NHS Dentistry

Wera Hobhouse Excerpts

Tuesday 9th January 2024 Commons Chamber

[Wes Streeting]

I agree. I am afraid that when it comes to serving personnel and veterans, there is a gulf between what the Government say and promise and what they do; that is not the only example.

One thing not in the Government’s amendment to Labour’s motion is a pledge to protect the NHS dentistry budget. That is odd, because the Prime Minister promised to do exactly that 18 months ago. The truth is that the Prime Minister broke that pledge in November when he gave the go-ahead for dentistry underspends to be raided, effectively waving the white flag on the future of the service. Can you believe it? Despite everything we have heard, there are dentistry underspends, and the Prime Minister thinks that other things are greater priorities than this crisis. The consequences of that decision are now being felt. The budget in some areas of the country is running out and dentists are having to stop NHS work for the remainder of the year. It is so deeply frustrating.

NHS dentists want to do more NHS work; it is the Government who are standing in their way. The Nuffield Trust’s stark report into the crisis suggested that NHS dentistry may have to be scaled back and made available only to the least well-off. Such an approach would be the end of NHS dentistry as a universal public service, yet that is exactly the approach that the Government are piloting in Cornwall. Children, the over-80s and those with specific health needs are given treatment; everyone else has to go private or go without. They will not admit it, but this is the future under the Tories: further neglect, decline and patients made to go without.

Worse still, NHS dentistry is the ghost of Christmas yet to come under the Tories. That is not partisan overreaction on our part; that is according to the lead author of the Nuffield Trust’s report. He wrote:

“For the wider health system, the lessons are troubling: without political honesty and a clear strategy, the same long-term slide from aspiration to reality could happen in other areas of primary care too.”

What has happened to NHS dentistry under the Tories is coming to the rest of the NHS if they are given another five years. That is not the continuity that the country is looking for—it is looking for change with Labour.

[Wera Hobhouse (Bath) (LD)]

My Bath constituency is also described as an NHS dental desert. The only option for people is to go private. The hon. Member has already said that it is Dickensian. Does he agree that it is not just a health problem but an equalities issue that the Government fail to recognise?

[Wes Streeting]

I totally agree. In fact, Claire Hazelgrove, Labour’s candidate in Filton and Bradley Stoke—next-door to the forthcoming by-election—was telling me about problems in her constituency and that exact challenge of people being left without or having to go private. One patient told her that her dental practice was now only seeing private patients. That same patient cares for her 84-year-old dad with dementia, who needed a tooth removal to allow him to eat. His appointment was also cancelled. That is what is happening before our eyes.

What of those who cannot afford it? Anna Dixon, Labour’s candidate in Shipley, told me of a woman in her town who had been turned away as an NHS patient and could not afford to go private. She was struggling with pain, it was affecting her eating, and she was at her wits’ end. With the Tories, if you have not got the money, you have not got the care.

--- Later in debate ---

[Victoria Atkins]

I am extremely grateful to my hon. Friend. His intervention shows the level of detail that colleagues on the Conservative Benches have gone into in trying to address the understandable concerns that local NHS providers are voicing. I will look into that. I am very keen on my three words: faster, simpler, fairer. I want to make it as simple as possible for dentists to rejoin and join the NHS. I will say more on that later.

The choice of whether patients are offered NHS exams and treatment lies with the dentists, who are independent contractors to the NHS. As well as making simple, common-sense changes, in July 2022 we announced a package of far-reaching reforms to make NHS work more attractive to dentists. We have created more bands for units of dental activity, so that dentists are properly rewarded for taking on more complex care, and the best-performing practices can see more NHS patients.

Previously, regardless of the amount of time the dentist took on each patient, they received the same payment for every individual treatment package in band 2, which covers fillings and tooth extraction. Perversely, that meant they received the same payment for doing one filling as for three. That left many dentists unable to afford to take on patients who had not seen a dentist for some time and therefore needed extensive treatment. That needed to be put right for the sake of both patients and dentists. Thanks to our reforms, dentists now receive five units of dental activity when they treat three or more teeth, which is a significant increase from the old maximum of three. Root canal treatment on molar teeth is now rewarded with seven units of dental activity, as opposed to three, meeting one of the British Dental Association’s key demands.

We also recognise the barriers that too many communities have faced when accessing NHS dentistry, with people left phoning around practices to see who was taking on NHS patients. That is why we have made it a contractual requirement for dentists to update the NHS website regularly, making it clear whether their practices are taking on new patients, as well as explaining the services that they offer, thus making it easier for patients to find a dentist that can deliver the care they need. These reforms have improved access to dentistry and ensured that the system better supports dentists and their teams, so they were well received by dentists, their representatives and patient groups across England, with Healthwatch’s national director recognising that these reforms show that the Government are listening to patients and taking action, and these reforms can help ensure that dental care is accessible and affordable to everyone who needs it.

[Wera Hobhouse]

I am pleased to hear about some of the reforms that we have raised in this Chamber many times, particularly on changing the dental contracts and units of dental activity, but may I raise another point? In official workplace data, dentists who do just one NHS check-up a year are counted the same as an NHS full-timer. Does the Secretary of State recognise that that is a problem, because that workplace data hides the scale of the problem?

[Victoria Atkins]

I am extremely grateful to the hon. Lady, who makes a fair point about measuring within the system how much work NHS dentists are doing. As I say, we are looking at all of this in the work that we are doing on the dentistry recovery plan. I repeat that I want to make it as simple as possible for dentists to register with the NHS, to continue offering the care that we all want them to, so I am grateful to the hon. Lady for her intervention.