Reforms to NHS Dentistry

Sharon Hodgson Excerpts

Thursday 27th April 2023 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

Sadly we have been here before, time and again, and this Conservative Government still refuse to act, consigning yet another public service to the scrapheap. Once again my constituents are paying more and getting less under this Tory Government. I thank my hon. Friend the Member for Bradford South (Judith Cummins) and the hon. Member for Waveney (Peter Aldous) for securing this very important debate. We need this crisis to be urgently addressed.

It cannot be denied any longer: we face an existential crisis in NHS dentistry. It really is at breaking point. The latest area in my constituency to be affected is Pennywell in Sunderland, where the Bupa branch will close its doors in June, affecting 7,800 NHS patients. Not a week goes by without correspondence from a constituent in dire need, in despair and often in acute pain, unable to find an NHS dentist and unable to afford a private one. The nearest NHS practice accepting new patients for those constituents is in South Shields, nearly an hour away from Pennywell on public transport. That is completely unacceptable.

We cannot accept dental care becoming a luxury available only to those who can afford it. To add insult to injury, during this Conservative cost of living crisis the Government have hiked dental care prices by 8.5%. Those choices are being made by the Prime Minister and his billionaire buddies, who have never had to worry about the cost of anything such as this and do not understand the effect that that record increase will have on the cost of living pressures facing ordinary people in my constituency and across the north-east. The hike will not put a penny into NHS dentistry, either; it will just force millions to reconsider whether they can afford necessary dental treatment. We risk the horror of DIY dentistry becoming the norm.

Across 13 years, the Conservatives have chosen millions of pounds of short-term cuts, but the long-term cost of health inequalities is a price my constituents will pay for generations. The Government chose not to listen to dentists and they knew that the woefully inadequate NHS dentistry contract was not fit for purpose. That is not a new problem. Make no mistake, not only are the Conservatives allowing this crisis to worsen, but their inaction suggests to me that this is actually the result they desire.

My constituents are furious, as am I. They are either forced to pay over £100 more for the exact same NHS care they could get under a Labour Government in Wales or they are left unable to access any treatment at all. We need a Labour Government who will prioritise healthcare access for all, clear up 13 years of Tory underfunding and mismanagement, and abolish the Prime Minister’s precious non-dom status in order to provide the treatment and dental care that the British people deserve. The people of Sunderland and Washington should not have to suffer because of Tory chaos and managed decline that leave dental care a luxury for the few.

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[Jill Mortimer (Hartlepool) (Con)]

I, too, thank everyone involved in securing this important debate, including the hon. Member for Bradford South (Judith Cummins), who so eloquently laid out the terrible state of NHS dental services in this country today and the desperate need for reform of that terrible Labour 2006 contract, which, in effect, destroyed NHS dental services in the UK. That is why I welcome the general direction of the Government’s plans for NHS dental reform, as outlined in the statement on 19 July last year. It is a good start, but we must do more. We must take this opportunity to not only put NHS dentistry back on track after disruptions during covid, but ensure we create a long-term sustainable plan to enable good NHS dentistry for all who want it.

I wholeheartedly agreed with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), when she said that

“the contract is the nub of the problem; it is currently a perverse disincentive for dentists to take on NHS work.”—[Official Report, 14 June 2022; Vol. 716, c. 135.]

That contract is the primary structural issue in NHS dentistry at the moment and has been since 2006. I have spoken to a dentist who owns 17 NHS practices across England, including two in my constituency. They are struggling financially to keep those practices going, but are totally committed to providing NHS dental services to my constituents and so push on despite the difficult environment.

[Mrs Hodgson]

Will the hon. Lady give way?

[Jill Mortimer]

No, I want to make progress.

That dentist’s many problems include the unfair way UDA rates are calculated, which ironically disadvantages areas such as Hartlepool, which have severe health deprivation. That has knock-on effects on their ability to employ staff at competitive rates and leads to a reliance on expensive locum dentists, further stretching the viability of the business. Dentists find a way to make their practices work with access contracts, but the lack of certainty they face because of the difference in competences between different integrated care boards adds further issues. For example, under one ICB’s access contract they were provided with clarity for a two-year period, but under our ICB they were still waiting to hear at the end of the month whether a contract would be renewed four days later. Not only did the survival of the practice and the jobs of 30 staff depend on that contract, but the dental care of 20,000 patients also depended on it. Thankfully it was renewed, but it is unacceptable that the ICB provided them with no indication of whether the contract would be renewed so close to its end. No business can run like that.

For areas such as mine that have a desperate need of NHS dental services, we should be fully valuing and supporting good dentists like that to ensure the survival of their essential services. I urge the Minister to consider radical reform of the way in which NHS dental service contracts are remunerated, so that established NHS dentists continue to offer NHS services to new patients. I would also like to see changes to stop newly qualified dentists being tempted into private work. It costs the taxpayer a significant amount of money to train a dentist, but they are not then required to work in the NHS. It is only fair on working people who have subsidised these professionals to train in their chosen career to expect a degree of payback. I would therefore welcome the Minister looking into the possibility of a staggered mandatory amount of NHS work per year for the first few years after qualification.

Good dental care starts with good preventive care, and I want to see a day when everyone who wants it can access NHS dental services for all routine procedures and check-ups, not just emergencies, without the difficulties that my constituents are currently facing.

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[Mrs Hodgson]

I am listening intently to what the Minister is saying. When I go back to speak to my local dentists, what do I tell them about the “when”? He is saying all the things that we would like to do and the Government would like to do. We want to see all that happen, but when will this contract that has needed changing since 2010—[Hon. Members: “2006!”.] We had changing it in our 2010 manifesto; we said we would update it in 2010. The Government have had 13 years to fix this, so when is it going to happen?

[Neil O’Brien]

I have mentioned some things that are already changing—some of the first reforms to the contract since 2006 that we have started to bring in. We are working on the plan at pace. There is no date for its publication yet, but we are working on it at pace because we are conscious of the urgency.

I thank the hon. Member for Bradford South and my hon. Friend the Member for Waveney for securing this important debate. I hope they have been assured that we have started to reform dentistry, that we are seized of the importance of the issue, and that we recognise that we can and must go further to further strengthen NHS dentistry.