Backbench Business

Supports the call for reforming the 2006 NHS dental contract, suggesting that the units of dental activity are at the core of current problems and urging for a new approach to properly reward dentists.

Highlights the crisis in accessing NHS dentists in south Manchester, calling for urgent action on simplifying registration processes for highly trained dentists from abroad to help alleviate shortages and improve services.

Mr. Howarth expressed his gratitude for the opportunity to debate the issue of NHS dental care, highlighting a survey in Knowsley where none of the 13 dental practices accept new NHS adult patients and only two accept children under 18 since September. He emphasised that this situation is exacerbated by chronic underfunding, contract referral issues, and growing oral inequalities. The British Dental Association pointed out the importance of early detection of oral cancer through access to NHS dental care, a particular concern for deprived areas like Knowsley where people are more likely to die from it than in affluent areas. Mr. Howarth urged the Government to take responsibility and introduced two short-term suggestions: (1) introducing a referral procedure for urgent cases, and (2) instituting an appeal process for patients unfairly removed from NHS dental lists.

The speaker highlights the ongoing shortage of NHS dentists, exacerbated by the transition to private practices and bureaucratic challenges. He suggests several solutions including allowing overseas dentists with good English from competent overseas dental schools to enter the UK directly without additional exams. Additionally, he proposes reducing regulatory burdens on small practices and revising the contract for units of dental activity. The speaker also advocates for encouraging mixed NHS and private services and emphasises the importance of teaching children proper oral hygiene and fluoridation in water supplies.

The current system is failing to provide adequate dental care, especially in areas like Bradford where only 2% of dental practices are open to NHS patients. This has led to a significant rise in child tooth decay and emergency hospital admissions for dental issues. The funding allocated by the government failed to meet its goals due to an unworkable setup, highlighting the need for comprehensive contract reforms.

There is not a single dental practice in the former Prime Minister’s constituency or the current Health Secretary's constituency that accepts new NHS patients. This issue affects all parts of the country and shows the urgency for action from the government to address the shortages.

In Scotland, access to NHS dentistry is a significant issue, with many constituents unable to see a dentist on weekends or in rural areas due to the lack of local services. The Scottish National Party's focus on another independence referendum instead of addressing these needs is frustrating for constituents who require urgent dental care.

I share the concern of my colleagues about the crisis in NHS dentistry, particularly affecting Blackburn and Darwen where no practices accept new patients. Children are ending up in hospital for tooth extractions due to a lack of dental care; 135 children under 10 were admitted last year alone. The issue extends beyond dentistry, encompassing primary care shortages across the country. There is a severe shortage of data and workforce planning by the Government which hinders recruitment and retention of staff in underserved areas like Blackburn.

I wholeheartedly agree with the motion on the NHS dentistry crisis. MPs are concerned about nine out of 10 practices not accepting new patients, including many children. The problem is systemic, rooted in the lack of local NHS involvement and outdated contracts that discourage dentists from providing NHS care due to financial constraints and regulatory pressures. There's a need for reforming these contracts and improving remuneration to attract more dentists into underserved areas like Blackburn. Additionally, we must address long-term issues such as training new dental professionals and encouraging private sector participation in delivering public services.

I rise to speak on behalf of a number of dentists in my constituency. Nicola Jones, an oral surgeon at Salisbury District Hospital, contacted me to say that the lack of available NHS dentists is causing significant challenges in the constituency. I recognise that from my mailbox over recent weeks. We need a comprehensive solution that incentivises dentists to offer an holistic service to people of all means and help those communities that have cold spots of dentistry supply. I urge the Minister to go beyond what his officials may be suggesting to him, to think radically and to take this opportunity to ask, ‘How can we reset after the dislocations caused by covid?’

Mr. Dowd reiterates the critical need for the Government to listen and act beyond superficial measures such as a £50 million allocation before summer, which he deems insufficient. He stresses an existential threat highlighted by dentists and the BDA due to unmet demand and deep inequalities in access. Noting that 91% of people and 80% of children struggle to access dental services, while 75% of dentists are reducing their NHS engagement, Mr. Dowd underscores the importance of addressing the stress and burnout among dentists, who have trained extensively but face significant pressure due to lack of support from the Government.

Mr. Hayes agrees that there are systemic issues stemming from contracts agreed upon years ago under a previous Labour government, noting also the issue of insufficient dentist training and specific regional challenges such as those in Lincolnshire.

Ms. Hobhouse highlights that while her mother had excellent NHS dental care, new patients face significant barriers due to the current contract disincentivising dentists from taking on NHS patients.

Ms. Maskell notes that in York people have had to wait up to six years for an appointment and expresses concern over the transition of dental services into integrated care systems, which may not have adequate power or leverage to address training, funding, and contract issues.

Expresses severe concerns about the lack of NHS dentists in Devon, noting that not a single NHS practice is accepting new patients. Mentions personal experience and constituent stories illustrating the dire situation. Highlights issues with training more dentists and international recruitment as long-term solutions, while also urging for immediate measures such as mobile dental services to address urgent needs.

Intervenes to support Saxby's comments, highlighting the issue of 'dental deserts' in Lincolnshire with 38 dentists per 100,000 population. Urges for clear government action.

Thanks local dental professionals and discusses issues such as the UDA system not being fit for purpose, financial reimbursement, and difficulties retaining dentists due to lack of training schools in the area. Highlights the need for incentives to attract more dentists into underserved areas and calls for measures to increase recruitment from overseas.

I thank the Backbench Business Committee for granting this important debate, and congratulate the hon. Member for Waveney (Peter Aldous) and my hon. Friend the Member for Bradford South (Judith Cummins) on having secured it. We support the motion in the form in which it has been moved; there is nothing in it that we disagree with. My right hon. Friend is absolutely right. There is no reason why the Government cannot expedite action on the issues he mentioned in his contribution and get those improvements in place. I pay tribute to my right hon. Friend and to my hon. Friends the Members for Blackburn (Kate Hollern) and for Bootle (Peter Dowd), as well as the hon. Members for Bath (Wera Hobhouse), for Mole Valley (Sir Paul Beresford), for Berwickshire, Roxburgh and Selkirk (John Lamont), for Gloucester (Richard Graham), for Salisbury (John Glen), for North Devon (Selaine Saxby) and for Loughborough (Jane Hunt), for their contributions. I welcome the Minister to his place. The backlog has not helped—we all acknowledge that; it goes without saying—but the Government’s spend on general dental practices in England has been cut by more than a third over the past decade, with the number of NHS dental practices in England falling by more than 1,200 in the five years prior to the pandemic. My hon. Friend the Member for Bradford South (Judith Cummins) raised that, and it cannot be ignored. The Minister’s next line of defence will be, “It’s all because of the dental contract.” There is some truth in that; however, after 12 years of this Government, I am afraid the line will not wash that it is solely the contract. We hear about the ABCD plan, and at least there is a recognition of dentistry. However, like my right hon. Friend the Member for Knowsley (Sir George Howarth), I worry that this kind of “Sesame Street” strategy does not come close to tackling the scale of the emergency that is gripping dental care. All we have heard from the Secretary of State is sticking-plaster solutions that tiptoe around the edges while failing to address the root cause. That is apparent in the Government’s “hit and hope” approach to dentistry. The £50 million of emergency funding announced earlier this year has done precious little to improve access. In fact, figures obtained by the British Dental Association showed that just 17.9% of that funding was drawn down. This is indicative of a sector that has completely lost faith in the Government’s ability to act. I fully support what the hon. Member for Waveney and other hon. Members on both sides of the House have said about education. Dentistry in schools, a prevention strategy and an emphasis on good oral health is absolutely crucial. The consensus and mood is there to get that done, so I hope the Minister will take that up and get going on that opportunity. As for many issues facing our NHS, much of the problem with NHS dentistry can be traced back to one thing: workforce. Any hope of an NHS recovery must be underpinned by a comprehensive workforce strategy. Where is that strategy? Was it accidentally shredded with the mini-Budget? I am sure the Minister will hail the fact that NHS stats show an increase of 539 dentists practising in 2021-22, compared with the year before. However, there is not much to be positive about beneath the surface.

I agree with him about the motion, but I did make the point that there were some short-term measures that could, and should, be taken within the three-month period that the motion envisages before the Government report back on progress.

The Minister thanked Andrew Gwynne for his kind words, congratulated Peter Aldous and Judith Cummins on securing the debate time, and acknowledged NHS dentistry workers. He promised to respond constructively to points raised in the debate and stated his commitment to improving access to dental care through steps like increasing funding, reforming contracts, and enhancing local accountability via integrated care systems. Quince emphasised the importance of transparency regarding which dentists are accepting new patients and addressed misconceptions about patient registration with dentists.

Graham highlighted the importance of giving chief executives of integrated care systems the opportunity to take responsibility for dental services, welcoming Quince's support for this approach.

Hobhouse pointed out that due to the current contract structure, NHS dentists prefer continuing relationships with existing patients over taking on new ones, creating a disincentive for accepting new patients despite technical rules allowing it.

Howarth asked Quince to address short-term measures that could improve the situation for those seeking NHS dental care. He noted that many practices are not currently taking on new NHS patients despite official guidelines allowing it.

Highlighted the importance of addressing oral cancer quickly, proposing short-term fast-tracking of emergency support.

Suggested a short-term simple contract to tackle the backlog in NHS dentistry.

Noted that £50 million was made available but hardly any of it has been spent due to systemic issues.

Stressed the issue is not limited to England; Scotland also faces similar problems with NHS dentistry.

Mentioned the importance of workforce planning in tackling the crisis.

Emphasised the significance of local NHS involvement and collaboration.

Highlighted the alarming rise of DIY dentistry as a consequence of limited access to professional dental care.

Stressed the importance of adopting a short-term UDA model, suggesting it is necessary to bring NHS practices up-to-date.

Noted previous attempts at addressing similar issues and called for urgent action.

Proposed using buses to increase accessibility to dental care as a method of improving patient reach.

Reiterated the need for short-term arrangements to alleviate the immediate crisis in NHS dentistry.