NHS Dentists: South-West England

Simon Jupp Excerpts

Wednesday 24th May 2023 Westminster Hall

[Chris Loder]

I thank the hon. Gentleman for his short and succinct intervention, as ever. He is absolutely right and confirms that this issue needs to be addressed across the United Kingdom, not just in the south-west. I am delighted that he has attended this debate on dentistry in south-west England.

The south-west region was recently rated fifth out of seven for adult NHS dental coverage, with only 35% of adults covered by access to essential dental services, which is below the national average. Dorset fares slightly better, but adults in my constituency and those immediately neighbouring it also experience below the national average coverage for an NHS dentist.

The inequality is also affecting children, whom I am particularly concerned about. Although they are faring better than adults, with a coverage rate of 46% in both Dorset and the south-west, that is still below the national average for access to NHS dental services. Without those services, almost one third of five-year-olds are suffering from tooth decay, which is the most common reason why children aged between five and nine are admitted to hospital. Tooth decay is mostly preventable, so its effects serve to demonstrate what a lack of access to NHS dentistry is doing to our children.

Why are we faced with this difficulty? Why is dentistry in England, and particularly the south-west, under such pressure? Although the answer is multifaceted, I believe the reason is primarily threefold: first, the National Health Service Act 2006 and the subsequent dental contract; secondly, the lack of institutional services and the knock-on effects; and finally, the NHS backlog following the covid-19 pandemic.

The National Health Service Act 2006 set out the provisions for agreement between NHS England and dental practices in relation to services that would be provided and the renumeration for those services. Before the Act became law, the National Audit Office and the Public Accounts Committee both produced reports to the then Government on reforming NHS dentistry, which raised concerns about the 2006 changes. Those concerns included the urgent need to change the incentive mechanism for dentists to increase their commitments to NHS dentistry, the difficulty for patients in better-off areas in accessing public health services, and the difficulty for those in more deprived areas in accessing any services at all.

The reports also raised concerns that there would be a shortage of NHS dentists, a glut of people who would be left without access to NHS dentistry, and no guarantees that the reformed contract would be enough to commit dentists to the NHS rather than private practice.

[Simon Jupp (East Devon) (Con)]

My constituents in East Devon regularly contact me about difficulties getting NHS dentist appointments in places such as Sidmouth, Budleigh Salterton and Exmouth. Problems with recruitment and contracts have been compounded by the pandemic, but that excuse will not wash forever. Does my hon. Friend agree that additional reforms of the NHS dental system cannot come soon enough for the south-west?

[Chris Loder]

I thank my hon. Friend for his intervention. I wholly agree with him that reforms are needed urgently, which is the main point I will be sharing with the Minister towards the end of my contribution. It is clear that some of the measures from the 2006 Act do not go far enough. In many cases, they actually deter NHS dentistry provision.

Many of these issues are evident up and down the country today. Discussions with my own integrated care board in West Dorset—which, as of 1 April this year, has taken delegated responsibility for commissioning dental services from NHS England—have confirmed to me that the dental contract signed in 2006 is simply not fit for purpose. It actually restricts the ability of the board to respond to the current situation. That is because the terms and structure of the contract make it incredibly difficult for the integrated care board to attract new dentists to work in Dorset. I am sure that other integrated care boards across the south-west share that problem. The ability to attract new dental talent, especially those who are working on NHS contracts, is further hindered by our specific circumstances in Dorset. We do not have adequate training infrastructure.