NHS Dentistry: Rural Areas

Motion made, and Question proposed, That this House do now adjourn.—(Gerald Jones.)

I am grateful to have secured this evening’s Adjournment debate on access to NHS dentistry in rural areas.

In my first few months as the Member of Parliament for Chippenham, there has been one issue that has been raised with me almost every day: the decision by Hathaway dental practice in Chippenham to close its doors to NHS patients on 1 November. Today, I wish to put on the record why dentists like Hathaway are ceasing to offer NHS dental care, and why that is particularly devastating in rural communities such as the one I represent.

Since being elected, I have corresponded with hundreds of my constituents about the state of NHS dentistry in Wiltshire. I have met patients, one of the directors of Hathaway dental practice, representatives of our integrated care board, Denplan and the British Dental Association—anyone that could help me understand what was happening, why it was happening, and how we might save NHS dental care in Wiltshire from disappearing altogether.

Only a week into this Parliament, I was able to raise the issue with the Secretary of State for Health and Social Care during a briefing on preventive healthcare. Today, I hope to make the case to Ministers—yet again—that NHS dental care is in crisis. The failure to fix NHS dentistry is proving catastrophic in rural communities up and down the UK and is, unfortunately, not a problem unique to the south-west. I thought it might be helpful for colleagues if I took the time to relay some of the facts.

I thank my hon. Friend for giving way. At a time when tooth decay is the most common reason for hospital admission in children aged between six and 10, and when my constituents in rural areas such as Swallowfield and Hurst struggle to access dentists, does she agree that the Conservative party has fundamentally failed the country on dentistry?

I agree that dentistry has been failed over the past 14 years.

According to the House of Commons Library, 51,000 children have not seen a dentist in Wiltshire in the past year.

My constituent in Ilton is now in debt because they had to take their son, who is eligible for free NHS dentistry, to a private dentist, as they could not find an NHS dentist in the whole of Somerset. Sadly, that comes as no surprise, given that four in 10 children in Somerset have not been able to see a dentist this past year. Does my hon. Friend agree that dentists need to be encouraged back into the NHS by reforming the broken NHS dental contract?

I do agree with my hon. Friend, and I will mention that point later in my speech. It is no surprise to me that children in her constituency are having similar problems to children in my constituency.

According to NHS England, only 33% of adults under the NHS Bath and North East Somerset, Swindon and Wiltshire integrated care board have seen a dentist in the past two years. According to a freedom of information request by the British Dental Association, my local ICB’s projected dentistry underspend equates to £4.6 million.

When Hathaway closed its door to NHS patients last Friday, this was a major blow to my constituents.

Some of my constituents in Melksham and Devizes, who until recently have had an NHS dentist in Chippenham, now find that the service has been stripped away from them. They now have to pay a monthly fee, which totals up to more than £150 a year at a minimum. Does my hon. Friend agree that that and the state of children’s dentistry are becoming a source of national shame? Urgent funding is needed now to revive vital services and to ensure that the oral health of the nation’s children and adults is protected.

I agree with my hon. Friend; that speaks to the fact that we are being left with a dental desert, with no sign of relief.

I commend the hon. Lady for securing this important debate. She mentioned that dental deserts can be a problem up and down the country. That is certainly the case in my constituency of North Northumberland. I welcome the Government’s dental rescue plan and the commitment to an additional 700,000 appointments per year. However, my situation is like hers: constituents in hundreds of square kilometres of my constituency tell me that they simply cannot access NHS dentistry. It is a real shame that no Conservative Members are here to hear this. Does the hon. Lady agree that rural residents should expect the same provision of NHS dentistry as those in urban areas?

I do agree with the hon. Member. The real issue for rural areas is, again, access to public transport. Dental provision might be relatively close in theory, but public transport does not allow people to get to the dentist. The issue of rurality is important and needs to be addressed.

Analysis conducted by the Rural Services Network shows that someone living in a rural area is less likely to be able to access an NHS dentist than those living in an urban area, with 10% fewer dental practices taking on new adult NHS patients in rural areas. The analysis also shows that in rural areas, there are 16% fewer dental practices with an NHS contract per 100,000 people. That again points to the fact that rural areas are definitely in a worse situation than urban ones.

I commend the hon. Lady for bringing this issue forward; the number of people in the Chamber indicates the interest in it right across the United Kingdom of Great Britain and Northern Ireland. Does she agree that dentistry is on the brink and that the additional national insurance contributions are going to push even more dentists into refusing NHS contracts and taking private patients only? Should not the Government immediately instigate an increase in prices in rural areas, to save the few dentists left who are braving rural isolation and the increased costs of operation?

I agree with the hon. Member. The disparity is clear. As he mentioned, rural areas are being hardest hit by our broken NHS dental contract system.

Unfortunately, there does not seem to be much hope on the horizon. Denplan tells me that 90% of dentists plan to reduce their NHS commitment in the next two years and that the UK has the lowest dentist-to-population ratio in the whole of Europe. Although all dentists are dedicated to improving the nation’s health, access to NHS dental services remains a persistent challenge under the current system, particularly in rural areas.

In lieu of the dental contract being renegotiated, could something not be done by the local integrated care boards that commission dentistry to make special provision for local contracts when dentists are considering giving up contracts in the short term? That could be done now, in lieu of that renegotiation.

I agree. Hold on. [Interruption.] Sorry.

Will my hon. Friend give way?

Yes—thank you, Richard.

My hon. Friend is making an excellent speech. She has mentioned ICB commissioning. I wrote to the Minister to ask whether there were set criteria for knowing where a patient is on the waiting list, and I understand that that is entirely in the gift of individual practices. Does my hon. Friend think that it ought to be for ICBs, or for NHS Devon in my case, to determine where people are on the waiting list for NHS dental care?