the Opposition will run our health system. Welsh Labour has the highest proportion of NHS dental practices not accepting new adult patients, and the joint highest proportion of those not accepting new child patients. In Wales, 93% of NHS dental practices are not accepting new adult patients. That is a higher figure than for any other nation in the UK. Some 86% of practices there are not accepting new child patients, which is the joint highest figure with Northern Ireland. Our plan is fully funded, but how will Labour pay for its plan? By using the magical money tree. The list of policies funded by the non-dom policy is as long as my arm. In 2022, it promised to fund a workforce plan. Last September, it became breakfast club meals. By October, it morphed into 2 million appointments and scanning equipment. By Christmas, it was funding a dentistry plan. It is the same old Labour: it has no plan.

[Mr Speaker]

I call the Father of the House.

[Sir Peter Bottomley (Worthing West) (Con)]

The House enjoyed the words of the Opposition spokesman, the hon. Member for Ilford North (Wes Streeting), although I am not sure how many he wrote himself; some may have seemed rather familiar to anyone who read Matthew Parris this morning on going to Ukraine to have a filling fixed.

In West Sussex, in Worthing and Arun, we want the same situation found in parts of London, where dentists have a sign saying, “New NHS patients welcome”. Has the Secretary of State been working with the British Dental Association and the General Dental Council to bring forward registrations, to get incentives right, and to make sure that dentists are no longer told, “You can’t serve any more patients because you will go above your limits”? Can she confirm that we are taking limits off, so that dentists, especially the young ones, can do as much work as they can, and can help as many patients as possible, so that we can get back to the situation that we were in before Labour changed the rules about 20 years ago?

[Victoria Atkins]

We have focused this plan on introducing the new patient premium—a bonus for new patients. Having discussed this carefully with professionals, we think that is one way that we can incentivise people into NHS practice. Dentists can already work up to 104% of the contract. Many do that, but some sadly do not, so we are trying to encourage those dentists who already have NHS contracts to go the extra mile and use the full slot available to them.

[Rachael Maskell (York Central) (Lab/Co-op)]

The Health and Social Care Committee took months gathering evidence and putting together a recovery plan, which the Government should have adopted. Dentists wanted that plan put in place. Central to it was reform of the NHS dental contract. However, the Secretary of State has completely failed to even mention reform of that contract. As a result, dentistry in my constituency in York, where constituents are waiting seven years to see a dentist, will not have the recovery that she talks about. Why did she not adopt our plan?

[Victoria Atkins]

I hope the hon. Lady will, as usual, be the help that I expect her to be to her constituents in publicising this plan. We are getting graphics and information out to all Members of Parliament, so that they can help their constituents understand what will be available in their area, because each and every one of us wants the very best for our constituents. She will be interested in the new patient premium, which is encouraging dentists back into NHS practice, or into NHS practice for the first time, and in the increased price for units of dental activity. Reform of the dental contract is part of our agenda, but we realised that we needed to give immediate help to communities such as hers.

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[Steve Brine (Winchester) (Con)]

I welcome the plan. Recovery and reform is right, and the Select Committee will study the plan carefully. The dental Minister, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), has already been invited to come before us, so that we can talk it through with her to see whether it reflects our aforementioned report on the subject. The golden hellos, the toothbrushing for pre-schoolers—as long as the workforce can handle it—and the mobile vans are good, but even a day longer of a contract focused on units of dental activity is a problem. Can the Secretary of State say how she plans to entice professionals into returning to NHS dentistry? So many have left, and that is key.

[Victoria Atkins]

Very much so, and that will be primarily through the patient premium, which will mean that from next month dentists will be able to turn their signs from “closed” to “open” for NHS patients. We wanted to use levers that could be deployed immediately in order to help our constituents.

[Daisy Cooper (St Albans) (LD)]

It is estimated that more than 12 million people are waiting for dental treatment, but the Government’s announcement says that it will help just 1 million. The Government’s underspend last year was £400 million, and it is expected to be the same this year, but only £200 million has been announced. This plan is a drop in the ocean. In St Albans, my dentists are desperate to provide NHS care, and my constituents are desperate to see a dentist. At the heart of the problem is the broken contract. Will the Government take up the Liberal Democrats’ plan to reform the contract and provide guaranteed access to an NHS dentist for everybody needing urgent and emergency care?

[Victoria Atkins]

I heartily recommend the recovery plan to the hon. Lady, because it offers 2.5 million more appointments and has a long-term ambition for the prevention of tooth decay in children. In addition, it has that long-turn vision about increasing training places for our dental professionals by 40% by 2031.

[Sir Paul Beresford (Mole Valley) (Con)]

As you are aware, Mr Speaker, I have a declared interest in this particular topic.

As my right hon. Friend the Secretary of State is aware, dentistry in England is a seller’s market. It is estimated that there are 5,000 dentist vacancies in England. When I came here in the early ’70s with my dental degree, like very many colleagues from Australia, New Zealand and so on, I presented at the General Dental Council, who said “welcome” and stamped my hand, and I went off and worked on the national health service the next day.

Now, and for decades, the General Dental Council has required graduates from world-class dental schools—every bit as good as the ones we have here—to wait, to pay and to sit what is called an overseas registration exam. Currently, the waiting list for the exam is 2,000 overseas dental graduates, many of whom are every bit as good as those we produce in this country. The GDC could change that overnight by accepting graduates automatically from known and trusted international schools. Will my right hon. Friend please have a small chat with the chairman of the General Dental Council?

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[Victoria Atkins]

I thank my hon. Friend and recognise the enormous expertise he brings to the Chamber on this matter. He knows—he has genuinely talked to me about this on many occasions—the important role that the General Dental Council plays to ensure that we get international dentists registered as quickly as possible. I very much look forward to discussing that with the GDC so that we can get more international dentists on to our register and working in our practices.

[Judith Cummins (Bradford South) (Lab)]

I welcome much in the plan, which mirrors many of my ideas over the years, and indeed much in Labour’s plan. However, on access, the Government claim that the recovery plan will deliver care for up to 2.5 million people, but Government data shows that 12 million people in England have unmet dentistry needs, which leaves about 9.5 million people without an NHS dentist. That includes my constituent Beverley Kitson, who has osteoporosis and takes alendronic acid as treatment. The drug has damaged her teeth, and she now requires a check-up every three months after four of her teeth have decayed to such an extent that they need to be extracted. Beverley has been with the same dental practice for 50 years, but she has just been told that it is going fully private, leaving her without an NHS dentist. Will the Secretary of State guarantee Beverley that she will be able to access an NHS dentist under these plans?

[Victoria Atkins]

We have very much tried to ensure that dentists who already hold NHS contracts will keep them and keep working them. That is why we have fallen upon the new patient premium to make it more in their financial interests to take on new patients. I appreciate the hon. Lady’s point about retention, which, again, we are looking to address through the increase in the UDA. But we all acknowledge that dentists are independent contractors, so we must ask them—and particularly those who are new dental graduates—to do their bit and help our NHS out.

[Maggie Throup (Erewash) (Con)]

A number of NHS dentists across Erewash have recently retired, leaving a cohort of my constituents without access to NHS dentistry. Unfortunately, practices are finding it really difficult to recruit replacements for the retirees. How will the plan help speed up that recruitment so that my constituents are not without NHS dentistry for much longer?

[Victoria Atkins]

May I thank my hon. Friend for all the work she did in the Department and has done on this subject? We are taking a long-term view with training dentists. As I said, last year, through the long-term workforce plan, we set out an ambition to train up to 40% more dentists by 2031. As we also begin the consultation on a tie-in with those graduates, we are confident that we will see a greater supply of dentists to our NHS services.

[Mrs Paulette Hamilton (Birmingham, Erdington) (Lab)]

The £200 million pledged today is less than half last year’s record-breaking underspend. The plan says that any underspends will be ringfenced for dentistry. That was promised by a Minister last year, but it did not happen because integrated care boards were using that underspend. Why should the 73% of dentists in the west midlands who cannot and are not accepting any new patients believe it will be any different this year?

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[Victoria Atkins]

The hon. Lady alights on an important fact that is sometimes lost in this debate: although an NHS dentist may have an NHS contract, they may not work the whole of that contract. Some NHS dentists very much do so; others work a fraction of it. We are trying to encourage dentists who do not use their full contract to do so, because that in itself will bring in more patients. We are confident that alongside the new patient premium, that will help constituents such as hers to get the treatment they need.

[John Redwood (Wokingham) (Con)]

Wokingham has a fast-growing population based on building a lot of new homes. So as the Secretary of State rolls out her new plans, will she also ensure that there are incentives to provide dental services on the NHS in areas where a population is moving in and needs them?

[Victoria Atkins]

My right hon. Friend raises an interesting point. Indeed, that is exactly the sort of discussion I am having with my right hon. Friend the Levelling Up Secretary, because I am really interested in having that connected and joined-up approach between planning and health. I think it could bring dividends for us all.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I do not believe that what the Secretary of State has described will deal with the complexity of dental problems out there. I have a constituent who was referred to the Manchester Dental Hospital for a possible abscess and was told that even an urgent referral would take a month. In fact, the dental hospital did not get back to her for five months after the referral; it offered her a telephone consultation. The amount of pain and infection meant that she had to seek private treatment at a cost of £4,000, but many cannot afford that, including the young man wheeled into Royal Bolton Hospital in great pain, leaking blood on the floor after trying to remove a painful tooth with pliers. What does the Health Secretary say to patients who have long-standing and complex dental problems and are paying the price by waiting in pain, paying for private treatment or trying to remove their own teeth?

[Victoria Atkins]

I take that constituency case very seriously. I am really keen to urge the hon. Lady that if a constituent contacts her in future with that level of discomfort and pain, she should advise that constituent to contact 111 and, if necessary, go to accident and emergency—[Interruption.] Labour Members are shaking their heads, but what she has just described is a serious situation. That constituent needs medical attention, and the NHS is there, ready and willing to help. That is the advice that she should be giving her constituents, and I hope that she takes it as seriously as I do. [Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The Secretary of State was giving an answer to a question. We do not need all this shouting. People might not agree with the answer, but you have to listen to the answer.

[Sir John Hayes (South Holland and The Deepings) (Con)]

In congratulating my right hon. Friend—my personal friend—on this welcome, excellent statement, may I ask her to forgive the ferocity with which my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) and I made the case for NHS dentistry when we met her recently? In that spirit, will she ensure that some of these new dentists come to rural Lincolnshire, where we desperately need good dental care? She has today irrigated the dental desert.

[Victoria Atkins]

I give my very sincere thanks to my right hon. Friend. The House can imagine the advocacy I have received from both him and my right hon. Friend the Member for Gainsborough (Sir Edward Leigh). On reaching rural and coastal areas, as a proud Lincolnshire MP myself I wanted to bring about a set of plans that will address those underserved areas. I am delighted that the plan meets with my right hon. Friend’s approval.

[Sir George Howarth (Knowsley) (Lab)]

The Secretary of State will be aware that the NHS dentistry crisis has been 14 years in the making. She will also be aware that it is impossible for anybody in Knowsley today to sign up with an NHS dentist. The measures the Secretary of State has described may, over time, help to meet the problem, but what advice would she give today to my constituents who cannot get an NHS dentist?

[Victoria Atkins]

The advice and guidance to dentists will be going out today, while the new patient premium that I have told the House about will come in from March—it is weeks away.

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

I thank my right hon. Friend the Secretary of State for an excellent statement and an excellent plan. It is exactly what patients in Suffolk have been waiting to hear—the rural payment, the bonus there and the mobile service. I am conscious that many dentists have chosen not to have more patients, and they might blame the contract—this, that or the other. That is why I welcome her plan about potentially tying in graduates to the NHS. My hon. Friend the Member for Mole Valley (Sir Paul Beresford) has already referred to the General Dental Council, which, in my view, has not taken full advantage of the regulations that came into force last March. Will the Secretary of State also look at the NHS’s own rules that further restrict the rapid supply of dentists into the NHS for our constituents?

[Victoria Atkins]

I thank my right hon. Friend for all the work she did on dentistry in the Department. I am conscious that many people have contributed to this plan; I am grateful to her and others. Again, I hear the observations on the General Dental Council, and will ensure that the GDC hears them as well. That is a fair challenge to the NHS. Colleagues will see that the plan is co-signed by NHS England, which shares our ambition to deliver those 2.5 million more appointments and set up the future of NHS dentistry for our country.

[Christine Jardine (Edinburgh West) (LD)]

Today’s statement by the Health Secretary will have been listened to with great interest by my constituents in Edinburgh West, who share a lot of the same concerns, face the same difficulty getting NHS dental treatment and will be looking for the same sort of solution as constituents in England. Could the Secretary of State clarify for me, and for all those who come to me, whether there will be Barnett consequentials? If there are, will she impress upon the Scottish Government the need to ringfence the money and actually invest it in dental services? If not, would she be willing to share with the Scottish Government how she is approaching the problem in the hope that they might actually respond and do something?

[Victoria Atkins]

I hear the frustration in the hon. Lady’s question. This is a devolved area—as it is in Wales—and is therefore a matter for the Scottish National party. I assume the hon. Lady will continue her usual advocacy on behalf of her constituents to ensure that the SNP looks at what is happening in England and tries to do better for Scotland.

[Neil O’Brien (Harborough) (Con)]

I really welcome this plan; I welcome the extra £200 million, the new patient bonus, the measures to get dentists into areas that do not have them and the minimum UDA. These are all good things that will help people in Harborough, Oadby and Wigston to get a dentist. Can I ask the Secretary of State to press on with two things? The first is the move to a proper national funding formula. Dentistry is the only part of the NHS without a funding formula, which disadvantages shire and coastal areas with older populations. The second is the next round of contract reform—the move to band 2b is working, and dentists are using it, but there are patients with complex cases for whom a capitation-like payment would be much better, as the British Dental Association pointed out. I encourage the Secretary of State to start working on that difficult group so that we can get extra help for them too.

[Victoria Atkins]

I must thank my hon. Friend for all his work. I know how much how much effort and commitment he has put into these plans, and it shows the genuine—[Interruption.] Sorry; the hon. Member for Ilford North (Wes Streeting) is being a little ungracious. My hon. Friend the Member for Harborough (Neil O’Brien) has been part of the united work across Government to deliver these plans. I very much take on board his recommendations and encouragement. As I say, we see this plan as delivering 2.5 million more appointments for our constituents, but of course we want to look to the long term as well.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

Is the Secretary of State aware that Rip Van Winkle fell asleep for 20 years? This Conservative Government have been asleep for even longer than that, as far as dentistry is concerned. Will the Secretary of State now wake up and talk to real working dentists, such as Phil Lucitt—one of my excellent NHS dentists in Huddersfield, who is in the Gallery with his wife today—and get something done about this crisis? It is a crisis in Huddersfield, as in every town in this country, such as Bristol, as we heard yesterday. People are in pain, people are suffering, and for 14 years her Government have done little about it.

[Victoria Atkins]

I must admit that I did not know quite where that question was going, but I think the hon. Gentleman is urging me to speak to dentists. I am delighted to reassure him that my ministerial officials and I do of course speak to dentists. In fact, only today I was at a practice in the heart of Westminster, speaking to a dental manager who welcomes this plan. I will veer away and resist the temptation to comment on Rip Van Winkle.

[Peter Gibson (Darlington) (Con)]

I welcome this dental recovery plan, which will help to deliver dentistry in Darlington. Can my right hon. Friend the Secretary of State provide me with advice on what more I can do to get my integrated care board to get on with the commissioning at Firthmoor community centre, which lost its dentistry practice 10 months ago? In looking to expand the number of dental training places, I urge the Secretary of State to look at Teesside University, which has ambitions to build on its existing dental technology provision and train the Tees Valley dentists of tomorrow.

[Victoria Atkins]

Thanks to the work of my hon. Friend and others, Tees Valley is a powerhouse of growth industries, as exemplified by the Chancellor in his Budget and autumn statements recently. I will take away my hon. Friend’s words of advice about his university. On the point about encouraging ICBs to take part in this work, as this plan is a joint document with NHS England, the expectation will be on ICBs to deliver the plan, because they exist to look after our constituents. This plan is one of the ways we will be able to secure that help.

[Mohammad Yasin (Bedford) (Lab)]

In Bedford and Kempston, like many areas in the country, we have a dental crisis. I have raised the matter of dentistry previously, including in a Westminster Hall debate. There can be no question but that under this Conservative Government there is a dentistry crisis and the people of this country have been failed. Why does the Health Secretary refuse to admit that 14 years of neglect and underspending have led us to this?

[Victoria Atkins]

Says the script. I assume the hon. Gentleman will welcome the 2.5 million more appointments that this dental recovery plan will deliver for all our country.

[Mrs Heather Wheeler (South Derbyshire) (Con)]

I thank my right hon. Friend the Secretary of State for this brilliant statement, and thank all the team for their huge amount of hard work. Today is dentist day—yesterday was dentist day for me, as I had an appointment with the Minister and an appointment with a real dentist from South Derbyshire. This news is absolutely superb. Will the Secretary of State get dentists to move to South Derbyshire, and ensure more free NHS dentistry there?

[Victoria Atkins]

I have no doubt that with my hon. Friend’s characteristic joy and as an irresistible force of nature, she herself will be an advert for dentists to come to work in her constituency.

[Dame Diana Johnson (Kingston upon Hull North) (Lab)]

A constituent recently told me that when she tried to register members of her family with an NHS dentist, she was told that there was an eight-year wait. We know that workforce is a really big issue. On that basis, will the Secretary of State meet me and a cross-party group of Members of Parliament to talk about how we could develop a dental school at the site of the excellent Hull York Medical School to grow our own dentists for the future?

[Victoria Atkins]

The right hon. Lady will know that part of the focus of the long-term workforce plan is to train people where they are most needed. I will happily arrange for her to meet the relevant Minister. On registration, the current system is not like a GP practice where, once a family is registered, they can only go to that GP. The whole reason that we have been encouraging dentists to update their details on the NHS website is so that people can move around to visit different dentists to get the treatment they need. Today’s plan will help turbocharge those efforts.

[Peter Aldous (Waveney) (Con)]

I welcome this recovery plan, which provides the foundation for putting NHS dentistry on a sustainable long-term footing. I urge my right hon. Friend to continue her negotiations to replace the existing NHS dentistry contract as soon as possible, and to provide funding to the Norfolk and Waveney integrated care board so that the University of Suffolk can open a new treatment and training facility in our area, to replicate the innovative service that is about to open in Ipswich.

[Victoria Atkins]

I understand my hon. Friend’s point, and I commend him for his work to ensure that his constituents receive the care and help that they deserve. On training, I hope he has drawn out from the plan the emphasis that we are putting on long-term ambitions. We understand that we need to train more dentists and get internationally trained dentists registered in our system. We recognise the critical role that dental hygienists and therapists can play as well.

[Clive Efford (Eltham) (Lab)]

If the Tories cared about the NHS, we would not have 7.6 million people on the NHS waiting list and dentistry in crisis. The answer that the Secretary of State gave to my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) demonstrates why we are in this situation. It is not about people turning up at A&E; the inability to access NHS dentistry services leads to people being in a crisis situation and needing emergency care. After 14 years of the Tory Government, why do we need a recovery plan for dentistry?

[Victoria Atkins]

The hon. Gentleman was obviously asleep at the beginning of my statement, because I set out what I hope is a fact agreed across the House about the pandemic—the real problem. People who had a relationship with a dentist before the pandemic do not face quite the same pressures as people who may have moved home or whose dentist may have moved practice. That is the cohort of people who we are trying to help. It really would help if Labour Members focused their arguments a little more on the facts, rather than on the scripts that their Whips have given out.

[Andrew Lewer (Northampton South) (Con)]

I very much welcome this statement and the meetings I have had with my neighbour, the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom). The Secretary of State said that Northamptonshire will be included in a dental van roll-out, which is welcome, but the rest of the statement had a very rural focus. She will recall that my Prime Minister’s question focused on shortage in Duston. Is it at least a possibility that vans will go to suburban areas as well as rural ones?

[Victoria Atkins]

The criteria that will apply to the areas covered by vans are clearly set on dental need and other factors such as distance from an NHS dental practice. We have been able to identify areas of particular need, where we want to get that help as quickly as we can through the dental van initiative and the other ways detailed in the plan.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Last year, about half of my constituents were able to access dental services—well below pre-pandemic levels. Under the plans, what proportion of my constituents can now hope to access NHS dental services within the next six months?

[Victoria Atkins]

The dental recovery plan sets out immediate-term, medium-term and long-term plans. In the immediate term, we have the new patient premium that will be live from next month, the increase in UDA value to £28 and the golden hellos that I have described to under-served parts of the country. There is a batch of measures throughout the plan to address the concerns from colleagues across the House.

[Paul Bristow (Peterborough) (Con)]

I have a plan to open a brand-new NHS dentistry practice in Peterborough. New financial incentives, increased UDA rates and recruitment of overseas dentists to Peterborough are all part of that plan. Will my right hon. Friend meet me and those who want to open new NHS dental clinics in Peterborough, so that we can take advantage of every part of her excellent plan?

[Victoria Atkins]

I commend my hon. Friend for his excellent work as a constituency MP. It is exactly that sort of drive and ambition that will deliver results for his constituents. I would be delighted to meet him to discuss his plans, and I am pleased that our national dental recovery plan will fit well with his own local delivery plan.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind)]

I regret to inform the House that the situation in west Wales is quite catastrophic, and recent reforms by the Welsh Government have probably made matters far worse. However, my constituents and I would like to know how much of what the Secretary of State has announced today is new money, resulting in Barnett consequentials for the Welsh Government.

[Victoria Atkins]

The hon. Gentleman articulates the case against Labour-run Wales with great power. There is £200 million on top of the £3 billion that we already spend on NHS dentistry in England

[Siobhan Baillie (Stroud) (Con)]

I have raised dentistry a lot, because Stroud constituents and dentists have been really worried, so I welcome the Government’s plans with NHS England. I give credit to Gloucestershire ICB, which recognised the complexity of this issue. Post pandemic, it set about raising provision and we have decent take-up so far. My plea to the Secretary of State and to the Under-Secretary of State for Health and Social Care, my right hon. Friend Member for South Northamptonshire (Dame Andrea Leadsom) is to continue their relentless focus on prioritising children’s appointments, and not to let parents off the hook, because we can all do better even if it is hard to get a toothbrush in a three-year-old’s gob every night. Will the Secretary of State say more about how ICBs will be supported to deliver the plans and integrate the work that they are already doing? The local areas that are prioritising this are making a difference.

[Victoria Atkins]

My hon. Friend was probably summing up this morning’s toothbrushing ahead of the school run for many mums and dads up and down the country. That is the point—we want to work with parents. We do not want to patronise them. The overwhelming majority of parents do a great job looking after their kids’ teeth. Our plans are to support those who are struggling. The expectation on ICBs is clear. The plan is a document between NHSE and us. We want to deliver this plan at local level. Expectations will be set on ICBs to make sure that they fulfil the potential of this great plan.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I welcome this long overdue focus on dental access. I am particularly interested in the 240 golden hellos that will be available. Clearly, they will be inadequate to deal with the scale of the challenge. I am also concerned that the focus of the statement seems to be on putting those golden hellos in rural areas. Visibility and transparency are needed about where they are allocated, because places such as Ellesmere Port have exactly the same issues as other areas in the country. We get phone calls every week from constituents asking where they can see an NHS dentist. We are not able to send them anywhere at the moment. Is the Secretary of State able to guarantee that in future we will be able to send them somewhere?

[Victoria Atkins]

I hope the hon. Gentleman will publicise the new patient premium, because that is one of the levers through which we will unlock places for new patients. I remember that he has taken an interest in this issue. I very much understand the point about location. We have set strict criteria for how dental vans will be deployed, but the new patient premium is across the country. We want as many people as possible to see NHS dentists and fill those 2.5 million more appointments.

[Martin Vickers (Cleethorpes) (Con)]

I particularly welcome the initiative to improve services in coastal and rural areas. The Health Secretary and I are constituency neighbours, and she will know the complexities of delivering local services in what we know as greater Lincolnshire, because her constituency is in the east midlands and mine is in Yorkshire and the Humber. Can she guarantee that the whole of greater Lincolnshire, from the south of the county up to Barton-upon-Humber, will receive the benefits of the new proposals?

[Victoria Atkins]

I am delighted to inform my hon. Friend and neighbour that the new patient premium applies across England, and of course people can move to the dental practice that can offer them the services they need, so I trust that his constituents will be as happy as mine.

[Hywel Williams (Arfon) (PC)]

Is the £200 million additional, in the sense of being diverted from other parts of the NHS in England, or is it new money from the Treasury that would attract the Barnett consequentials for Wales, Scotland and Northern Ireland? Which is it?

[Victoria Atkins]

We have finite resources. As I have said, this is additional money. I have prioritised dentistry across the board, but this is £200 million of additional money—in addition to the £3 billion that we spend in England.

[Sir Jeremy Wright (Kenilworth and Southam) (Con)]

I welcome what my right hon. Friend has said, and I understand why some of the new resources that she has announced are directed at particular types of intervention and particular groups of patients, but does she agree that one of the downsides of such an approach, at least potentially, is the extra administration that will obstruct dentists in the effective delivery of that resource? Will she therefore ensure that the funds are easily accessible, and that there is no such extra administration that would make that more difficult? Does she accept that longevity and consistency of funding matters, because it enables dentists to plan properly for their patients?

[Victoria Atkins]

My ethos is to make our NHS and social care system faster, simpler and fairer, and not just for patients but for practitioners. We do not want bureaucracy to get in the way of the delivery of these services, and I am impatiently keen to get them up and running in Members’ constituencies, so we will ensure that we make it is easy as possible for dental practices to use them.

[Alistair Strathern (Mid Bedfordshire) (Lab)]

I am sure that fellow former teachers who are here today will have memories of the disappointment they felt when, after repeated delays and excuses, a student finally handed in some work, only for it to turn out to be not just a copy of someone else’s work, but a pretty poor one at that. After so much delay and uncertainty, dentistry is at breaking point, so any progress, however late, has to be welcomed. But every local professional network I have met has stressed the need for fundamental reform of the dental contract so that things can get done. Given that this Tory Government have been in place for 14 years, why will the Minister not commit herself to finally reforming the contract and providing the boost to dentistry that my constituents so desperately want to see?

[Victoria Atkins]

I think it is very courageous of any Labour Member of Parliament to talk about education, because we know just how dire the education results are in Labour-run Wales. Yes, I have committed to reform of the dental contract, and we will deliver these services immediately because we want to deliver results for the hon. Gentleman’s constituents as well as ours.

[Selaine Saxby (North Devon) (Con)]

I thank my right hon. Friend for securing this vital plan, and I also thank her team for their ongoing engagement in what has been a difficult issue in my constituency since long before the pandemic. I cannot wait to see a dental van in South Molton and Ilfracombe, and to welcome new dentists to Barnstaple, Braunton and beyond. However, I recognise that this will take time. We have recruitment challenges despite our staggeringly beautiful surf beaches, which extend far beyond my right hon. Friend’s Department. Given her success in securing today’s announcement, might she be able to help me to promote these new dentistry opportunities to attract those who may not have previously considered spectacular, if remote, North Devon to be their future?

[Victoria Atkins]

My hon. Friend is exactly right. She is a wonderful constituency Member who speaks up for her constituents, and I can assure them that she has been talking to me since the moment I was appointed. As for advertising the new services, this is an opportunity for Members across the House—and I do hope that Opposition Members will be gracious—to ensure that their constituents are aware of them. We all want the best for our constituents, and the more we encourage local dentists to take up the new patient premiums and units of dental activity as well as the golden hellos, the sooner we will all see benefits in our constituencies.

[Imran Hussain (Bradford East) (Lab)]

For nearly a decade, I have stood in this Chamber and told numerous Ministers that there is more chance of finding gold bricks on the streets of Bradford than there is of getting an NHS dentist when you need one. For 14 years, Ministers have made a political choice to ignore our calls, but now, in a general election year, the Government suddenly want to take part of Labour’s plan and present it as their own—frankly, it is shameless. Will the Minister at least accept that unless there is proper reform, our NHS dentistry will remain rotten to the core?

[Victoria Atkins]

Again, we have heard a very loud performance from the hon. Gentleman—a typically loud performance. If only it had been as factual as it was loud. I have already set out, in response to the hon. Member for Ilford North (Wes Streeting), the difference between Labour’s plan and our fully funded plan to secure immediate and long-term changes. After 14 years of opposition, is this it?

[James Sunderland (Bracknell) (Con)]

As the Health Secretary will recall, we met recently to discuss dentistry in Bracknell, so I really welcome the plan that she has announced today. Will she please confirm, for the sake of absolute clarity, that a cornerstone of the recovery plan will be quicker and easier access to NHS dentists, and also that they will be properly incentivised to absorb all the patients who need support?

[Victoria Atkins]

Indeed, and it was a pleasure to meet my hon. Friend to discuss the issues facing his constituents. I hope he recognises that we will have those aims very much in mind in the delivery of the recovery plan. We will begin to see the roll-out of those 2.5 million more appointments in the coming weeks as the new patient premium takes hold.

[Richard Burgon (Leeds East) (Lab)]

Last month, Healthwatch Leeds submitted evidence to the Health and Social Care Committee—testimonies from people at the sharp end of the NHS crisis. One said:

“I am really struggling to find an NHS dentist that is accepting new patients at the moment. I am an apprentice and get paid minimum wage and cannot afford a private dentist.”

Others spoke of the way in which, according to Healthwatch Leeds,

“having no access to treatment is impacting on their general well-being and mental health.”

One of them said:

“ I just don’t know what to do, who to turn to, how to get help. I just want to be able to smile again”.

Is it not the case that this Government’s plan is too little too late, and that the queues snaking around dentists’ surgeries are testimony to the failure of 14 years of Conservative government and a deliberate undermining of our valuable public services?

[Victoria Atkins]

The hon. Gentleman has quoted Healthwatch. I presume that he will also be gracious enough to acknowledge that the move to introduce 15 dental vans has, in fact, been welcomed by Healthwatch.

[Bob Seely (Isle of Wight) (Con)]

We need more NHS dentistry on the Isle of Wight. I welcome this recovery plan, but can the Secretary of State tell me by when my constituents will see its benefits?

[Victoria Atkins]

By 1 March, because that is when the new patient premium comes into force. Other aspects will take a little longer, but we are clear about the immediate benefits, and we want to get those out to people as quickly as possible.

[Richard Foord (Tiverton and Honiton) (LD)]

In Devon and Cornwall last year, 57% of dental surgeries had at least one vacancy. Before 2016, more than 500 dentists registered in the UK had trained in European countries, and they made up a quarter of the workforce. Will the Secretary of State heed the call from the Association of Dental Groups for it to be made easier for qualified European dentists to practise here in the UK?

[Victoria Atkins]

That is exactly what we are doing, and not just in relation to other European nations but in relation to other countries around the world. We want the General Dental Council to ensure that qualified dentists from overseas are recognised and supported, and get on to our registers as quickly as possible.

[Julian Sturdy (York Outer) (Con)]

Like many others, I very much welcome the recovery plan, and I thank the Secretary of State for meeting me earlier to discuss the issues that we face in York. However, may I press her on the subject of integrated care boards? Will she ensure that they are held to account? Will they face increased monitoring to ensure that they spend the allocated money on dentistry and on the target areas in the recovery plan, and will that money remain ringfenced?

[Victoria Atkins]

I well understand why my hon. Friend has asked that question, about a matter that other Members have also raised. We are exploring ways in which we can make the expenditure of the dentistry budget more transparent, because it is right for ICBs to reflect the needs of local residents and deliver the services that should be available under this dental recovery plan.

[Tom Hunt (Ipswich) (Con)]

I very much welcome these interventions, particularly as I raised a question just a few weeks ago in Prime Minister’s questions about the time period. I am particularly pleased about that. On international dentists, I completely agree with what many colleagues have said. I have a close friend whose husband is Mexican and fully qualified as a dentist. The period between him getting the right to be in the UK and becoming a dentist in the UK is two or three years—it is far too long and there is far too much bureaucracy. I appreciate the announcement on therapists. We have 24 new ones on the new course in Suffolk, but 400 applied so I think there is room for even more therapists to play a key role. Can we also make sure that the consultation period is rapid? This is a common-sense policy and I think we should just get on with it. Finally, will the Secretary of State visit Ipswich to see the new dental centre and hear the case we are making for a dental school? We are the obvious place in the east of England, now that we have a dental centre.

[Victoria Atkins]

My hon. Friend will appreciate that I get a lot of invitations, but I will do everything I can to meet him. His passion and ambition for his local area shine through, and not just in the question he asks today but in the question he asked the Prime Minister a few weeks ago. He is absolutely right: we need the General Dental Council to work with us—I think it will—to ensure that we can get more international dentists registered as quickly as possible, for the benefit of our constituents.

[Andy Carter (Warrington South) (Con)]

I welcome what the Secretary of State has said today. I also pay tribute to the ICB in Cheshire for the work that it has done to make additional appointments available in Warrington, where it has been incredibly difficult to access NHS dentistry despite there being many dentists on the high street, because so many have decided to move away from the NHS. Can she explain how the changes announced today will incentivise dentists to return to providing NHS services, so that constituents in Warrington South can get the NHS appointments they want?

[Victoria Atkins]

As I have said, dentists are independent contractors but we want to encourage them back into the NHS if they have left it, and we believe that the new patient premium and the work on the UDA are just two of the levers that we can deploy to achieve that. We also have a longer-term vision for our NHS, and through the long-term workforce plan we will be training 40% more dentists by 2031. That is real ambition and a plan for the long-term future of our country.

[Anna Firth (Southend West) (Con)]

I completely welcome this plan, and particularly my right hon. Friend’s focus on underserved areas and coastal communities. This is something I have raised before in the Chamber. Southend is a coastal city with over 180,000 residents but only three dentists currently accepting NHS patients, so we qualify on both counts. Please could she confirm for Southend and Leigh residents that we will also get either a van or better dental care, preferably within months, not years?

[Victoria Atkins]

I am delighted to tell my hon. Friend that those dental surgeries already operating under NHS contracts will have the benefit of new patient premiums and the increased rate of UDA. On the dental van, she will appreciate that we are having to apply strict criteria to this, but I am delighted to see how enthusiastic she is about this recovery plan.

[Holly Mumby-Croft (Scunthorpe) (Con)]

I thank my right hon. Friend for this really welcome plan. Can she give any advice to patients who are registered with an NHS dentist but have not been seen in the last two years? Should they contact the dentist if they want an appointment or should they wait to be contacted? For those who are not registered, where will they find a list of dentists that they can contact to register their interest in becoming a patient?

[Victoria Atkins]

I thank my hon. Friend and fellow greater Lincolnshire MP for her question. In terms of the mechanics of this being delivered, the new patient premiums will come into force and patients can already look at the NHS website to see which practices have places available in their area. They can go there; they do not need to have had an existing relationship with that dental practice. We will also be setting out for constituents and Members of Parliament how, once the new premium comes in, people can get in contact and get the appointments we all want them to get.

[Ben Everitt (Milton Keynes North) (Con)]

More dentists, more appointments, more incentives for NHS work and a focus on underserved areas—this is exactly what Milton Keynes needs. I would like to thank the Secretary of State and, in particular, her dental Minister and my constituency neighbour, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), for all the work they have done, and in particular for listening to me banging on about dentistry in Milton Keynes for so long. I seek just one more clarification, please. Will the mobile dentist vans be serving hard-to-reach rural areas, such as my beautiful market towns and villages in Milton Keynes North?

[Victoria Atkins]

I join my hon. Friend in his praise for our right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom). As I say, we are having to apply strict criteria to the dental vans. We want to get them out as quickly as possible to the most underserved areas, but we do not want dental vans to be the limit of our ambitions. The idea behind them is very much to revitalise those parts of the country that do not have NHS dental practices within a reasonable distance, and we are convinced that dental vans are just one of the levers by which we will achieve that.

[Matt Vickers (Stockton South) (Con)]

As my right hon. Friend knows, I am extremely concerned about access to dentistry for residents in Stockton South, so I hugely welcome this unprecedented investment and the places it will create locally. Can she confirm that the Government are committed to tackling the situation as quickly as possible and also for the long-term, and that they will continue to consult on broader workforce and contract reform?

[Victoria Atkins]

I am delighted to confirm that. We have wanted to deal with the issues as quickly as we can, but also with an eye to the future. This is the way in which the Government set out our plans for the NHS and for our social care system. I am confident, for example, about the introduction of golden hellos for new dentists. We know that that works with GPs and we now want to try it with dentists to see whether we can get dentists into those areas that do not have the service they need at the moment.

[James Wild (North West Norfolk) (Con)]

According to the National Audit Office, North West Norfolk has one of the lowest numbers of dentists per population. Can my right hon. Friend confirm that my constituents will benefit from the £20,000 incentives and from the mobile dental vans? On training, will she look closely at the proposal from the University of East Anglia for a dental training school? That is the obvious place to have it in the east of England.

[Victoria Atkins]

My hon. Friend will not be surprised to learn that I have received rather a lot of lobbying about the location of future dental schools. He will see in the plan that we are very open to the idea of training people with a view to their remaining in those areas. This is where golden hellos come in, and they will most definitely apply in the hardest-to-reach and underserved areas. As I say, we are taking very careful criteria-driven decisions about where the dental vans will be supplied, but we understand the problem that Norfolk has.

[Andrew Jones (Harrogate and Knaresborough) (Con)]

I welcome the statement and also thank my right hon. Friend for meeting me recently to discuss dental care in Harrogate and Knaresborough, where we have recently seen two practices hand back their NHS contracts, causing significant patient concern. I was pleased to hear her comments earlier about the retention of dentists within the NHS. Does she agree that good oral health is a critical part of good overall health, that establishing best practice early in life is essential and that that involves the very earliest years and supporting parents?

[Victoria Atkins]

Very much so. The truth is that teeth appear long before reception class, and this is why we want to focus not just on babies and toddlers in early years settings but, importantly, on pregnant mums because their oral health while pregnant can have ramifications for their baby. The dental recovery plan is seeking to address this through a long-term sweep from the very beginning of life to adulthood, with 2.5 million more appointments and a long-term plan for NHS dentistry in our country.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the Secretary of State for answering for more than an hour. We will now proceed, but first I will take points of order.