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Access to NHS Dentistry
10 February 2022
Lead MP
Peter Aldous
Waveney
Con
Responding Minister
Maria Caulfield
Tags
NHSEmploymentForeign Affairs
Word Count: 27559
Other Contributors: 23
At a Glance
Peter Aldous raised concerns about access to nhs dentistry in Westminster Hall. A government minister responded.
Key Requests to Government:
The Government needs to provide long-term funding for NHS dentistry, step up recruitment and retention of dental professionals, complete the new NHS dental contract as soon as possible, highlight the role of water fluoridation, and ensure greater accountability in integrated care boards. There is also a need for more training places, recognition of EU-trained dentists, simplification of the PLVE process, allowing whole teams to initiate treatments, and creating a retention strategy. Mr Madders urges the Minister to listen to dentists and address the financial unviability of providing NHS services in high-need areas. He calls for contract reform that acknowledges the challenges faced by the sector and commissions dental services for a higher proportion of the population. I urge the Government to implement a national dental service that is free at the point of need and not dependent on people's ability to pay, reinstate the school dental service, ensure older people also access these services as poor dental health can lead to malnutrition and premature death, create new structures in our healthcare system to integrate mental health, physical health, social care, and dental care, support the York Health and Care Alliance, and establish a new dental school in York along with Hull.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Lead Contributor
NHS dentistry has been the top issue in my inbox for nine to ten months. The situation is a national crisis, especially acute in Lowestoft and Waveney due to retirements of dentists and difficulties in recruiting new ones. The net Government spending on general dental practice has decreased by a third over the past decade. Since May 2021, while there have been improvements locally, these are short-term solutions. Access to NHS dentistry is particularly challenging in rural areas but also affects metropolitan regions. Recent data shows that 44% of patients new to practices cannot get an appointment; in my area, this rises to 56%. There has been a significant increase in DIY tooth extraction and undiagnosed mouth cancers, with children suffering the most. Mr Madders is concerned about the challenges faced by dentists and patients in accessing NHS dental services. He notes that waiting times are increasing, preventive action is being neglected, and health inequalities are rising due to a system that accommodates only half of the population. He mentions specific instances where constituents had difficulty finding a dentist willing to take on new patients, especially those requiring significant treatment. One constituent contacted 45 practices without success, while another faced issues with their registration being terminated during shielding. Healthwatch York found that it took over two years for 45% of York residents to find a dentist in 2018. The number of people who have not seen a dentist in the last two to three years has risen sixfold, and the number of children who have seen a dentist has fallen by 44%. Only one practice out of 39 is accepting NHS patients on to a waiting list, which already has 2,000 people. Some constituents are forced to travel up to 40 miles or more for dental care or even consider going abroad due to cost.
Andrew Selous
Con
Truro and Falmouth
Expressed concern over the accuracy of data regarding NHS dentists in Leighton Buzzard, highlighting discrepancies between official reports and constituent experiences. Emphasized the need for better data to ensure proper oversight and addressed issues such as children's oral health, elderly dental care, and dentist shortages.
Daisy Cooper
Lib Dem
St Albans
Ms Daisy Cooper relayed the struggles of her constituents, who have faced long waits for NHS dental appointments and were forced to seek private care. She criticised the current payment system as inadequate, discouraging dentists from treating more complex cases, and urged reforms to the workforce strategy.
Duncan Baker
Con
North Norfolk
My father, an NHS dentist for 23 years, noted the detrimental effects of sugary foods and drinks on children's teeth, suggesting fluoridation as a solution. The MP highlighted the crisis in dentistry, noting that not a week goes by without constituents unable to get an NHS appointment. He cited the loss of 40 NHS dentists in his area over two years, resulting in a 9% drop. Duncan Baker called for urgent reform of the UDA contract and proposed that newly qualified NHS dentists should be required to complete a year of training in areas with high needs.
Giles Watling
Con
Cannock Chase
There have been no detrimental effects found from fluoridation anywhere, and rumours suggesting otherwise should be dismissed. He highlighted the widespread issue of NHS dental care, noting that 85% of dental practices are closed to new patients and nearly half of patients resort to private treatment due to access problems. He also mentioned one child being admitted to hospital every 10 minutes for tooth extractions, urging proactive measures. Watling emphasized the need for local devolution of power over NHS services in coastal areas with pockets of deprivation, advocating for increased recognition of overseas dental qualifications and use of Brexit freedom to attract more dentists from abroad.
James Wild
Con
North West Norfolk
Mr Wild highlighted the low number of dentists per head in his constituency and poor dental activity levels compared to national figures. He expressed disappointment over unsuccessful procurement processes for Fakenham and Thetford, advocating for increased dental student intake despite recent reductions. He also called for a dental school in East Anglia to address coverage gaps.
Jerome Mayhew
Con
Broadland and Fakenham
Jerome Mayhew highlighted the pressing issue of access to NHS dentistry in his constituency, noting that constituents frequently face difficulties in securing necessary dental treatment. He cited an example where a constituent had to perform DIY fillings due to lack of available treatment. Furthermore, he expressed concern over local dentists leaving the NHS and moving towards private practice, attributing this partly to poor communication from NHS managers. Mayhew also emphasised the importance of training facilities in attracting young dentists to rural areas.
Judith Cummins
Lab
Bradford South
The hon. Member for Bradford South intervened on the lead MP's points about recruitment difficulties in East Anglia during the recent procurement process. Ms. Cummins highlighted the severe impact of the pandemic on NHS dental services, noting that over 40 million appointments were missed since the start of the pandemic, equivalent to a year's worth of dentistry before the pandemic. She also mentioned chronic underfunding and contract issues leading to recruitment and retention problems in dental practices. The BDA estimates it would take £880 million annually just to restore budgets to 2010 levels.
Karin Smyth
Lab
Bristol South
Expressed concern about the decline in NHS dentistry staff, patients struggling to access appointments, and the underfunding of NHS dentistry. Emphasised that £50 million funding is inadequate given 40 million lost appointments since the start of the pandemic. Highlighted inequality in dental care among children in deprived communities and called for a long-term strategy to address workforce issues.
Kevin Hollinrake
Con
Thirsk and Malton
In Helmsley, dental services have not been recommissioned after 20 months, indicating that the commissioning process is too slow and bureaucratic for new dentists. The MP intervened to question the £10 billion fraud figure cited by Duncan Baker, suggesting it was not accurate. He pointed out that £4.6 billion of this amount was a write-down of current value versus value at the time of the pandemic. Mr. Hollinrake expressed concern over the lack of NHS dentistry availability in his constituency, highlighting emails from constituents detailing unmet dental needs due to a lack of NHS services. He criticised the commissioning process for being overly bureaucratic, noting that it took 20 months to reopen an NHS service after a dentist closed their doors, despite willingness to take up the contract. Does the Minister think that it is acceptable for commissioners to take 20 months commissioning a service when we have dentists who want to take that work and take on that surgery?
Khalid Mahmood
Lab
Birmingham, Perry Barr
My constituents have suffered greatly due to the impact of COVID-19 on dental treatment, especially for those with conditions like diabetes. John Charlton from Severn Trent Water has worked for over 30 years to promote fluoridation in water, which is a significant public health achievement.
Maria Miller
Con
North Hampshire
Expressed concerns about the state of NHS dentistry, highlighting issues like a lack of data on waiting times and inconsistent service delivery during the pandemic. Emphasized the need for clearer role definition between private and public dental provision, better contracts that promote prevention and continuity of care, and more accountability in regional commissioning. The MP asked Duncan Baker what he would have done differently in 2006 when the current dental contract was put in place, implying that there were opportunities to influence the Labour Government then.
Munira Wilson
Lib Dem
Twickenham
Wilson paid tribute to Healthwatch Richmond for bringing attention to NHS dentistry issues and highlighted the low funding for NHS dentistry in her constituency, noting that less than half of those seeking care could secure a routine appointment. She cited examples of constituents struggling with access to dental treatment, including a carer who had to pay £700 out-of-pocket due to inability to find an NHS dentist for her daughter.
Paul Beresford
Con
Midsomer Norton and Bath
In Birmingham, dentists can identify which part of the city patients come from based on dental health conditions due to varying levels of water fluoridation. Discussed the challenges faced by dentists, including low pay, heavy regulation, and patient demand for mixed NHS/private practice. Highlighted the impact of COVID-19 on dental services, noting reduced productivity due to hygiene protocols. Emphasised the need for more dentists, suggesting solutions such as increasing dental schools and attracting international practitioners. Advocated for prevention measures like teaching children proper oral care and expanding water fluoridation.
Peter Bottomley
Con
Worcestershire South and Worcestershire
Agrees with Sir Robert Francis, Judith Cummins, and Peter Aldous. Praises Clive Efford for his role in the Stephen Lawrence case. Highlights issues faced by NHS dentistry due to insufficient funding and flawed contracts since 2006. Emphasises the need for immediate action on emergency situations and long-term solutions including fluoridation and recruiting more qualified dentists from abroad. Raises concerns about the current UDA system and excessive administrative burden on dentists, impacting their ability to take new NHS patients. Bottomley suggested that the NHS should have a list for every constituency detailing every dental practice and its situation. This would help MPs, patients, and the NHS understand and address local issues better.
Peter Dowd
Lab
Bootle
Peter Dowd thanked colleagues for raising the issue and criticised the government's approach to addressing crises in health services, including dental care. He mentioned cuts to dental budgets over the past decade and highlighted the need for better funding and contract reform. Dowd cited statistics showing a significant loss of NHS dental appointments since the pandemic.
Richard Fuller
Con
North Bedfordshire
Mr Fuller highlighted the challenge of infrastructure and access to dental services due to rapid housing development in his constituency. He noted difficulties dentists faced during the lockdown period and called for more efficient use of existing resources through preventive rather than reactive dental care methods. He questioned why young people end up in A&E due to tooth decay, suggesting better resource allocation is needed.
Mr. Largan welcomed the additional £50 million investment in NHS dentistry but expressed concerns over the long-term sustainability of dental services, noting that 70% of appointments have been missed since the start of the pandemic. He called for a serious drive to improve recruitment and retention of dentists, and urged better representation of NHS dentists in governance bodies.
Rushanara Ali
Lab
Bethnal Green and Stepney
The chair requested that the hon. Member wrap up his speech to accommodate remaining speakers within a three-to-four-minute informal limit.
Selaine Saxby
Con
North Devon
Ms Saxby highlighted the severe shortage of NHS dentists in North Devon, noting that only 36% of children and 43% of adults had seen a dentist within the last year. She cited statistics showing North Devon's hospital dental extractions for nought to 19-year-olds at double the national average (0.8% vs. 0.4%). Ms Saxby emphasized the urgent need for innovative solutions, such as facilitating international recruitment and improving access through community diagnostic centres.
Siobhan Baillie
Con
Stroud
The MP highlighted the critical health issue of access to NHS dentistry, noting that her constituents frequently report difficulty in finding NHS dentists. She mentioned a constituent's experience during pregnancy and the challenge for parents seeking NHS dental care for their children. The MP expressed concern about a 17% drop in NHS dentists in Gloucestershire over one year and questioned the delays in implementing new contracts for NHS dentists despite £3 billion spending.
Tan Dhesi
Lab
Slough
Dhesi highlighted the severe impact of the pandemic on NHS dentistry, noting that an estimated 38 million appointments were missed. He emphasized the decline in Government spending on NHS dentistry by more than a third over the past decade and criticized the managed decline of public services under the Conservative Government. Dhesi also pointed out that nearly two-thirds of practices are operating at less than 70% of pre-COVID capacity, with more than half of dentists planning to reduce their NHS commitments due to being overworked and undervalued.
Virendra Sharma
Lab
Ealing, Southall
Mr Sharma highlighted the severe crisis in NHS dentistry caused by chronic underfunding and exacerbated by the pandemic. He cited a dentist from his constituency who is struggling with an influx of patients unable to see a dentist for years. Mr Sharma noted that net Government spending on general dental practice in England had been cut by about a third over the past decade, leading to a shortage of dentists and difficulties in recruitment and retention. Healthwatch England reported that 85% of dental practices were closed to new adult patients pre-pandemic, with a full year's worth of appointments lost due to social distancing measures during the pandemic. He emphasised the need for long-term solutions focused on prevention and sustainable funding.
Wera Hobhouse
Lib Dem
Bath
Ms Hobhouse paid tribute to dentists in Bath but noted that access to NHS dental services is at an unprecedented low, with 40 million NHS appointments lost since the pandemic. She cited a Healthwatch survey reporting no NHS dentists in her constituency taking on new patients and highlighted chronic underfunding and privatisation as major issues. For the purpose of giving everybody a voice, Wera Hobhouse urged acknowledging that the dental contract was introduced under a Labour Government. She highlighted the importance of public funding for a good service.
Government Response
Maria Caulfield
Government Response
I congratulate the hon. Members for Waveney (Peter Aldous) and Bradford South (Judith Cummins) on securing the debate, and acknowledge the significant impact of the pandemic on dental services, generating a backlog that is evident in postbags across constituencies. Dentists have faced immense pressure due to reduced service levels during lockdowns and subsequent capacity issues. The government has taken steps such as setting up joint working between NHS England, the chief dental officer, and the Department; announcing £50 million for additional appointments and capacity generation through cancellation lists; relaxing the upper tolerance threshold from 104% to 110%; and initiating informal negotiations with the British Dental Association (BDA) for dental contract reform. The minister also discussed initiatives aimed at improving recruitment, retention, and training of dentists, including a consultation on recognizing international dentist qualifications, setting up centres of dental development in underserved areas, and advancing preventive measures such as water fluoridation proposals under the Health and Care Bill.
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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.