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NHS Dentists: South-West England — [Julie Elliott in the Chair]
24 May 2023
Lead MP
Chris Loder
Responding Minister
Neil O'Brien
Tags
NHSTaxationEmployment
Word Count: 13357
Other Contributors: 17
At a Glance
Chris Loder raised concerns about nhs dentists: south-west england — [julie elliott in the chair] in Westminster Hall. A government minister responded.
Key Requests to Government:
I urge the Minister to maintain his commitment to reforming the unpopular 2006 dental contract and making vital changes to unfair remuneration. I ask for immediate review and reform of the contract and compliance within it, plans for a substantial dental school in Dorset, and better understanding from NHS 111 regarding our dental practices' capacity.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Lead Contributor
Opened the debate
I am concerned about the alarming downward trajectory of access to NHS dentistry in rural parts of Dorset and across the south-west. If someone living in Dorset rings their nearest NHS dentist, there is a 22% chance that they will be told the practice has gone private, a 42% chance that it is not taking new patients with special needs, and a 50% chance that they will be added to a waiting list over 12 months long. The National Health Service Act 2006 set out provisions for agreement between NHS England and dental practices which have deterred dentists from committing to the NHS rather than private practice. The backlog following the covid-19 pandemic has exacerbated these issues, with 45% of dentists reducing their NHS commitments. MP Kerry McCarthy highlighted significant issues in Bristol East regarding NHS dental services. There is a shortage of dentists, with many not accepting new patients and others deregistering existing ones due to high demand elsewhere. Some practices are closing down entirely, affecting numerous constituents. Pregnant women face difficulties accessing free dental care despite entitlements. An estimated 2,000 dentists left the NHS last year, leading to a crisis where some people have resorted to pulling out their own teeth in pain due to unavailability of emergency appointments.
Andrew Gwynne
Ind
Gorton and Denton
Expressed concerns about the lack of NHS dentists in the south-west, highlighting that only seven out of 465 dentists were accepting new patients last year. Called for urgent reforms to dental contracts and workforce plans to address the crisis, noting a need for preventive measures and community-based services.
Devon, Teignbridge
Healthy teeth are critical to overall health. The exclusion of dentistry from free NHS services at inception is concerning. There's a shortage of dentists in Devon with no NHS dental appointments available and patients waiting up to seven years for treatment. The situation highlights the need for more recruitment, better retention, and broader professional roles.
I propose considering improvements for dental therapists, delegating the £50 million underspend in the south-west across the area, encouraging graduates from the Peninsula Dental School to stay in the region due to high demand, and bringing forward the dental recovery plan urgently.
Derek Thomas
Con
St Ives
He expressed concern over the lack of NHS dentists in the south-west, highlighting that practices are giving up or reducing NHS contracts due to low funding. He cited a practice losing £132,000 in clawback funds this year, enough to treat 1,600 patients. He urged for reform of the dental contract and an increase in UDA value to £30 to help practices afford more treatment. Derek Thomas also called for better workforce data on dentistry and supported full implementation of direct access by dental care professionals.
Jim Shannon
DUP
Strangford
Across the United Kingdom, there are issues with accessing NHS dentists. In his constituency, 100% of people cannot get an NHS dentist, and paying online for a yearly subscription is not feasible for many, including elderly individuals.
Asked if dentistry should be included in the upcoming NHS staffing plan aimed at increasing the number of people being trained across various medical disciplines, including dentistry.
Jonathan Gullis
Lab
Slough
He intervened to agree with the hon. Member for West Dorset that reforms are urgently needed and confirmed some of his points about the lack of fit for purpose in dental contracts.
Kevin Foster
Con
Torbay and Torre
Mr Foster discussed the difficulties constituents face in finding NHS dentists, noting that some areas have no practices accepting new patients. He highlighted two main issues: ensuring existing dental workforce offers NHS services and expanding future capacity through training and recruitment.
Luke Pollard
Lab Co-op
Plymouth Sutton and Devonport
NHS dentistry in Plymouth is broken, with a waiting list over seven years long and an estimated 22,000 people on it. The city's only emergency dental service handles over 300 calls daily but has only 20 available slots. Dentists are leaving the NHS due to poor remuneration and difficult working conditions. Luke Pollard called for a reform of the NHS contract, a national plan for recruitment and retention, an increase in dental students, funding for dental therapists, and fairer regional funding. Inquired about additional training places for dentists in Plymouth, suggesting it could significantly impact the region's dental provision.
Nicola Richards
Con
North Devon
She agreed with the hon. Member for West Dorset, noting her constituency's challenges similar to those in Dorset and urging the Minister to hear their concerns.
Richard Drax
Con
South Dorset
There are only 10 dental practices in South Dorset, none of which accepts new NHS patients. Healthwatch found that no dentists are taking on new adult patients and over half have waiting lists longer than 12 months. The British Dental Association warns of an 'existential threat' to NHS dentistry due to insufficient funding before the pandemic, with only 50% of population's needs met. Asked about the disincentives dentists face, such as caps on payment and money taken off them for underspending.
Richard Foord
Lib Dem
Honiton and Sidmouth
Mr Foord highlighted the severe lack of NHS dentists in South-West England, citing examples from his constituents who face challenges accessing dental care. He mentioned statistics from a BDA survey showing that nearly three in five dentists in the south-west have reduced their NHS commitment by an average of 30%. Mr Foord also noted that 49% of south-west dentists are likely to go fully private, while 15% may move abroad.
Mr. Robert Syms acknowledged the challenges faced by NHS dental services since the covid-19 pandemic, noting a significant backlog and many professionals leaving the field. He supported solutions proposed in previous speeches and emphasised the need for both short-term and long-term plans to address these issues, such as speeding up the dental recovery plan and increasing investment in training more dentists, including proposals for new dental schools in regions like Dorset.
This problem is particularly severe in rural parts of the south-west. I suggest that dentists should be brought to remote areas via buses or mobile units so that young people can access dental services.
My constituents in East Devon face difficulties getting NHS dentist appointments in areas like Sidmouth, Budleigh Salterton, and Exmouth. Problems with recruitment and contracts have worsened during the pandemic, but additional reforms of the NHS dental system cannot come soon enough.
Tim Farron
Lib Dem
Westmorland and Lonsdale
Mr. Tim Farron highlighted the struggles rural communities face in accessing NHS dental care due to high housing costs, lower working-age populations, and physical distances from services. He mentioned that a family in his constituency would need to travel 160 miles for an available NHS dentist appointment. Concerning financial aspects, Mr. Farron pointed out that patients who lose their NHS status often face unaffordable private plan costs, with one example being £1,000 per year for a family of four. He also raised the issue of underfunding in the system, suggesting that unit payments are insufficient to cover operational costs, leading dentists to feel financially pressured and unable to provide quality care.
Wera Hobhouse
Lib Dem
Bath
In Bath and North East Somerset, over 105,000 adults have not seen a dentist in two years. Children's access has also declined significantly. Dental desert conditions exist due to staff shortages and an alarming rate of retirement among dentists. Dentists are often cross-financing NHS and private patients, leading to financial strain. The British Dental Association reports that current data on NHS dentistry is inaccurate.
Government Response
Neil O'Brien
Government Response
Responded by outlining reforms underway to improve NHS dentistry, including creating more UDA bands, introducing a minimum UDA value, allowing dentists to deliver up to 110% of their UDAs, and easing entry for overseas dental professionals. Mentioned the establishment of centres for dental development aimed at retaining local talent. He also discussed measures to empower hygienists and therapists, improve access for new patients, address historical variations in UDA delivery, and enhance workforce growth through a forthcoming plan. Emphasised devolving decision-making from NHS regions to integrated care boards for better accountability and integration with other services.
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About Westminster Hall Debates
Westminster Hall debates are a chance for MPs to raise important issues affecting their constituents and get a response from a government minister. Unlike Prime Minister's Questions, these debates are more in-depth and collaborative. The MP who secured the debate speaks first, other MPs can contribute, and a minister responds with the government's position.