That this House has considered access to dental services in West Sussex.
It is a pleasure to serve under your chairmanship, Sir Desmond, to have secured this debate—on Sussex Day, no less; I am confident that the Minister will have some excellent responses on behalf of all constituents in Sussex—and to have the opportunity to lay out the impact of the historic failings within the dental contract before the Minister.
The state of access to NHS dental services across the country is utterly disgraceful. In Sussex, 63% of adults had not seen a dentist in the two years prior to June 2025. Similarly, four in 10 children had not seen a dentist during that time. Fourteen million people were unable to access NHS dental care in early 2025 across the UK. The result of people locked out of NHS dental services has been a rise in cases of DIY dentistry, with a survey earlier this year suggesting that 7% of UK adults had attempted some form of DIY dentistry.
All that contributes to an alarming increase in hospital admissions for tooth-related issues. Tooth decay is now the most common reason for hospital admission among children aged between six and 10, with more than 100,000 children admitted to hospital with rotting teeth between 2018 and 2024. Those figures outline a dire situation that is only getting worse. Improvements in oral health are being wiped out, and tooth decay rates are at levels not seen since the 1990s.
I commend the hon. Lady on bringing this forward. She is absolutely right that there is a dental crisis not just in West Sussex, but across the whole United Kingdom. Some 14 million people cannot get an NHS dentist. Whenever I look back—and I am old enough to look back, at my age—I think that perhaps we should move back to the situation I can well remember in the past, when there were full-time NHS dental surgeries in community hospitals. They never let us down. Those positions must pay enough for dentists to be comfortable. Is that perhaps where we are going?
I thank the hon. Gentleman for his passionate advocacy for NHS dentistry in West Sussex. I am grateful to him for caring about access to NHS dentistry across the whole country. He is a fierce advocate for Strangford and makes the important point that the situation we are in is a damning indictment of the failure of the previous Government—a failure that the Prime Minister himself referred to regularly in the run-up to the general election. It was a stick that he used to beat the Conservative Government with in every televised debate, when he spoke about rotting teeth falling out of children’s mouths.
We are still going backwards, dealing with problems on a scale not seen for generations, all at a time when the British Dental Association has warned that NHS dentistry is facing an existential threat. Parliament often hears the term “postcode lottery”, but I cannot think of a more applicable example than NHS dental services for residents in Chichester and West Sussex.
Last week I had the opportunity to conduct a little bit of research with a staff member who has recently moved to London and needs to register with an NHS dentist. Within two miles of his new postcode in London, 10 surgeries were accepting NHS patients. Entering the postcode of my constituency office in Chichester into the NHS search tool produced a very different result: zero surgeries accepting new adult NHS patients within a 12-mile radius. There were none within the city itself, and only one surgery was accepting new patients under the age of 17. That means that residents not registered locally have to travel to other towns and cities. At the time of looking, the closest surgery was in Littlehampton in the constituency of the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths). That is not close to the city of Chichester.
I commend my hon. Friend on an excellent speech. Some of my residents still travel to their NHS dentist clinic in Nottinghamshire, which is a more than 500-mile round trip from Cornwall. Does my hon. Friend agree that Cornwall integrated care board needs to sort out its underspend? This year, there was a £1.2 million underspend that could have been invested in vital NHS dental services. I understand that West Sussex is a good example: it has managed to reinvest any underspend money on the services that my hon. Friend is talking about, which are so desperately needed in West Sussex and in Cornwall.
My hon. Friend makes an excellent point about his local ICB. The underspend issue has plagued the dentistry contract over many years. The ICB for Sussex did manage to commission more urgent dental care using its underspend, meaning that it had very little to give back to the Treasury. That was absolutely the right thing to do; I commend my hon. Friend for recognising that that is an opportunity that Cornwall ICB could take. However, the Sussex ICB invested in urgent dental care while not addressing the problem that we have in routine dental care.
Residents in Chichester cannot access routine dental care in their own city and are forced to travel considerable distances. That takes time out of people’s lives, costs money, and creates additional risks. Imagine someone making that 140-mile round trip for a routine appointment, only to discover that they require an emergency procedure. They would be miles away from their home and family, and might not be capable of driving themselves home afterwards. That is completely unacceptable in today’s society.
To make matters worse, a number of individuals told me that they had been removed from their surgery’s patient list, particularly during the pandemic when they did not want to be in close contact with others. They had no notification that that was happening. Others were informed out of the blue that their surgery was switching to private care and that, unless they paid, they would need to seek treatment elsewhere. Given the costs involved, as reflected in the national figures, many simply choose to go without care altogether.
It is a pleasure to serve under your chairmanship, Sir Desmond. I thank my hon. Friend the Member for Chichester (Jess Brown-Fuller) for shining a light on this important subject, which causes such distress for residents of West Sussex.
The Department for Health, like many Government Departments, has promised a consultation, as well as extensive reform of the dental contract. I appreciate that the Minister wants to get this right. He has said that the dental system is complex. He has also made it clear in the past that these changes will not be rushed. Speaking to dentists across my constituency and beyond, very few people would say that taking two years just to start a consultation could be called rushing.
The Government need to be clear with both dentists and patients. Dentists were told that the consultation would come last year; then they were told that it would come before the start of summer—but summer is more or less upon us, and we are still waiting. At this rate, the Government risk making no meaningful reforms to dentistry within this Parliament. This sense of political inertia is, of course, not confined to one Department, and we do not have to look far to imagine the reason for that.
Alongside those delays sits an equally serious issue: funding. The Government have been clear that no new funding is available for dental reform; I imagine that the Minister himself finds that deeply frustrating. Only about 40% of adults are effectively provided for within the current NHS dental budget, and even that is propped up by an estimated £1 billion cross-subsidy from private provision. The Public Accounts Committee was clear in its assessment: without frontloaded investment, meaningful reform has no chance of success.
What does this mean for residents in my constituency of Horsham? The honest answer is that we do not fully know, which is frustrating to say the least. Under the previous Conservative administration, West Sussex county council had not carried out a comprehensive oral health survey since before 2019. I have written to the new Lib Dem-led council asking it to ensure that West Sussex is included in the next survey, because without reliable data, we simply cannot design effective or targeted reforms.
The hon. Member is making a powerful point for his constituents. Similarly, in Northern Ireland only 50% of adults are registered with NHS dentists. Almost 400,000 registrations have been lost since 2023, and ultimately practices are leaving NHS dentistry because it is financially unsustainable. Would he agree with me that there needs to be a UK-wide look at this? While health is a devolved issue in Northern Ireland, there needs to be learning from the UK, because this is not just about waiting times, but about people finding a dentist who will actually take them on. Does he agree with me that we need a UK-wide resolution?
I very much agree that this is a national crisis. Some local authorities or local ICBs are better than others, but this is basically a national problem and needs national action.
The dentist I mentioned has told me that many of his peers have already stopped offering NHS services, and the ones left are increasingly considering doing exactly the same. That tells us that the entire dental system is slipping into freefall. The broader figures reinforce the local picture. Only 40% of adults in West Sussex have seen a dentist in the past two years, which is a fall of 7%. Among children, the figure has dropped from 63% to 58%. Over the past five years, the number of residents per dentist in West Sussex has increased by a fifth. That is a huge jump, and further evidence that the system is heading for collapse.
From my conversations with the chief executive officer of the newly merged Surrey and Sussex ICB, I know that dentistry is a priority area for her and that the team are doing their best to introduce flexibility where possible. However, they face cuts of up 50% in budgets and staffing, which are enormous challenges not just for the leadership, but for the NHS teams on the ground. There is real concern that, unless we change now, dentistry risks becoming an expensive luxury, rather than a universally accessible service.
To conclude, the combination of delayed reforms and reduced funding is leaving patients without access to care and professionals without the support they need to provide it. Oral health inequalities continue to widen. I appreciate that this Government are once again picking up the pieces from their Conservative predecessors, but the obligation now falls on today’s Ministers. Unless we see a change in trajectory, we will be left with exactly what the Public Accounts Committee warned us about—no money, no reform, no teeth.
It is a pleasure to serve under your chairmanship, Sir Desmond. I congratulate the hon. Member for Chichester (Jess Brown-Fuller), my constituency neighbour, on securing this very important debate. Access to NHS dentistry is one of the issues that my constituents raise with me most often, and when they do, they are not talking about contract reform, commissioning arrangements or NHS structures. They are talking about pain, cost, worry and ringing practice after practice but still not being able to get an appointment.
Anthony in Littlehampton contacted me after being told that he needed a crown. He is on personal independence payment and employment and support allowance. The treatment that he needs would cost hundreds of pounds. His question was simple: how is he meant to afford that? Clare in Bognor Regis did everything that patients are told to do. She remained with her NHS dentist and kept up with her appointments. Yet she was then told that NHS provision at her practice was being reduced and that she would be placed on a waiting list. Jill in Middleton-on-Sea is a pensioner who has spent years trying to navigate a system in which practices close, go private or stop taking NHS patients altogether. She is still trying to find care that she can afford.
It is a pleasure to serve under your chairmanship on Sussex Day, Sir Desmond. I start by congratulating my hon. Friend the Member for Chichester (Jess Brown-Fuller) on securing this important debate on access to dentistry services in West Sussex. I also thank my fellow West Sussex MPs, my hon. Friend the Member for Horsham (John Milne) and the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths), for taking part in the debate. Of course, I particularly thank the hon. Members for Strangford (Jim Shannon) and for Upper Bann (Carla Lockhart), and my hon. Friend the Member for North Cornwall (Ben Maguire), for their interest in the debate and for making links between our experience in West Sussex and their experiences in their constituencies.
My constituents in Mid Sussex know all too well about the challenge of accessing dental services both for them and their children. An incredible 133,560 children covered by the NHS Sussex integrated care board did not see a dentist last year. That is 41% of them. The figure was even worse in 2024, with more than 140,000 children not seeing a dentist. Dozens of my constituents have contacted me to say that their local dentists are no longer taking NHS patients, leaving them and their children without the vital preventive dental care that they need and that we know saves the NHS a fortune down the line.
Recently, a constituent contacted me after spending months trying to find an NHS dentist. Practice after practice told her the same thing—that no NHS places were available. Faced with either a long wait or private fees she simply could not afford, she was left with nowhere to turn. Sadly, as we have heard during the debate, that story is anything but unique.
I apologise for intervening again, but I want to make a point about cancer patients, similar to the one made by the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths). The teeth of cancer patients are heavily impacted by the strength of the drugs, so does the hon. Lady agree that the Government need specifically to consider how they can support cancer patients post-treatment and that cancer patients should be able to access free dental care quickly and efficiently?
The hon. Lady makes a really good point. We know that cancer treatment is a real priority for this Government and it certainly makes sense that her suggestion is considered.
I hear from parents who are worried about finding appointments for their children; I hear from pensioners who are living with pain while waiting for treatment; and I hear from families who are forced to choose between paying for private dental care and paying for other essentials. There is currently only one dental practice in Burgess Hill accepting under-17s and the same is true in Haywards Heath; they are the two main towns in my constituency. For too many people in Mid Sussex, access to an NHS dentist feels less like a right and more like a lottery.
When discussing this crisis, we often hear the phrase “DIY dentistry”. Its use has become so commonplace that we risk forgetting what it actually means. It means people pulling out their own teeth with pliers, or gluing crowns back into place. It means people attempting to treat serious dental problems themselves, because they cannot access professional care. A recent survey found that around 7% of UK adults had attempted some form of DIY dentistry. Over a third of those had tried to extract a painful tooth themselves; others had attempted to drain abscesses or repair fillings at home. People are doing these things because they are in pain and because they feel that they simply have no alternative.
It is a pleasure to serve under your chairmanship, Sir Desmond. I thank the hon. Member for Chichester (Jess Brown-Fuller) for securing this important debate, and for outlining the issues that her constituents—and, indeed, many constituents across the country—are facing. It is something of an irony that I find myself speaking on NHS dentistry for the second time in as many days, having co-sponsored yesterday’s Backbench Business debate on precisely this issue, but if anything, that underlines the scale of the issue we are dealing with.
The hon. Member for Chichester will know that West Sussex borders my constituency, which spans Surrey and Hampshire. Many of my constituents in Haslemere and the surrounding villages routinely access services across that boundary, and would regard West Sussex as part of their natural health economy. I am sure the same is true vice versa, because dentistry does not respect administrative lines, and access to care either exists or it does not.
Let us be clear about the scale of the problem. Oral health is not a luxury issue; as my hon. Friend the Member for Bognor Regis and Littlehampton (Alison Griffiths) set out so clearly and passionately, it is fundamental to dignity, confidence, employability and overall health, yet access to NHS dentistry has become a postcode lottery. Nearly 14 million people are struggling to access care, and in many areas more than 70% of practices are not accepting new NHS patients, including children. As far as I can tell, not a single dentist in my constituency of Farnham and Bordon is accepting new NHS patients.
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I ask the Minister what his solution would be for people attempting to register locally, people living in the area already and people moving to it after years of increased mandated development in my constituency. I would like to share with the Minister a few examples of what this means for my constituents in Chichester, who very kindly got in touch with me to share their stories. Kathryn moved with her family to the area four years ago. She still travels to Three Bridges for dental care. Christine still returns to the Isle of Wight for treatment. Marina and Denise moved to Bracklesham in 2011—15 years ago—and have never been able to register for an NHS dentist locally. Jim contacted me to say that he undertakes a 140-mile round trip just to receive routine dental care.
On top of that, individuals who have been lucky enough to secure an NHS place often face enormous waiting times for treatment. Jade shared her experience of being placed on a waiting list for routine root canal treatment and then being ignored for months. At 28-weeks pregnant, she suddenly found herself in excruciating pain and required emergency surgery. As we know, that costs the taxpayer a lot more than if the issue is addressed before it becomes an emergency. Another mother contacted me to say that three years ago her son developed an abscess over Christmas. They were unable to secure emergency treatment so they joined a waiting list at three separate practices. They still have not secured an appointment.
Those examples all point to a broken system in Chichester and across the country—one that is failing my constituents and worsening health outcomes. In the long run, it is also making the country poorer: the failure to invest in preventive care means that individuals require more serious and expensive treatment further down the line. This has to end. That view is shared by the dentists I spoke to ahead of today’s debate. A key issue raised by them and many across the profession is the state of the NHS dental contract. The British Dental Association identified it as a major factor driving NHS dentists into the private sector. The current settlement has been widely criticised since its inception back in 2006. The Health and Social Care Committee published a report in 2023 calling for an urgent overhaul of the system, and the Labour party promised to renegotiate the contract in its manifesto.
One former dental nurse who contacted me described the contracts as being like
“tying dentists’ hands behind their backs.”
That is hardly practical if they are trying to perform a root canal procedure. The contracts are failing patients because the number of patients a dentist can see on the NHS is limited according to the units of dental activity that they have been commissioned to deliver. The nurse I spoke to suggested patients are being referred to hospitals for routine procedures because contractual arrangements prevent practices from carrying them out themselves and being renumerated.
The Government promised to reform the contracts, but they have been slow to address problems that are widely recognised across the sector. The consultation that the Government announced in April must lead to a contract that is genuinely patient-focused, with greater flexibility in commissioning. When it was announced, the Government committed to bringing out the consultation before the summer, but the official line has changed slightly to “in due course”. I share the concern raised by campaigners that any further delay will mean that a new system will not be implemented before the end of this Parliament. Will the Minister commit to bringing out the consultation before the summer and to a firm deadline for when formal contract renegotiations will begin? Frankly, we cannot afford any further delays.
Another issue is costs. Lab costs went up 9% last year, but NHS contract holders got just a 3.55% uplift—add to that the hikes in national insurance contributions, which have exacerbated an already dismal situation. The British Dental Association believes that an average NHS dentist is losing £25 per routine dental check. Without support and changes to the contracts, many practices will continue to be pushed into the private sector, as we have already seen happen to many. In West Sussex, the number of dentists with NHS activity has dropped by 13% since 2019. I imagine that that figure is actually an underestimation, because a practice can offer just one NHS appointment a year and still feature on the list of NHS providers.
Local dentists are also concerned that the merger of the Surrey and Sussex ICBs, alongside a 50% reduction in ICB running costs, could undermine the local commissioning expertise and local relationships with providers. Can the Minister today provide any reassurance that, at a time of significant change within our ICBs, they will be given the resource to maintain and improve relationships with contract providers?
The Government talk a good game on dentistry, but they are tinkering around the edges and leaving major issues such as the contracts so far unresolved. They quietly dropped their manifesto pledge of delivering 700,000 more dental appointments, under the guise of broadening the definition of urgent dental appointments for clinical reasons. That is a sticking plaster that addresses the requirement for more urgent dental appointments, but does not address those who cannot get routine care, which in many cases would prevent them from needing the emergency care.
The Liberal Democrats have long called for reforms that will address the root of the crisis. Our £750 million plan would begin to undo years of underfunding, guarantee urgent and emergency dental care for everyone who needed it, and hopefully bring an end to DIY dentistry. That would be needed to address the backlogs in emergency care. I have heard of wait times of up to 18 months at St Richard’s in Chichester for complex dental treatment such as difficult extractions.
It is clear that the system is broken. Nobody is naive enough to believe that it can be addressed overnight, but the Government have had two years. All the while, residents in Chichester continue to have a lack of access to basic dental services. Dentists want to help patients, but it is not currently financially viable for many to stay in the NHS. That has to change, and I urge the Government to listen carefully to contributions from all Members in today’s debate, and take the steps that they promised in their manifesto.
The data that we do have is deeply concerning. A quarter of children in West Sussex are at high risk of tooth decay compared with a national average of roughly half that level. From an early age, we are sending out the message that oral health is not a priority. At the same time, we are seeing a growing reliance on urgent dental care, but as a substitute for routine check-ups. Preventive dentistry—the very foundation of a sustainable system—simply cannot function under those conditions. We risk raising a generation that engages with dental services only at a moment of crisis, and that will have profound long-term health consequences.
I am very much seeing the impact of this in my Horsham casework. One of my constituents, Gail, was recently removed, along with her daughter, from the dental register. It was not from any fault of her own, but simply because there are not enough dentists left who are willing to operate on NHS contracts. That is distressing enough for patients, but it is also deeply frustrating for dental professionals, who find themselves forced to turn away patients who they can see are in urgent need.
Another constituent, Medi, does have access to a dentist, but not locally, and we have heard the same from other Members. She has to travel three hours for her appointments in another part of the country completely. She suffers from arthritis, so the journey is not just inconvenient, but very painful. However, she cannot find anyone closer, and even the waiting lists are vague about when a place may eventually be available.
I have also heard directly from dentists in Horsham. One practitioner, who has worked in the NHS for over 15 years and has trained NHS dental graduates, told me that, each year, funding has become more constrained and the administrative burden continues to grow. Without proper support for preventive care, he warned, dentists simply “don’t stand a chance”.
Those are not isolated cases. They show what happens when NHS dentistry becomes too difficult to access. People wait, put treatment off and make compromises that they should not have to make, and then routine problems become urgent ones. We too often talk about dental care as though it sits separately from the rest of the NHS. It does not. Poor oral health affects confidence, nutrition, wellbeing and wider health outcomes, including in respect of heart disease and septicaemia.
One constituent who contacted me, Andrew from Bognor Regis, was undergoing treatment for two separate cancers. Through no fault of his own, regular dental appointments had—understandably—fallen by the wayside while he focused on fighting those illnesses. When he later tried to access NHS dental care again, he found himself in effect locked out of the system—abandoned at precisely the moment he needed support the most. What struck me was not simply his concern about finding dental care, but the wider impact that poor access can have on a patient’s healthcare journey. A patient battling cancer should not also be worrying about whether they can access a dentist.
However, there has been some local progress and I would like to recognise it. In Bognor Regis, mydentist is now delivering additional NHS dental activity and offering about 56 urgent appointments each week. That matters. Urgent appointments help people to get treatment when they need it the most, and stop problems becoming even more serious. The local ICB has also confirmed that new NHS dental contracts have been awarded for both Bognor Regis and Littlehampton, with services expected to open next year. That is welcome. But let us be honest: we are not where we need to be. My constituents should not have to become dental detectives simply to find treatment. They should not have to wait until pain becomes an emergency before the system responds. Urgent care is important, but must not become a substitute for routine access.
We also need to get much more serious about prevention. That starts with children. It starts in the early years with good habits, education and helping families to understand the importance of looking after their oral health. Prevention is better for patients, and it is also better for taxpayers.
Finally, we need to make every appointment count. I recently met Katie Cook, the practice manager at the new mydentist in Bognor Regis, and she told me that around 5% of appointments each week are lost because patients simply do not attend. This is not about blaming people—life happens—but a cancelled appointment can often be reused; a missed appointment cannot. When so many residents are desperate to be seen, that lost time matters. The national dental contract still needs reform, access needs to improve and patients need clearer routes to care when they cannot find an NHS dentist.
I will finish by asking the Minister three questions. First, what further steps will the Government take to improve access to routine NHS dentistry so that people are not forced to wait until a problem becomes an emergency before they can be seen? Secondly, what more can be done to support prevention, particularly among children and young people, so that we stop problems from developing in the first place? Thirdly, what assurances can the Minister give that areas such as West Sussex will receive the additional capacity needed to bring down waiting lists and improve access to NHS appointments?
My constituents do not expect miracles—they understand the pressures facing the NHS—but they do expect to be able to see a dentist when they need one. They expect a system that prevents problems rather than simply responding to crises, and they expect access to NHS dentistry to be determined by need, not by whether they can afford to go private. That is the standard my constituents deserve, and it is the standard they expect this Government to deliver.
The scale of the challenge to turn that situation around is enormous. As my hon. Friend the Member for Chichester noted, recent NHS figures show that around 60% of adults have not seen a dentist in the last two years, and over 5 million children did not see a dentist at all in the year to June 2025. Tooth decay remains the most common reason for hospital admission among children aged six to 10. That is truly shameful.
The previous Conservative Government left NHS dentistry in a deeply fragile state. Years of neglect and a fundamentally flawed dental contract drove dentists away from NHS provision, leaving patients to pay the price. Although the current Government inherited this crisis, they simply cannot inherit the excuses. The public were promised 700,000 additional urgent dental appointments, yet only around 100,000 have been delivered so far. Ministers might point to commissioning figures, but patients judge success by whether they can get an appointment when they need one. Far too many people across West Sussex still cannot do so.
I welcome any increase in dental places, and the Government have made moves in that respect. However, I am sure that we all accept that there will be a long pipeline before the trainees of today become the fully fledged dentists who are able to carry out work doing NHS contracts.
More importantly, training more dentists alone will not solve the problem. The dental contract remains broken, as we have already heard today. Dentists continue to tell us that the current system discourages them from doing NHS work and fails to reflect the complexity of the treatment that they provide. Unless the Government are prepared to commission and fund more NHS dentistry, increasing the number of dentists will not automatically increase access for patients. That is why contract change is so important.
In April, Ministers announced a consultation on changing the contract, with proposals expected before the summer. Midsummer’s day is next week. Patients waiting in pain cannot afford further delays, and dentists who are considering their future in the NHS cannot afford further uncertainty. The Government must set out a clear timetable for reform and ensure that implementation is not kicked into the long grass.
The Liberal Democrats believe that there is a better way forward. We have proposed a £750 million dental rescue package to end dental deserts and restore access to NHS dentistry. We would guarantee access to an NHS dentist for everyone requiring urgent or emergency care. We would fix the broken dental contract, expand training places, continue recognition of EU-qualified dentists and put proper workforce planning into law. We would also guarantee free dental check-ups for children, pregnant women, new mothers and those on low incomes while investing in prevention and oral public health, because if we are serious about solving this crisis, we must stop treating dentistry as an afterthought.
This debate is about real people in Mid Sussex and across West Sussex and the country. It is about the parent in Haywards Heath who cannot find an NHS dentist for their child, and the older resident in Burgess Hill who is living with pain while waiting for treatment. It is about families who are doing everything right, but finding that accessing basic NHS dental care is increasingly impossible. No one in Mid Sussex should ever be forced into DIY dentistry, and no child should end up in hospital because routine dental care was unavailable.
I would be grateful if the Minister could address three points. First, when will the Government publish and implement proposals for dental contract changes? Secondly, how will Ministers ensure that additional training places result in greater NHS capacity, rather than simply increasing the number of dentists working outside the NHS? Thirdly, what specific action is being taken to tackle unmet dental need and dental deserts in areas such as West Sussex? People in Mid Sussex and across our region deserve access to timely, affordable NHS dental care. I hope the Government will respond to this crisis with the urgency it demands.
It is often suggested that we simply have a workforce shortage, but the issue is not that we do not have enough dentists; it is that, understandably, too few are willing to work within a contract that no longer makes sense. The 2006 NHS dental contract, introduced under the last Labour Government, is based on units of dental activity. It pays the same whether a dentist carries out one filling or six, rewards volume rather than complexity, and actively discourages preventive care. That contract is central to why the system is struggling.
The Government came into office promising a dental rescue plan, including urgent appointments, contract reform, workforce expansion and a greater focus on prevention. Those commitments were clear and repeated, yet delivery has not matched the rhetoric. In practice, the additional appointments that have been rolled out amount in many cases to only a small increase in urgent capacity. According to the British Dental Association, they are equivalent to a couple of extra slots per dentist per month. At the same time, the long-promised NHS workforce plan has still not been published and, without it, there is no credible road map for how capacity will be met. Warm words about recruitment are no substitute for a clear and funded strategy that tells practices and patients what the future looks like.
We also need to recognise inefficiencies within the current system. In some practices, around one in seven NHS appointments is missed, costing individual surgeries tens of thousands of pounds a year. That is not just a frustration for clinicians—it is lost capacity in a system that is already under extreme pressure. However, rather than addressing the structural incentives that contribute to this, the Government’s response has been piecemeal. The consequences of all this are not evenly distributed; rural and coastal communities are particularly badly affected, with some having as few as 10 NHS dental practices per 100,000 people. These so-called dental deserts are not accidental, but the predictable outcome of a system that does not align funding, workforce planning and local need.
There is a striking example of underused capacity in my local area. In Haslemere, the hospital contains a fully equipped dental suite that remains unused despite clear local demand. That facility could serve patients across the West Sussex border, given the natural geography of where people access care. Instead, it sits idle.
I think everyone in this Chamber agrees with prevention in principle, and with the need to move away from a purely treatment-based model. The challenge is delivery. Likewise, workforce expansion is essential, but announcements without a credible plan do not translate into appointments. Ultimately, what is required is straightforward in principle, but urgent in practice: a properly funded and credible workforce plan, contract reform that rewards prevention and complexity rather than volume, and a serious strategy to address dental deserts that reflects real geography and need.
We should also acknowledge the previous efforts of the Conservative Government, including the dental recovery plan, which did attempt to address these issues through recruitment incentives, training expansion and support of overseas qualified dentists. I accept that some measures had limited uptake, but they were at least an attempt to respond to a growing crisis. The question now is whether this Government build on what works or continue to drift without clear direction. Patients do not care which Government designed which contract or which plan; they care about seeing a dentist when they need one.
I end with three straightforward questions that I asked the Minister in yesterday’s debate, but to which I did not get an answer. When will we see a fully funded and credible NHS dental workforce plan? How many additional dentists, hygienists and therapists are required to meet demand? What is the plan to ensure that dental deserts do not become a permanent feature of our healthcare system? Patients deserve these answers not in the future, but today.