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- Before we begin, I remind Members to observe social distancing and to wear masks. There is clearly a lot of interest in the debate. We will work out roughly how long people have to speak, but I do not intend to impose a strict time limit, unless people abuse the timings. We will give you an indication of how long to speak for, and if you could roughly stick to it that would be really helpful. I call Peter Aldous to move the motion.
- I beg to move,That this House has considered access to NHS dentistry.It is a pleasure to serve under your chairmanship, Mr Efford. I thank the Backbench Business Committee for granting this debate. I am grateful to the hon. Member for Bradford South (Judith Cummins) for her work in helping to secure it.NHS dentistry has been the No. 1 issue in my inbox for the past nine to 10 months. This is a national crisis, though the problem in my constituency—in Lowestoft and Waveney—is acute. Dentists have retired, which has led to resources and dental capacity being taken away from the area, notwithstanding the increased need and demand following the pandemic. Many of the remaining practices are experiencing difficulties in recruiting and retaining dentists, and the situation has been exacerbated by a lack of funding, with net Government spending on general dental practice being reduced by a third over the past decade. That said, the overall situation locally has improved since I first raised concerns in an Adjournment debate on 25 May last year, and I will outline the improvements later. They are welcome, but I am concerned that they might be a short-term sticking plaster and might not provide a long-term solution.As we emerge from covid, the situation both locally and nationally has reached crisis point. Locally, that is due to covid, as well as retirements in two NHS dental practices in Lowestoft and the closure of the mydentist practice in Leiston, in the constituency of my right hon. Friend the Member for Suffolk Coastal (Dr Coffey). That practice closed due to the difficulty of recruiting dentists to work in the NHS in the area—a theme that is repeated across the country.Access to NHS dentistry is a problem that has been brewing for a long time. The situation can be likened to a house built on shallow and poor foundations. The earthquake of covid has led to that house falling down. There are now parts of the country—particularly in, though not confined to, rural and coastal areas—that are dental deserts.
- Mr Khalid Mahmood (Birmingham, Perry Barr) (Lab)I thank the hon. Gentleman for securing this important debate. On that point, my constituents in the city of Birmingham have hugely suffered through the covid. People like myself, who suffer from diabetes, have had huge issues with dental treatment. I hope that we can move forward and return to treating people in the best way possible.
- While there are particular problems in rural, coastal and more peripheral locations, which it is difficult to get dentists to move to, it is clear from looking around the Chamber today that the problem is not confined to such areas and is an issue in metropolitan areas as well. Sir Robert Francis, chair of Healthwatch England, has commented:“Every part of the country is facing a dental care crisis, with NHS dentistry at risk of vanishing into the void.”I believe there are five issues that need to be tackled to address the problem. First, a secure, long-term funding stream must be provided. Secondly, we need to step up the recruitment and retention of dental professionals. Thirdly, it is vital that work on the new NHS dental contract, which has been being developed for more than a decade, is completed as soon as practically possible. Fourthly, it is important to highlight the role that water fluoridation can play. Finally, there is a need for greater accountability and for dentistry to have a voice in the emerging integrated care boards and partnerships.
- I congratulate my hon. Friend on securing this important debate. Another point that needs developing is that in Helmsley, in my constituency, the commissioners have still not recommissioned services after 20 months. The commissioning of dental services by the NHS is simply too slow and too bureaucratic. It is a real deterrent for new dentists to take these contracts.
- I thank my hon. Friend for that intervention, and he is right. There has been a recent procurement process in East Anglia, but it has been only half successful. There are places that have not been able to get dentists to fill those voids.Figures published in March 2020, before the pandemic, show that 25% of patients new to practices in England could not get an appointment. The situation has got worse: the most recent figures, from 2021, show that that number has increased to 44%; in my area, it is 56%. Dentistry was locked down from March to June 2020 and the ongoing restrictions on dentists—fallow time between appointments—are still limiting the ability to see more patients.The latest figures on workforce, published in August 2021, show that 951 fewer dentists performed NHS dental activity than 12 months earlier, with 174 of those losses in the east of England. Those figures confirm that parts of England are becoming dental deserts; beyond Suffolk and Norfolk, that includes the east Yorkshire coastline, Cornwall, Portsmouth and the Isle of Wight.The lack of access to NHS dentistry has a fivefold impact on patients. First, millions are missing appointments. Secondly, there has been a significant increase in DIY tooth extraction. Thirdly, the poor are hit hardest. Fourthly, mouth cancers are going undiagnosed. Finally, children are suffering. This very serious situation has been confirmed by the “Great British Oral Health Report” carried out by mydentist.I apologise for going on at length, Mr Efford, but it is important to emphasis the crisis we are facing. I will now briefly outline some of the solutions. The first issue that must be tackled is getting more dentists and dental practitioners working in the NHS. The Association of Dental Groups has put forward its “six to fix” proposals for solving the workforce crisis, which I will summarise. First, we need to increase the number of training places in the UK. That is a long-term measure. Secondly, in the short term, the Government should continue to recognise EU-trained dentists. Thirdly, there needs to be a recognition of other overseas qualifications. We have an opportunity to make more of our links with Commonwealth countries such as India, which has a surplus of highly skilled English-speaking trained dentists.
- Mr MahmoodI apologise for intervening on the hon. Gentleman twice, but I just want to make the point that John Charlton, with Severn Trent Water, has worked on getting fluoridation in water for the past 30 years. We should pay tribute to him for the great work that he has done.
- I am very grateful that the hon. Gentleman intervened on me, because Birmingham is the model of how to do this. As a Birmingham MP, it is right that he highlights that, and I thank him for it.
- As I will set out in my speech, my father was an NHS dentist for 23 years. He trained a long time ago in Manchester, and he told me that the advent of sugary foods and drinks had had an enormously detrimental effect on children’s teeth over the years. The one thing we can do to solve that problem is fluoridation of our waterstream. It has made such a difference, and I thank the hon. Member for Birmingham, Perry Barr (Mr Mahmood) for raising that point.
- I am grateful to my hon. Friend for re-emphasising that.
- Birmingham is an interesting case. Not all of Birmingham is fluoridated, so when a child arrives, dentists can tell which part of Birmingham they have come from. No cavities, no fillings—fluoridated. Fillings and cavities—non-fluoridated.
- I thank my hon. Friend for re-emphasising that case.
- I thank my hon. Friend for being so generous in giving way so many times.There is another point that ought to be mentioned here. As far as I am aware—I hope my hon. Friend can confirm this—no detrimental effects from fluoridation have yet been found anywhere, and we ought to scotch any rumours to the effect that they have.
- Order. Before the hon. Gentleman responds, I should just point out that a number of Members who have their names down to speak are intervening. To respect others who want to speak, could you please refrain.
- I am grateful because, with those four interventions, we have re-emphasised the importance of fluoridation.There is a need for greater accountability, and the Health and Care Bill can provide the framework within which that can be secured. It is welcome that the commissioning of dentistry is set to move to integrated care systems. That can make for a more transparent system, but there is a risk that dentistry and its impact on overall health could be overlooked in the integrated care proposals. It is important that dentists are properly represented on integrated care system boards.At Report stage of the Health and Care Bill, I tabled new clause 18, which called on the Secretary of State to publish an annual report on access to NHS dentistry, to collect data on the length of waiting times for primary dental care treatment and, if necessary, to take action. The Minister for Health declined to accept the new clause. I do not know whether a similar clause will be introduced in the other place. If it is, I would urge the Government to give it serious consideration. Such a reporting mechanism can drive sustainable and meaningful improvement in access to NHS dentistry.Mr Efford, you will be delighted to learn that I am coming to a conclusion. Tackling access for NHS dentistry, which has been neglected for 15 years, is an opportunity that we must grasp in order to demonstrate the levelling up of healthcare right across the UK. We must put in place an NHS dentistry system that is fit for the 21st century, instead of reversing into the 19th century.
- I am grateful to the hon. Member. It looks like we have six minutes each for Back-Bench speeches. If anyone can deliver their speech in less time, it would be very helpful.
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