NHS Dentistry: South-west

Vikki Slade Excerpts

Tuesday 12th November 2024 Westminster Hall

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Vickers. It is interesting that the hon. Member for Truro and Falmouth (Jayne Kirkham) mentions dental vans: we were due to have one in Dorset, but I heard from my local NHS dentist in Corfe Mullen that they were seriously concerned about the prospect. They were worried that if they took it out to their rural community, there would be mayhem and frustration on the part of people who had not seen a dentist in so long. They were actually in fear for their staff, so they decided not to take the dental van. They also noted that it was 2.4 times more expensive than operating a practice, so they decided that they would invest the practice’s extra money in an additional graduate dentist. I met her a few weeks ago: her name is also Vicky. I am really excited about the work she could do, particularly in children’s health, but the decision to increase national insurance without exempting dentists means that the equivalent of half her salary will now go on additional national insurance for the staff within the practice. That is jeopardising the opportunity for practices like Corfe Mullen dental surgery to take on such staff.

It is interesting that dental care was available on the NHS from its inception. The original advert for the NHS stated that it would provide

“all medical, dental and nursing care”

for everyone—

“rich or poor, man, woman or child”.

I am sure Beveridge and Bevan would turn in their graves if they thought that adults were pulling out their own teeth and children were being hospitalised for tooth extraction. It has already been said that fewer than a third of adults in the south-west are receiving dental care. When we describe it as a desert, we are not talking about our wonderful beaches. It is genuinely a dental desert.

I find it hard because NHS Dorset has told us that it had a £9 million underspend in the last year, yet people are spending hours on the phone, begging for help. I am pleased that our ICB has approved an increase in the price of the unit of dental activity, but why is that being delayed until next year, and why are we not going further? Why is it that our hospital can find the money to go to a private hospital and sort out all the knee replacements, but our dentists cannot be brought online to deal with urgent cases? I ask the Minister to instruct ICBs across the south-west and beyond to ringfence the underspend in dental budgets, so that it cannot be used to plug the gap elsewhere in the service while people are struggling.

Katie in Bearwood told me that she will lose her front tooth if she does not get help soon. She wakes up every day with blood on her pillow and all over her teeth. The pain is so unbearable that it has her in tears, and she has lost two stone in weight as she can barely eat. She cannot get a referral to hospital without paying to see a private dentist. She is ashamed to go out in public. She said that she will have to pay £1,000 in private costs before she can be seen, but nobody will give her a loan. Zoe in Wimborne told me it has been nine years since she has seen a dentist, and that she is close to using the old-fashioned method of string and a door. It is absolutely ridiculous. It cannot be allowed to carry on.

I cannot not talk about the children in our area. It is wonderful that the Government are bringing in supervised toothbrushing, but what is the point if children then cannot see a dentist? I was mortified in 2022 when I took a foster child who had come to live with me to my dentist, because I had assumed that, as with GP practices, looked-after children would automatically be added to a family’s NHS practice. How wrong I was. We did not realise, so we insisted on telling the dentist that they had to see this child. He was 11 years old and he had seven teeth gone already. He needed those teeth replacing for his future and for his smile. If we cannot do it for the adults, we must at the very least do it for our children, especially our looked-after children.

--- Later in debate ---

[Stephen Kinnock]

The first thing I will say is that I am not going to take any lectures from any Conservative Member about the state of our dental system. What brass neck we see from that party, both in the Chamber and in this place—lecturing us, given the disgraceful state of our NHS and the fact that the biggest cause of five to nine-year-olds going to hospital is to have their rotten teeth removed! I will not be taking any lectures on that from the Conservative party. Of course, I am more than happy to answer the hon. Lady’s detailed questions, many of which I feel I have already answered in my preceding comments. I will not take any more interventions from her because I need to finish shortly.

Our 10-year plan will set out how we deliver these shifts to ensure the NHS is fit for the future. To develop the plan, we must have a meaningful conversation with the public and those who work in the health system. We are going to conduct a range of engagement activities, bringing in views from the public, the health and care workforce, national and local stakeholders, system leaders and parliamentarians. I urge hon. Members from across the House to please get involved in this consultation—the largest in the history of the NHS—at change.nhs.uk. I urge them to make their voices heard in their constituencies, through the deliberative events.

[Vikki Slade]

I have been on to the survey, and it is incredibly limited. It would be helpful if there were a way for the public to be encouraged to introduce more freeform responses.

[Stephen Kinnock]

I am slightly surprised to hear that. The presentation I received on the portal showed there was a clear channel through to having a more discursive engagement with the platform. I will take that feedback away and, through officials, will come back to the hon. Lady on that point.

I thank the hon. Member for Honiton and Sidmouth once again for bringing the issue of dentistry in the south-west to this debate. On 4 July, we inherited a profoundly challenging fiscal position, but I can assure him that we remain committed to tackling the immediate crisis facing NHS dentistry, and that we are taking steps to make delivery more efficient through long-term reform.

To recap, we are committed to providing 700,000 more urgent dental appointments, delivering the golden hello scheme to recruit more dentists in areas of greatest need, bringing in preventive measures to improve our children’s oral health and negotiating long-term contract reforms to make NHS dentistry more attractive. Those steps will help tackle the place-based disparities commonly seen in dentistry, and ensure that everyone who needs to access NHS dentistry can get it, including in the south-west.

Our NHS dentistry is broken after 14 years of Tory neglect and incompetence, but it is not beaten. In 1945, it fell to Clement Attlee’s Labour Government to create a health system for the 20th century. Now, 79 years later, it falls to this Government to clear up the mess we have inherited, to get NHS dentistry back on its feet and to build an NHS dentistry service fit for the 21st century. That is what we shall do.

Children’s Hospices: Funding

Vikki Slade Excerpts

Wednesday 30th October 2024 Westminster Hall

[Vikki Slade (Mid Dorset and North Poole) (LD)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I thank the hon. Member for Liverpool West Derby (Ian Byrne) for securing this debate. Every time I meet a parent whose family is supported by a children’s hospice, I am immensely moved by their resilience. Gemma, whose three-year-old son Finlay has been cared for by Julia’s House for more than two years, wrote an incredible blog about parental mental health, which can be found on the Julia’s House website. In the debate about money, we should never forget that there are not only children whose lives will be shortened, but parents whose capacity to follow their careers and support their wider family is curtailed and siblings whose childhoods will look very different—so-called glass children, who look strong on the outside but are so fragile they could smash to a thousand pieces.

Children’s hospices and other charities that support young carers and siblings, such as MYTIME Young Carers and Mosaic in Dorset, deserve our unwavering support. They should not have to rely on charity shops and crazy challenges to make ends meet—although this crazy MP has agreed to do a crazy challenge for her children’s hospice next year. My local children’s hospice, Julia’s House, is just half a mile from my home on the border of Broadstone and Corfe Mullen and I have visited numerous times since it opened 20 years ago. It has one of the lowest public funding streams across the hospice sector, with only 8% of its funding coming from the NHS. I had no idea that the support it provides for a child in the last six weeks of life is effectively unfunded. I find it shocking that we expect the NHS to fund the birth of our children, but we are relying on charity to fund care at a child’s death.

When I visited Julia’s House on Monday, I was greeted by a nurse clutching her mobile phone. She showed me the rooms that were prepared for a family who were expected to arrive at any time because their child was approaching the end of their life. The mermaid suite, which was built to support a child’s needs both before and after their death, was ready to welcome them. However, I heard that the nurses would need to be available around the clock and would receive no funding from the NHS, despite the fact that hospice care releases intensive care hospital beds. The cost of end of life care was three times the hospice’s usual per-child funding because of the medication and end of life support. The hospice would have to take that money from the respite, sibling support and regular care programmes to make sure that the family could be given the choice they are entitled to under the NHS gold standard.

Annabelle’s family have been through that already. Annabelle had a genetically inherited condition and was a frequent visitor to Julia’s House, where she enjoyed respite stays, made friends, joined the hospice choir and even got to meet a member of her favourite pop band, the Vamps. She passed away earlier this year at the age of just 18, and her family now face the agonising prospect of losing Robbie to the same condition. He is now receiving care at Julia’s House. But it is not just Robbie; another sibling is also receiving care and support through counselling, and both parents benefit from the respite breaks that will ultimately give them a chance of staying together. I dread to think what will happen to such families if hospice services are cut back.

The hospice grant has not been confirmed beyond 2025. It needs to be guaranteed in the long term and cover every child that meets the threshold, right up to the point of their death. In Dorset, seven months into the financial year, the contracts with local health services have not yet been confirmed by NHS Dorset and NHS Bath and North East Somerset, Swindon and Wiltshire. I ask the Minister to write to the ICBs and insist that they passport 100% of the grant to our precious children’s hospices and commit to a sustainable future for our children’s hospices.