Access to Dentistry: Somerset

I will call Anna Sabine to move the motion, and I will then call the Minister to respond. I remind other Members that they may make a speech only with prior permission from the Member in charge of the debate and the Minister—that is often forgotten. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30-minute debates.

I beg to move,

That this House has considered access to dentistry in Somerset.

It is a pleasure to serve under your chairmanship, Mr Stuart. My grandfather might not have been a toolmaker, but he was dentist. He worked near Slough, and as a child I loved visits to the dentist because we got to play in the electric chair and dissolve bright pink mouthwash tablets in plastic cups, and we always got a Lambrusco and lemonade afterwards, which was of course entirely appropriate.

That regularity of dental treatment means that, at 45, I am lucky enough to have no fillings at all, and I am not particularly scared of dentists. Many children growing up today in my constituency of Frome and East Somerset are not so lucky: one in five children in Somerset has tooth decay by the time they are five. Although we know that difficulty in accessing an NHS dentist is a nationwide challenge, data reveals that the south-west is particularly neglected. The most recent Office for National Statistics data shows that it has the worst access problems of all regions in England, with 99% of people without a dentist failing to secure the NHS treatment they needed in the last month.

Furthermore, only 32% of adults in Somerset saw an NHS dentist in the two years to June 2024, which is much lower than the national average of 40%. The picture for children in Somerset is equally shocking: only 42% were seen by a dentist in the year to June 2024, well below the national average of 55%, and way below pre-covid averages.

My hon. Friend’s point about the south-west is absolutely right. Some 217 visits per 100,000 to accident and emergency are for dental-related issues, compared with 154 for the next highest region. So the south-west is a real outlier, and not in a good way. Does my hon. Friend think that that is having a detrimental effect on hospitals and A&E?

Yes, I absolutely agree, and I will talk later about how poor access to dentistry impacts other parts of the health sector.

Yesterday, I was lucky enough to visit a local primary school in Frome, along with a friend who is a dentist. We started with an assembly about the many superpowers the mouth has, in which I was delighted to be given the leading role of saliva. Then we moved on to taking two reception classes through a supervised toothbrushing session. The school is part of the Government’s supervised toothbrushing scheme, an initiative I welcome. Sadly, of the 30 children in the room, 10 did not have consent for the toothbrushing—some because forms had not been returned, and some because there was a parental objection to the activity or to the use of fluoride. To ensure that they did not feel left out, my dentist friend played a game where they counted their teeth instead. She said that, based on what she could see from that game, that group of 10 children had 50 obviously decayed teeth, and one child had at least 10 teeth that would need to be removed under general anaesthetic. Those children were four and five years old. Although the scheme overall is to be welcomed, I hope consideration will be given to having an opt-out rather than an opt-in, to ensure that the children who most need the scheme are actually benefiting.

Somerset used to be well above the national average on access to dentistry. As recently as 2018, 55% of adults were seen by an NHS dentist in a two-year period, compared with 50% nationally.

I commend the hon. Lady for securing the debate, and she is right to highlight the issue affecting children but also adults. Does she agree that the news that some pensioners are carrying out their own barbaric dentistry should send shockwaves about the affordability and accessibility of NHS dentistry? Does she also agree that there is a need for immediate intervention in each trust area, whether in Somerset, Scotland, Wales or Northern Ireland?

Yes, there are certainly some horror stories about tooth removal. It does beg the question as to why NHS dental services in Somerset and the wider south-west have deteriorated in the last seven years. It seems to me that that is symptomatic of a lack of investment in the region, in terms of not only health and social care but withdrawn levelling-up funding and diverted rural England prosperity funding.

My hon. Friend talks about the need for investment, and much of that will be in training new dentists. Does she therefore agree that it is baffling that a brand-new dental school at the University of East Anglia could be delayed by a full year because the Treasury refuses to release funding until a month after the deadline for UCAS course listings, and that another year’s delay is unacceptable for her constituents in Somerset and mine in North Norfolk?

That sounds very frustrating, particularly when, as we are seeing, there are so many crises in our dental services.

A constituent emailed me in February to say that four weeks previously her husband, who is in his late forties, had had a massive stroke. He collapsed into the sink in the kitchen and hit his face on the taps, breaking his teeth. He was discharged from hospital on 14 February, but cannot speak, is partially paralysed, needs continuing care, rehabilitation and adjustment, and is suffering dental pain. He is not registered with an NHS dentist and cannot afford private dental care, so they called 111 and, after four calls, drove to an appointment where the dentist was given just 30 minutes to treat only one tooth, which he had to remove. My constituents will have to call 111 again to get treatment for the next tooth. The husband needs dentures, is on soft foods and is still in pain. As that case shows, and as my hon. Friend the Member for North Norfolk (Steff Aquarone) pointed out, a failure to invest now in dentistry not only causes more pain for the individual, but gets more expensive and adds to pressure on other areas of the NHS in the longer term.

A constituent in Mansfield, who works in a local NHS practice, wrote to me to suggest that dental therapists, hygienists and other professionals could be utilised a lot more effectively to deal with capacity. Does the hon. Member agree that to free up more appointments, such as those her constituent needs, and to ensure that people get better and more timely care overall, it would be better to utilise the skills of other people in the dental profession, in the south-west and throughout the UK?

Yes. That is one of the things I have talked about extensively—or rather I have been talked at extensively by my dentist friend about the way in which we manage staff and who does which bits of work in dentistry. It is really important that the Government engage with the British Dental Association about that to understand some of the complexity of how the contracts are working at the moment and what could be improved.

If we do not deal with people’s dental pain, we get more pressure on the NHS in the long term: cancers go undiagnosed, and people are forced to use 111 or A&E. It cannot make sense that people have to use 111 to organise their dentistry if they do not have an NHS dentist. People are simply being pushed around the system instead of being treated and instead of illness being prevented. I absolutely understand and appreciate the financial situation the Government inherited from the Conservative Administration, but I am concerned that not enough is happening fast enough on dentistry.

The previous Government tried to tackle this problem by offering golden hellos to dentists in rural areas to encourage the uptake of NHS dentistry, but in reality that did not work. What we really need the new Government to do is to advance at pace with renegotiating the dental contract. Does my hon. Friend agree that if the new Government can get on with that rapidly, we might see an improvement in rural areas and, indeed, the whole UK?

I do agree. Golden hellos are all very well, but the challenge—as I hear from dentists in my constituency—is that once dentists leave NHS dentistry and go into the private sector, which more and more are doing, nothing will ever get them back again. That is a loss that we do not recover from.

It is a pleasure to serve under your chairmanship, Mr Stuart. I thank the hon. Member for Frome and East Somerset (Anna Sabine) for securing this important debate. Does she agree that Somerset benefits enormously from Bridgwater & Taunton College, where nurses and midwives are trained? Will she join me in asking the Minister whether dental hygienists, and in due course dental students from the University of Bristol Dental Hospital, might also train there and provide a service to the whole of Somerset?

I was not actually aware that we had those facilities there, and I am happy to know more about them. Yes, I would certainly join any call for more dentistry skills to be brought into the Somerset area.

The Health Secretary made a point of meeting the British Dental Association on his first day in office, but the BDA tells me that there has been little follow-up. Could the Minister confirm whether the Government have now entered into formal negotiations to reform the dental contract? If they have not, when do they expect to do so? I am sure the Minister will rightly highlight in his reply the roll-out of the 700,000 extra urgent appointments.

The 700,000 new urgent dental appointments cover only a third of the need for urgent care, and are being funded by simply recycling underspends in an already stretched budget. Does my hon. Friend agree that what we actually need in Somerset is new money to invest in NHS dentistry, as promised at the election?

I totally agree. I was coming on to say something similar: the roll-out of the 700,000 extra urgent appointments is a positive start, but it covers less than a third of the need for urgent care appointments. The Government must put more money into dentistry so that people can get the help they need.

The area around Minehead, in my constituency, has the smallest number of dentists in the country. Does my hon. Friend agree that the fact that the area is both rural and coastal presents a unique set of problems because of deprivation and neglect, which means that the dental desert there is felt very acutely indeed?