NHS Dentistry

(Limited Text - Ministerial Extracts only)

Read Full debate
Tuesday 9th January 2024

(3 months, 2 weeks ago)

Commons Chamber
Read Hansard Text Watch Debate
Victoria Atkins Portrait The Secretary of State for Health and Social Care (Victoria Atkins)
- View Speech - Hansard - - - Excerpts

I beg to move an amendment, to leave out from “House” to the end of the Question and add:

“recognises the impact of a once-in-a-generation pandemic on NHS dental services, with 7 million fewer patients seen in England across 2020 and 2021; notes these challenges were reflected in both Scotland and Wales; acknowledges the steps already taken to recover services in England including the introduction of a minimum rate and increased payments for complex dental activity to better reward dentists for their work; welcomes the publication of the Long Term Workforce Plan which committed to expanding dental training places by 40 per cent; and supports the upcoming publication of the Government’s plan to further recover and reform NHS dentistry and promote good oral health throughout life.”

It is a pleasure to update the House on the work the Government are doing to strengthen NHS dentistry across the country. We are reforming our NHS and social care system to make it faster, simpler and fairer. Dentistry is a vital part of our NHS and improving dentistry is one of my top priorities. The hon. Member for Ilford North (Wes Streeting) represents a deeply urban seat, so I am pleased that he has presented me with an excuse to boast about the fact that I represent, and am very proud to represent, a rural and coastal constituency. That is why fairness is one of my three priorities for our NHS. I know the challenges that rural and coastal communities face when it comes to accessing an NHS dentist appointment, and the disparities in health that we see between rural and coastal communities and city centres. I will come to some statistics in a moment.

I am determined to fix these issues, and the other problems facing NHS dentistry, so that anyone who needs to can always see an NHS dentist, no matter where they live. Indeed, one of my very first acts as Secretary of State was to respond to the Health and Social Care Committee’s recommendations on dentistry. We agreed to the majority of those recommendations, and we stand firmly behind the ambition that NHS dentistry should be accessible and available to all who need it.

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I am going to make a little progress, but I promise to give way later.

The whole House understands that the pandemic placed a long-lasting and heavy burden on NHS dentistry. [Interruption.] I hear groans from Opposition Members, but they cannot ignore the fact that some 7 million people did not come forward for appointments during that long period of the pandemic because dentists had to shut, and we were unable to accommodate those needs within the system because of the severe strictures under which we were all placed as a society. We shepherded the sector through the pandemic with £1.7 billion of direct support to compensate for NHS activity that could not be delivered. As we recover from the pandemic there are no quick fixes, but our recovery is well under way. Let me give the latest statistics, because the hon. Member for Ilford North missed them out in his speech. The Government delivered 6 million more courses of NHS dental treatment in 2022-23 than in the previous year. [Interruption.] In the two years to June 2023, the number of adults seeing a dentist increased by 1.7 million compared to the number in the previous year, and 800,000 more children saw a dentist in the year to June 2023.

Opposition Members cannot have it both ways. While I was reading out those statistics they were saying, “You cannot make those comparisons because of the pandemic”, but that is the point: people did not come forward during the pandemic, so, as we must all know from experience in our own constituencies, there is a backlog that dentists around the country are having to work through—and they are making progress.

--- Later in debate ---
Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

In fairness, I will give way to the hon. Member for North Shropshire (Helen Morgan) first, because she rose earlier.

Helen Morgan Portrait Helen Morgan
- Hansard - - - Excerpts

Like the Secretary of State, I represent a rural community, and the reason dentists are handing back their NHS contracts where I live is that they cannot recruit another dentist to come and help them. They have not had a day off, they cannot meet their commitments under their contracts, and they cannot recruit. They have offered golden hellos of 25%, but they have not been able to get anyone to come and work with them. What will the Secretary of State do to recruit the dentists whom we need to see the people in dental deserts such as North Shropshire?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

As I have explained, in relation to dentistry but also in relation to wider healthcare, the long-term workforce plan, which was requested by NHS England and by clinicians, is the means of laying those foundations for the future of the NHS. I will now give way to the hon. Member for Wallasey (Dame Angela Eagle).

Angela Eagle Portrait Dame Angela Eagle
- Hansard - - - Excerpts

I thank the Secretary of State. I wanted to intervene earlier when she was talking about the pandemic. In my constituency many people were thrown off their dentists’ lists during the pandemic, often with no notice, and then found that they could not register anywhere else. That is what happened, I believe, all over the country. Can the Minister explain what she is going to do about it? It was not that people were not visiting their dentists; they were denied access.

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

The hon. Lady has raised an interesting and important point, because, of course, dentists are independent contractors to the NHS, and I have to work with the levers that are available to me. As I have said, we have already invested £1.7 billion to try to help with the recovery, and the House will, I hope, look forward to our dentistry recovery plan when it comes to other ways in which we can improve that. The important point, however, is that because those dentists are independent contractors, we must work with the profession to encourage them back to the NHS to offer the services that we all want to see.

John Hayes Portrait Sir John Hayes (South Holland and The Deepings) (Con)
- Hansard - - - Excerpts

Is not the root of the problem the contracts that the NHS has with dentists? The roots of that, of course, lie with the previous Government, a Labour Government, rather as they do with the GP contracts. Does my right hon. Friend not need to revisit the genesis of this problem, as well as training more dentists here in the UK?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I thank my right hon. Friend, and indeed my friend, my Lincolnshire neighbour, who knows as well as I do the pressures that we face in ensuring that our constituents receive the same quality of care that we expect across England. He was right to draw attention to the—I would argue—badly drafted contract of 2006, but he also touched on the complexity involved in finding systems that would work better.

--- Later in debate ---
Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I cannot wait to reach the part of my speech that will deal with the hon. Gentleman’s suggestions, but first I will allow him to intervene, because I enjoy this back and forth.

Wes Streeting Portrait Wes Streeting
- Hansard - - - Excerpts

So do I. The Secretary of State is far more entertaining than her predecessor. Given that she is painting a picture of improvement, how does she explain the story in The Times which revealed that NHS dentistry activity is now falling in 2023-24 compared with 2022-23? Is it not the case that things are going backwards rather than forwards? How does the Secretary of State explain that, and when are we going to see her plan?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I am grateful to the hon. Gentleman for raising that point, because according to the latest statistics available to me, 18.1 million adults were seen by an NHS dentist in the 24 months up to 30 June 2023. That is an increase of 10%, and what does it mean in reality? It means that over 1.7 million more adults were seen than in the previous year. I know that we are all concerned about the health of children; some 6.4 million children were seen by an NHS dentist in the 12 months up to 30 June 2023, an increase of 14%, which means, in real terms, an increase of 800,000 on the previous year.

I accept, of course, that there is more to do, and we will be setting that out in our dental recovery plan shortly, but this is not just about big numbers. [Interruption.] The hon. Gentleman asks when “shortly” will be. As he knows full well, “shortly” is a little shorter than “in due course” and a little longer than “imminently”.

We have introduced several simple and effective measures to improve the nation’s dental health. The Health and Care Act 2022 made it simpler to expand water fluoridation schemes, because raising the fluoride level to 1 mg per litre is a straightforward way to prevent tooth decay. It has proved effective in parts of England as well as Canada, the United States, Ireland and Australia, and the chief medical officer has concluded that there is “strong scientific evidence” that water fluoridation can drive down the “prevalence of tooth decay”.

Anthony Mangnall Portrait Anthony Mangnall
- Hansard - - - Excerpts

I congratulate the Secretary of State on the progress that has been made, while, obviously, recognising that there is more to be done. I wonder if she will help me to ask the shadow Minister to correct the record. He said that in 2010 and 2015 Labour had a plan for dental practice, but there is no mention of that in the Labour manifestos. I will come back and correct that if necessary, but the hon. Gentleman is out there stating that Labour has had a plan for dental recovery since 2010, and that is not in those manifestos.

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

My goodness me! My hon. Friend has identified a “cavity” in the shadow Minister’s so-called plans.

None Portrait Several hon. Members rose—
- Hansard -

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I am going to make some progress.

I am very pleased that, subject to a public consultation which will be published shortly, we have secured funding to expand water fluoridation schemes across the north-east of England. [Interruption.] The hon. Member for Ilford North may be interested to know why we have identified the north-east, given that he read out so many constituency names in his speech. The north-east was chosen because natural fluoride levels there are among the lowest in the country, and the proportion of five-year-olds with teeth extracted because of tooth decay is among the highest. We have wanted to address that very real health inequality to ensure that more than 1.6 million people in the area can benefit from this expansion, subject, as I have said, to a public consultation.

Supervised tooth brushing has been raised. That has indeed been proven to drive down oral health inequalities, which is why we have already introduced a toolkit that local authorities are using to introduce supervised tooth brushing across schools, nurseries and family hubs. We have been clear that we want to see that happening in more areas. I would encourage any colleague who is concerned about that, rather than waiting for some mythical date in the future, to ask our local authorities whether they are using these toolkits, because they are freely available, and they can and should put them in place.

Catherine West Portrait Catherine West
- Hansard - - - Excerpts

The Secretary of State rightly talks about prevention, but what about the opposite, where rates of oral cancer have gone up because prevention has not been in place? What assessment has she made? If she does not have the data to hand, will she write to me with the assessment that the Department of Health and Social Care has made of the link between failure on prevention and cancer?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I thank the hon. Lady, and particularly for the constructive tone of her intervention, because she is right. This is not simply about teeth health; it is also about the conditions that dentists check for—probably without anyone quite realising that they are doing so. I will take the hon. Lady up on her invitation to write to her on the figures, but that is why we are looking at health inequalities across the country and, importantly, focusing on encouraging dentists to re-register with the NHS if they have left, because it is vital for tackling much wider health conditions in addition to the pain and discomfort that tooth decay can bring.

Ashley Dalton Portrait Ashley Dalton (West Lancashire) (Lab)
- Hansard - - - Excerpts

Will the Secretary of State give way?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

No, I will give way to my hon. Friend the Member for North West Norfolk (James Wild) and then I will make some progress.

James Wild Portrait James Wild (North West Norfolk) (Con)
- Hansard - - - Excerpts

My right hon. Friend mentioned levers. One issue facing recruitment in North West Norfolk is the time involved in getting on to the NHS performers list. Newly in post, will she look at that issue and bring forward proposals as part of the plan to speed up that process and boost recruitment?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I am extremely grateful to my hon. Friend. His intervention shows the level of detail that colleagues on the Conservative Benches have gone into in trying to address the understandable concerns that local NHS providers are voicing. I will look into that. I am very keen on my three words: faster, simpler, fairer. I want to make it as simple as possible for dentists to rejoin and join the NHS. I will say more on that later.

The choice of whether patients are offered NHS exams and treatment lies with the dentists, who are independent contractors to the NHS. As well as making simple, common-sense changes, in July 2022 we announced a package of far-reaching reforms to make NHS work more attractive to dentists. We have created more bands for units of dental activity, so that dentists are properly rewarded for taking on more complex care, and the best-performing practices can see more NHS patients.

Previously, regardless of the amount of time the dentist took on each patient, they received the same payment for every individual treatment package in band 2, which covers fillings and tooth extraction. Perversely, that meant they received the same payment for doing one filling as for three. That left many dentists unable to afford to take on patients who had not seen a dentist for some time and therefore needed extensive treatment. That needed to be put right for the sake of both patients and dentists. Thanks to our reforms, dentists now receive five units of dental activity when they treat three or more teeth, which is a significant increase from the old maximum of three. Root canal treatment on molar teeth is now rewarded with seven units of dental activity, as opposed to three, meeting one of the British Dental Association’s key demands.

We also recognise the barriers that too many communities have faced when accessing NHS dentistry, with people left phoning around practices to see who was taking on NHS patients. That is why we have made it a contractual requirement for dentists to update the NHS website regularly, making it clear whether their practices are taking on new patients, as well as explaining the services that they offer, thus making it easier for patients to find a dentist that can deliver the care they need. These reforms have improved access to dentistry and ensured that the system better supports dentists and their teams, so they were well received by dentists, their representatives and patient groups across England, with Healthwatch’s national director recognising that these reforms show that the Government are listening to patients and taking action, and these reforms can help ensure that dental care is accessible and affordable to everyone who needs it.

Wera Hobhouse Portrait Wera Hobhouse
- Hansard - - - Excerpts

I am pleased to hear about some of the reforms that we have raised in this Chamber many times, particularly on changing the dental contracts and units of dental activity, but may I raise another point? In official workplace data, dentists who do just one NHS check-up a year are counted the same as an NHS full-timer. Does the Secretary of State recognise that that is a problem, because that workplace data hides the scale of the problem?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I am extremely grateful to the hon. Lady, who makes a fair point about measuring within the system how much work NHS dentists are doing. As I say, we are looking at all of this in the work that we are doing on the dentistry recovery plan. I repeat that I want to make it as simple as possible for dentists to register with the NHS, to continue offering the care that we all want them to, so I am grateful to the hon. Lady for her intervention.

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I am going to plough on, I am afraid.

Earlier, Labour Front Benchers—perhaps not understanding that they were doing so—set out the philosophical difference between our two parties on how to grow the economy. As our economy grows, we on the Conservative side of the House want to attract the best and the brightest from around the world to work in our NHS, in our tech sector, in our life sciences industry, in our movie industry—hon. Members may know that it filmed “Barbie” this year—and in many other thriving industries. Labour, however, apparently wants to shut the door by taxing such people on earnings they make outside the UK. I speak, of course, of non-domiciled tax status.

If I may correct the hon. Member for Ilford North, because I appreciate that he has not spent any time on the Front Bench, last year alone non-domiciled taxpayers paid £8 billion in UK taxes on their UK earnings. That is equivalent to more than 230,000 nurses. Labour wants to put that at risk and put the UK at a disadvantage in the highly paid, highly competitive, highly mobile international labour market. This really is yet another branch of the magic money tree that Labour has always been looking for, to which they apparently want to add £28 billion a year of taxes or increased borrowing and increased inflation.

How they want to spend this money is interesting as well, because in 2022 Labour promised that their non-domiciled taxation would fund a workforce plan. Last September, it became breakfast club meals. Then, by October, it had morphed into 2 million hospital appointments and MRI and CT scanners. Now, apparently, it is funding a dentistry plan. One wonders how all these magic branches on the magic money tree will add up to all the promises made so far.

Wes Streeting Portrait Wes Streeting
- Hansard - - - Excerpts

Will the right hon. Lady give way?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I will resist, but only because I am going to ask the hon. Gentleman to intervene in a moment—he should be careful what he wishes for. I also notice that he talked about reform of the dental contract but did not give any detail. Government is not as easy as selling a book. It cannot be cut and pasted from Wikipedia, as some on the Labour Front Bench seem to like to do. It is about being clear on what you would do differently. Now, Labour in Wales is of course running the Welsh NHS. They do like to do things differently. People there are almost twice as likely to be waiting for health treatment as in England.

Virginia Crosbie Portrait Virginia Crosbie (Ynys Môn) (Con)
- Hansard - - - Excerpts

The Leader of the Opposition states that the Labour Government in Wales is a blueprint for what Labour can do in the UK. Given that 97% of high street dentists in Wales state that Labour’s reforms are not working, does the Secretary of State agree that NHS dentistry is being destroyed by Labour in Wales, and that if Wales is their blueprint for UK dentistry, we should all be very afraid?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I thank my hon. Friend, who represents a Welsh constituency. The chair of the British Dental Association wrote to the Labour Welsh Government to complain about their plan and, I understand, used words such as “toxic mix of underinvestment” and “untested targets.” The picture in Wales, if it is the Leader of the Opposition’s blueprint, is perhaps not as convincing as the shadow Health Secretary would have us believe.

The fundamental difference between the current systems in England and Labour-run Wales is that Wales has a capitated list system for dentistry. I am willing to give way so that the shadow Health Secretary can clarify whether he wants to bring in that system.

Wes Streeting Portrait Wes Streeting
- Hansard - - - Excerpts

I cannot believe that is meant to be the right hon. Lady’s big “Gotcha.” She cannot even tell us when she will bring forward her plan, let alone what is in it. They have had 14 years to come up with a plan. This is absolutely astonishing. As much as I enjoy these partisan knockabouts at the Dispatch Box, the sight of the Health Secretary giggling and laughing at her own jokes will be of small comfort to people who are literally pulling out their own teeth.

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

Just to cut through all the froth, the hon. Gentleman has not, in fact, answered my invitation. Does he wish to have a capitated list system, as they have in Wales, or does he have other plans? Could he please answer?

Wes Streeting Portrait Wes Streeting
- Hansard - - - Excerpts

Like any responsible Government, we would consult the dentistry profession, the BDA, and come up with a serious programme for dentistry reform. If the right hon. Lady wants to ask me questions and have me answer them, the Government should call a general election and I will happily oblige.

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

Again, cutting through the froth, the hon. Gentleman called this debate and has not set out his plan. He knows full well that this is an Opposition day debate and I am responding to Labour’s motion by moving an amendment. He has no plan on dentistry. When I asked him to clarify whether he will follow the capitated system in Wales, he declined to answer. I assume that is because he knows we tested a prototype system based on the Welsh capitation approach here in England, and the results were clear. It worsened access and widened oral health inequalities.

The hon. Gentleman quoted the Nuffield Trust, placing great emphasis on it, in his opening speech. As he agrees so much with the Nuffield Trust’s report, does he also agree with its former chief executive who said that his ideas on general practice represent

“an out of date view”

and “will cost a fortune”?

It is becoming increasingly clear that the Labour party’s approach to our NHS is empty words about reform followed by the phrase “funded by non-doms.” We are very lucky in this country—on this side of the House we consider ourselves blessed—to have incredible dentists working across the NHS.

Here are some facts for Opposition Members. There are now 1,352 more dentists working in the NHS than 14 years ago, thanks to the stewardship of this Conservative Government. I thank them and their colleagues for everything they do, and we are backing them to build a brighter future for NHS dentistry by taking concrete steps to improve recruitment and retention. That is why our long-term workforce plan, the first in NHS history, will expand dentistry training places by 40%, providing more than 1,100 places by 2031, which will be the highest level on record under any Government.

Over the same period, this Government’s plan will also increase training places for dental therapists and hygiene professionals to more than 500. The importance of the long-term workforce plan to dentistry’s future was recognised across the sector, and Professor Kirsty Hill, who chairs the Dental Schools Council, backed our plan:

“Expansion is a significant and positive development, and we commend the government for recognising the importance of increasing dental hygiene and dental therapist positions. These roles play a vital role in enhancing capacity and improving care.”

Debbie Abrahams Portrait Debbie Abrahams (Oldham East and Saddleworth) (Lab)
- Hansard - - - Excerpts

I find it absolutely extraordinary that the Health Secretary lectured the shadow Health Secretary on calling a debate to hold this Government to account. Twelve million people are not able to access dental care, including thousands in my Oldham constituency.

--- Later in debate ---
Rosie Winterton Portrait Madam Deputy Speaker (Dame Rosie Winterton)
- View Speech - Hansard - - - Excerpts

Order. The hon. Lady knows that she must not refer directly to other Members.

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I think the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) was raising her voice at me, but it was not me who heckled her. I recognise the passion she brings to her intervention, and I simply made the point that this is an Opposition day debate. The hon. Member for Ilford North understandably set out some of his plans, which is his job, and I was merely questioning him on the detail of those plans. Sadly, he was not able to provide that detail.

The long-term workforce plan is about not just training more staff but delivering value for hard-working taxpayers. Currently, around a third of dentists do not carry out any NHS work. This simply is not fair on the taxpayers who fund their training, which is why, through the long-term workforce plan, we are exploring the introduction of a tie-in period that encourages dentists, after they graduate, to spend a minimum proportion of their time delivering NHS care. We have also made it easier for experienced dentists from around the world to come to the UK to ply their trade, which is apparently something with which Labour Members do not agree.

Last year, we brought forward legislation to give the General Dental Council greater flexibility in administering the overseas registration exam. The Government welcome its decision to triple the capacity of the next three sittings of part one of the ORE, from August last year, and to increase the number of sittings of the second part of the exam from three to four, creating an additional 1,300 places. Ministers will continue to meet the GDC to discuss how we can make these flexibilities as effective as possible, to get more dentists into the NHS workforce delivering care for patients.

Seema Malhotra Portrait Seema Malhotra
- Hansard - - - Excerpts

I thank the Secretary of State for giving way. It is worth repeating that the Nuffield Trust has warned that NHS dentistry is at its most perilous point in its 75-year history. That goes alongside recent Healthwatch polling suggesting that one in 10 people in England have ended up paying for private dental treatment in the last 12 months because they could not find an NHS dentist. It has been the same in my constituency, where the majority of dental surgeries are not taking on new patients. Can the Secretary of State explain how on earth things have got this bad?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I trust that the hon. Lady has been listening to the whole debate, because I set this out in some detail at the beginning of my speech. I will not repeat the impact of the pandemic, but I hope she has taken on board the £1.7 billion of investment that has already seen a sizeable increase in the number of adults and children being treated by NHS dentistry.

I do not pretend that this is the full stop at the end of the sentence. We have a plan and I look forward to our debate when that plan is published, because I suspect it will be welcomed across the House.

Dominic Raab Portrait Dominic Raab (Esher and Walton) (Con)
- Hansard - - - Excerpts

I commend my right hon. Friend for her powerful speech. The plan will improve financial incentives for NHS dentists and support practices to take on new patients, but to what extent will she and the plan take on board high operating costs and, indeed, the high cost of living in areas where there is high demand for NHS dentistry?

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I thank my right hon. Friend for his intervention. I can imagine that the concerns he outlines are very pressing in his constituency, and one important priority behind the dental recovery plan work is addressing health inequalities. Although I have spoken about rural and coastal areas from a constituency perspective, we also understand, of course, that there are differing cost of living pressures in different parts of the country. He makes an important point about the costs for NHS dentists operating in very expensive parts of the country, such as his constituency, and I thank him for doing so.

Our workforce is not just made up of dentists; dental care in England could not function without the vital contribution of dental and orthodontic therapists, dental hygienists, dental nurses and clinical dental technicians. We recognise the importance of harnessing the skills and knowledge of all those professionals. They can support dentists to carry out first-class care, and we must empower them to take on more responsibility and to work at the top of their licences. That is why last year we issued guidance to NHS practices, supporting them to make the most of everyone in the dental team and make a difference to patient care. Since then, NHS England has made it clear that dental therapists and dental hygienists can provide patients with direct care, provided they are appropriately qualified, competent and indemnified. We have also run a consultation to enable dental therapists and hygienists to deliver more treatments. That will boost access to care for patients and support dentists, and we will be setting out our next steps shortly.

Victoria Atkins Portrait Victoria Atkins
- Hansard - - - Excerpts

I am conscious that Opposition Members will want time today, so I am going to bring my remarks to a close. It is my mission, as Health and Social Care Secretary, to build an NHS that is faster, simpler and fairer, and of course I include dentistry in that work. We have taken the long-term decisions that will improve access to dental care. Delivering 6 million more courses of treatment, expanding dentistry training places by 40% and making it easier for patients to find a dentist to deliver the care they need are just some of the ways in which we are going to achieve that. Of course, we must make sure that dentists are properly rewarded for all the work they do. Through our soon-to-be-published dentistry recovery plan, we will go further, to make NHS dentistry accessible and available for everyone who needs it, no matter where they call home in this great country.

None Portrait Several hon. Members rose—
- Hansard -

--- Later in debate ---
Andrea Leadsom Portrait The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
- View Speech - Hansard - - - Excerpts

I welcome the chance to come to the House to hear from colleagues about the challenges of dentistry and access to dentistry, as well as some of their constructive ideas for our recovery plan, so that all our constituents can get the healthcare they deserve at a time when systems continue to be under huge pressure since the covid pandemic. The Opposition were rather determined to debate dentistry today; I am a bit suspicious that that is because they are trying to pre-guess what the Government’s dentistry recovery plan will contain, but I am as desperate as they are that we get on with it and I can assure all colleagues across the House that I am working flat-out on that.

When the Prime Minister asked me to take on this job in November, I leapt at the chance to improve our whole nation’s health and especially—as colleagues throughout the House will know—to prevent future ill health in babies and children. It is the chance to change the future health of every baby and child that is the big opportunity here, and I am proud of some of the measures we have already introduced to support supervised toothbrushing through the start for life programme and in local authorities.

The Opposition’s motion talks about supervised toothbrushing for three to five-year-olds. I do not know whether they do not know this, but we have teeth from before we are born. If children do not get your supervised toothbrushing until they are three at a minimum, their teeth are about four-and-a-half years old. It is much more important to have that supervised toothbrushing in the family hub, education for parents and supervised toothbrushing in nurseries. Let us say that that is something we can all agree on: children certainly have their teeth long before they are three, so I think our plan will be significantly better.

As my right hon. Friend the Secretary of State said in her opening remarks, recovering and reforming NHS dentistry is a top priority for the Government. That is why one of the first things I did as a new Minister was to host a roundtable with key figures from the dental sector, including the chief dental officer Jason Wong and dentists from right throughout the country, to hear about the challenges they face. I have also met colleagues from throughout the House to hear about the specific challenges in their constituencies. I have heard them loud and clear, and every bit of feedback is informing our dentistry recovery plan.

I want to set out some of the recovery that is already under way—not enough by any means, but good progress, and not the failure that Labour wants to portray it as. It is a good recovery from a disastrous situation during covid. In 2022-23, 6.1 million more courses of treatment have been delivered than in 2021-22, and seven out of 10 patients have had a good overall experience of dental services, according to surveys. More than 18 million adults were seen by an NHS dentist in the 24 months to June 2023, which was an increase of 10% on the previous year. Some 6.4 million children were seen by an NHS dentist in the 12 months up to 30 June, which was an increase of 800,000 compared with the previous year. Nearly 1,400 more NHS dentists were available in 2022-23 than in 2010-11.

Of course, in our long-term workforce plan we announced a 40% increase to dentistry training places—that is incredibly important. I pay tribute to all our NHS staff, who continue to work tirelessly to deliver vital dental care to those who need it the most. Dental staff deserve our support, which is why we are working flat out on both short and long-term solutions for the recovery and reform of NHS dentistry.

Colleagues raised a number of points that I will seek to answer in turn, although I apologise that cannot deal with them all. The hon. Member for Sheffield, Brightside and Hillsborough (Gill Furniss) and a number of other Opposition Members raised the issue of tooth decay in children. I totally agree with her that good oral hygiene right from the very beginning, even before milk teeth come through, is absolutely crucial. She also praised community dental services, and I share her gratitude to those who go out into care homes, hospitals and community centres to help people with urgent care needs.

My hon. Friend the Member for Winchester (Steve Brine), who chairs the Health and Social Care Committee, made a number of incredibly helpful points. He asked specifically whether we plan NHS access for all. We certainly intend it for all who need it. He asked how we will realise it. He said that we need to get NHS dentists back on side through our reforms, and asked about the dental workforce. He is absolutely right to raise those issues, all of which will be dealt with in our recovery plan.

My hon. Friend the Member for St Ives (Derek Thomas) is a huge campaigner for his area’s needs. He and I have already met on a number of occasions to talk about dentistry. He is right to highlight that some areas are struggling more than others because of under-delivery on NHS contracts on the one hand and insufficient NHS contracts on the other. I am prioritising measures to tackle both.

The hon. Member for Stockport (Navendu Mishra) talked about the UDA rate, which he said was just too low. I have a lot of sympathy for that argument, but equally, he will appreciate that the ’22 reforms ensured that dentists would be paid more for complex treatments.

My hon. Friend the Member for Totnes (Anthony Mangnall) rightly challenged Labour. This is a Labour Opposition day, but Labour has no real plan. Labour Members talk about lots more appointments but do not say how they will deliver them. They talk about raising the money from non-doms but they have spent that money many times over. They plan to supervise toothbrushing for three-year-olds, but that is too little, too late.

The hon. Member for Weaver Vale (Mike Amesbury) raised the issue of access to dentists. He was right to do so because that is a key challenge for everybody throughout the country. There is no clear pattern of deprivation going hand in hand with poor access to dentistry; if anything, the worst access to dentistry is in coastal areas. We are looking carefully at that to improve access right across the country.

The hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) pointed out that his ICB is supporting and promoting drop-ins where there is availability for patients. That is exactly what ICBs should be doing and is brilliant news. I appreciate his points about the difficulty that dentists find in updating the NHS website. If he wants to take that up with me separately, I will be happy to look into it on his behalf. Likewise, the hon. Member for Lewisham East (Janet Daby) raised an important case about dental insurance. If she writes to me, I will be happy to take it up on her behalf.

My hon. Friend the Member for Congleton (Fiona Bruce) talked in particular about the workforce plan and training, which are so important. We will look at many ways of increasing access, both by enabling dental therapists and hygienists to work to the extent of their licence and by getting far more overseas-registered dentists and improving their throughput so that they can start working, particularly in the least well-served areas.

My hon. Friend the Member for Darlington (Peter Gibson) highlighted the problem with NHS dentists returning their contracts in order to work privately, and he is right that we need to work on that. He shared great thoughts about a dental school at Teesside University, about the importance of graduate dentists working in the NHS and, of course, about the importance of mobile dentistry, all of which are crucial ideas.

My hon. Friend the Member for North Devon (Selaine Saxby) talked about long distances and the problem of getting dentists into more rural areas. She also raised the fact that toothbrushing and prevention are crucial. There have been some great contributions from Members right across the House, for which I am very grateful.

Dentistry has been one of the most challenging subjects in my portfolio as a new Minister, and I am determined to address it. As my right hon. Friend the Secretary of State outlined, we are investing £3 billion a year in dentistry, and we need to ensure that every penny is spent properly and delivers the best results. However, the honest truth is that to recover from covid, during which hardly anyone saw a dentist, whether private or NHS, money will not be the silver bullet—a quick funding fix cannot solve all of the backlog and deliver on our ambition that everyone who needs an NHS dentist should be able to access one. As such, we are working on both short-term recovery and long-term system reform, supported by the profession. We will be fixing some of the fundamental flaws in patient access and health inequalities that have been highlighted and exacerbated by the pandemic, many of which have been raised in the Chamber today. We have made good progress on dentistry, particularly through the 2022 reforms, and can be proud of the improvements achieved to date. Again, I sincerely thank all dental staff for their hard work and commitment to recovery.

Finally, having been on the receiving end of “in due course” for many years myself, colleagues will realise that I am chomping at the bit to reveal more about our dentistry recovery plan. I need to ask them all to be patient just a little while longer, but I will change the line about when to expect it from “shortly” to “very shortly”.

Question put (Standing Order No. 31(2)), That the original words stand part of the Question.

--- Later in debate ---
16:31

Division 34

Ayes: 191


Labour: 163
Liberal Democrat: 13
Independent: 6
Democratic Unionist Party: 6
Social Democratic & Labour Party: 2
Alliance: 1
Green Party: 1

Noes: 299


Conservative: 295
Independent: 1

Question put forthwith (Standing Order No. 31(2)), That the proposed words be there added.