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Category: Health

  • Wera Hobhouse – 2022 Speech on NHS Dentistry

    Wera Hobhouse – 2022 Speech on NHS Dentistry

    The speech made by Wera Hobhouse, the Liberal Democrat MP for Bath, in the House of Commons on 20 October 2022.

    I have been horrified—honestly horrified—to hear reports of people pulling out their own teeth because they are unable to see a dentist. Unfortunately, that is now a reality as a result of Government underfunding of dentistry over many years. In my constituency, only three in 10 patients have seen an NHS dentist in the past two years and only six in 10 children have been able to see a dentist in the past 12 months, although the NHS continues to recommend that all under-18s see a dentist at least once a year.

    The way in which the Government have let the NHS dentistry system collapse is a national scandal. Nearly a quarter of all British people have failed to secure a local NHS dentist appointment in the last year. Of those, one in five have resorted to what we now call DIY dentistry, which is terrible. Our public services are so starved of funding that people are being forced to stop trying, or to pay for private treatment. The British Dental Association says that we are facing an “existential threat”. People’s health is at risk if they do not have access to dentistry. Tooth decay is the No. 1 reason for hospital admissions among young children. Oral cancer is one of the fastest-rising types of cancer, and claims more lives than car accidents in the UK: we should remember that.

    People in deprived communities are the most likely to suffer. Healthwatch research shows that those on lower incomes are worst hit by appointments shortages. The problem has been made worse by the pandemic, which increased the backlog, but the problem was there before. Limited access to such primary care means that problems cannot be caught early. People should not be facing a choice between being left in pain and paying for private care as we head into this difficult winter. We must do all we can to make sure that they can access the right services and that we address these profound health inequalities.

    One of the major reasons for the backlog is staff shortages in the NHS. The number of NHS dentists is falling: one in eight is approaching retirement and 14% are close to leaving the profession. My constituents have been particularly affected: nearly 15% of dentists have been lost from Bath clinical commissioning group since 2016. At a time when demand for NHS services is increasing, we urgently need a strategy to plug these very big staffing gaps.

    The Government admit that they do not know how many dental practices applied to access the extra £50 million of funding announced earlier this year. To me, that means that they are asleep at the wheel. The Government must make sure that we have enough dentists if support for the sector is to be effective. We need increased numbers of dentist training places in the UK and continued recognition of EU trained dentists’ qualifications. Dentists must be incentivised to take NHS payments and there needs to be more funding for the sector to meet patient demand. Everyone in the UK should be able to access a dental health check-up on the NHS. Proper workforce planning for health and social care must be written into law, including projections for dentists and dental staff.

    The crisis facing NHS dentistry is on an unprecedented scale. Although it has been worsened by the pandemic, the emergency is not new. Most importantly—I am repeating what many have said this afternoon—the Government must reform the NHS dental contracts, which create absurd disincentives for dentists taking on new NHS patients. A review was promised earlier this year. Where is it? Oral health cannot be treated as an afterthought and my constituents cannot wait any longer.

  • Richard Graham – 2022 Speech on NHS Dentistry

    Richard Graham – 2022 Speech on NHS Dentistry

    The speech made by Richard Graham, the Conservative MP for Gloucester, in the House of Commons on 20 October 2022.

    This is the first debate for a long time in which I have agreed with every single word of the motion, so I congratulate my hon. Friend the Member for Waveney (Peter Aldous) and the hon. Member for Bradford South (Judith Cummins). Frankly, we and all our constituents are concerned about the growing crisis in NHS dentistry. We are worried that nine out of 10 practices are not accepting new NHS patients, including large numbers of children. We also regret the number of dentists who are moving away from NHS practice. Those are all issues to which all hon. Members could strongly relate, if they were here.

    I have been asking myself how the problem came to be and what can be done. First, it strikes me that there is a wider issue with the delivery of public services. Governments will always be judged on the same things: whether they can achieve economic growth to provide jobs and fund public services; whether they can manage those public services competently; and whether they can do so with compassion so that our most vulnerable constituents are looked after. In the health and care sector as a whole, there is no doubt that there are significant challenges in all three aspects. Dentistry is just one aspect of the effective delivery of public services, an issue that we all recognise from emails and telephone calls with often very frustrated constituents.

    However, there is a particular aspect of dentistry that is unique. With acute hospitals, mental health services, ambulance trusts and so on, MPs have some agency: we can organise regular meetings with NHS trusts, hold them to account, ask difficult questions, discuss problems and find out what they need from the Government. With dentistry we have no agency, because the local NHS organisations—they are currently known as integrated care systems, but frankly in most of our constituencies it is easier to refer to them as the local NHS—have no agency. They have no say in the contracts between NHS England and the dentists.

    As my hon. Friend the Member for Mole Valley (Sir Paul Beresford) helpfully pointed out, the contracts go back to 2006. Most of us have no idea what is in them. I have never seen them; I was not aware of them. No dental association, nationally or locally, has ever contacted me—or, I suspect, many of us—to say that there is a problem that needs to be resolved or to ask for help. The first we hear of it is when constituents contact us to say, “I cannot get an NHS dental appointment for myself, my children or my family.” At that stage, we go back to the local dentists and ask what the problem is.

    This is what a local dentist in Gloucester has come back with:

    “The majority of dentists move away from the NHS because of the continual pressures that the NHS contract places upon them in terms of requirements, payments, audits…and many other factors”.

    She writes that an NHS dentist in her surgery, who has ceased to be an NHS dentist,

    “was under a prototype contract that was patient-centric and when this was discontinued and changed to align with the usual NHS contract, the dentist did not feel this gave the best type of care for patients”.

    She goes on to say:

    “I’ve continually battled”—

    she has been doing this for 25 years, by the way—

    “to ensure that any patients who want NHS dental services should be able to access them, but there needs to be correct remuneration for the time and quality of services, removing a treadmill of patient care.”

    That suggests that there is a problem with the contract, as my hon. Friend the Member for Waveney rightly says, as well as the problem of there being no local NHS involvement.

    I welcome the Minister to his role. I know that he will bring to it the same quality of analysis and compassion that he brought to his role in the Department for Work and Pensions. I hope that he will look closely at how the contracts can and should be changed—I believe that there is a window of opportunity in April—to allow all local NHS organisations to play a key role in the distribution of resources, emphasis, recruitment and so on. We will then finally have some agency, so we can do better than replying to our constituents with “I am very sorry to hear this, but there is absolutely nothing I can do,” which frankly is more or less the situation at the moment.

    Several colleagues have helpfully indicated solutions beyond the contract. I agree with the point about making it far easier for dentists, whether they come from the nations of the Commonwealth, such as New Zealand and Australia—mentioned by my hon. Friend the Member for Mole Valley—or from India or Hong Kong, which is another example that was given earlier. The Government clearly have an opportunity to do something about this if they wish, not just in the short term but in the longer term, and I hope the Minister will give us some good news in that regard.

    There is also the issue of skills and training. Setting up a new dental school, first, takes time; secondly, is expensive; and thirdly, will not solve short-term problems, although we do need to look at capacity for the longer term. There is a continuing problem with longer-term thinking—in the context of public services, and indeed in other contexts—to which all Governments have been susceptible for too long.

    The private sector certainly has a role to play. At the risk of plugging a particular organisation, I will mention an organisation of which I think the Minister will be aware: Genix, which has a training facility in Leeds. Its founder and CEO, Mustafa Mohammed, has a strong track record of supporting the whole business of upskilling and training dentists and providing NHS dentistry services around the country. Let me reassure my constituents and others who feel that dentistry is an entirely public-sector activity by saying that just as the private sector, through GP surgeries, plays such an important part in, for example, the delivery of covid vaccinations, it can play an important part in dentistry as well.

    There is, in fact, a role for a mixed economy, and, as was pointed out earlier, there is an opportunity for some short-term contracts. Perhaps the Department could step in directly, with NHS England, to provide relief for those in pain and for those with children who may never have seen a dentist in their short lives. I am sure we would all welcome that.

    That leads me to the question of what some term the nanny state—the role of education and proselytising about the value, particularly for young families, of getting stuck in with toothpaste and toothbrushes, and, perhaps, the opportunity to relieve them of VAT. We know that, just as with education, if things start well there is a strong likelihood that they will continue well, whereas if they start badly and people’s teeth do not get the treatment they need at an early stage, there will be problems later. I believe that the Government have an opportunity to play a part in this, although not uniquely, for everyone can play a part; and I hope the Minister will allude to that as well when he winds up the debate.

    Let me finally say that dentistry clearly needs to be represented in local NHS bodies—especially if they are actually going to play a role in it, which I very much hope they will—and that cash will be crucial. Nothing comes cheaply, but I think we can all agree that sorting out dentistry and making sure everyone has access to NHS dentists is a very precious cause, and we all hope we will find solutions fast.

  • Kate Hollern – 2022 Speech on NHS Dentistry

    Kate Hollern – 2022 Speech on NHS Dentistry

    The speech made by Kate Hollern, the Labour MP for Blackburn, in the House of Commons on 20 October 2022.

    I share the concern of the hon. Member for Waveney (Peter Aldous) and my hon. Friend the Member for Bradford South (Judith Cummins), who tabled the motion. Many of my constituents in Blackburn are at the sharp end of this crisis, because there are currently no practices accepting new NHS patients in Blackburn or Darwen and families are facing the consequences. Children end up in hospital because they cannot get the dental treatment that they need. Between 2020 and last year, 135 children under 10 were admitted to hospital for tooth extraction. That is an appalling state of affairs. Constituents in Blackburn and many around the country are being forced into DIY dentistry.

    Although we are here to discuss NHS dentistry, Members will be painfully aware that these sorts of fires are burning throughout primary care and throughout our health system. The workforce and access inequalities are driving health inequalities between the regions. The Government have let the problem get out of hand, because they cannot introduce a serious workforce plan to ensure that we have the staff we need to treat patients on time.

    A recent briefing from BUPA stated:

    “There is a lack of data about the dental workforce to inform a clear, centrally driven plan focused on improving recruitment and retention…the registers of the General Dental Council only list dental practitioners, but not whether they are practicing.”

    It is important to have meaningful data so that we can start making the plan to deliver the dentists that this country needs.

    A constituent of mine, who works for the NHS, said that she is

    “expected to provide a minimum standard of care to all patients”—

    and asked:

    “Where is the support for dentists to provide the same?”

    She asked me to ask the Minister: where is the additional support to train and retain NHS dentists, especially for areas in the north—such as Blackburn—to which it is traditionally hard to recruit?

    The Minister needs to publish the Government’s health and social care workforce plan as soon as possible. It needs to account for how communities in places such as Blackburn are often under-served by the primary care system. Dentists, like GPs, often want to practise and work in more urban communities. It is important that the right incentives are delivered to get them practising and staying in the most under-served communities, like Blackburn.

  • John Lamont – 2022 Speech on NHS Dentistry

    John Lamont – 2022 Speech on NHS Dentistry

    The speech made by John Lamont, the Conservative MP for Berwickshire, Roxburgh and Selkirk, in the House of Commons on 20 October 2022.

    The dental services that my constituents use are the responsibility of the Scottish Government in Edinburgh. My comments will focus on the challenges that we face in Scotland in accessing NHS dentistry.

    I begin by thanking the dentists in my constituency, who are doing the best they can and working hard to provide essential services for people across the Scottish Borders. There is no doubt, however, that dentists, dental staff and medical professionals are hamstrung in their ability to meet the needs of every constituent because of the lack of support and help they get from the Scottish National party Government in Edinburgh. Although the SNP would like to pretend otherwise to deflect from their failures, Scotland’s NHS is devolved and is the sole responsibility of the SNP Government in Holyrood.

    However, instead of focusing on improving waiting times in Scotland’s NHS for dentists and GPs, the SNP Government are again distracted by their endless obsession. They are again banging on about another referendum when people across the Scottish Borders and across Scotland want the focus to be on their everyday needs. Whether we are talking about nationalists or Unionists, the SNP or Scottish Conservatives, would it not be better for everybody if the Scottish Government’s No. 1 priority was to deliver better public services for the people across Scotland? We know that that will not happen with the SNP. Its first, last and only real priority is another referendum to break up the United Kingdom, as it proved again this week.

    If SNP Members were here to represent the SNP, I would tell them that those who talk about division all the time are letting down my constituents. They fail my constituents across the Scottish Borders every day and every week. One constituent wrote to me recently about the lack of emergency care on weekends. While in pain and clearly in need of help, they were told to go to the shops and buy a temporary filling repair. If any Members were here to represent the SNP, I would ask them to tell me how that person is helped by another independence referendum when the SNP Government are failing to deliver for them right now.

    Another patient wrote to me about the closure of dental services in Berwick-upon-Tweed just across the border. As a result of the lack of local services, she was not offered a spot for treatment nearby in the Scottish Borders. She was told that the only dentist available was miles and miles away. It was far too far away for her to travel there. That is another direct result of the SNP Government in Edinburgh not understanding the needs of local people in the Scottish Borders and rural areas across Scotland.

    My constituents should be able to see a dentist in person when they need help. Local people in the Scottish Borders deserve the same access to the NHS that people in the rest of Scotland and the United Kingdom receive. Despite the best efforts of healthcare staff, that is simply not happening. Too often, the needs of people in the Scottish Borders have been overlooked by the SNP Government in Holyrood. So I would ask SNP Members, if they were here—I add again, for the Hansard record, that they are not—how the flimsy economic plan for independence revealed this week helps my constituents get access to the health services they need.

    Another constituent wrote to me about her two-year-old son, who has not been able to see a dentist since he was born. The next time the SNP is making big, overblown promises about the future of Scotland, why does it not try delivering for future generations of Scottish people by doing the day job and providing the basic services that people need?

    The SNP Health Secretary, Humza Yousaf, is completely failing to deliver for Scotland. Recent statistics revealed that one in four people in Scotland have tried and failed to get a dental appointment over the past year. In rural areas, the problem is even more acute. Access to the NHS is a big problem for local people in the Scottish Borders. It is time that the SNP recognised that, accepted responsibility for its failures and got a grip on the situation. To conclude, will the UK Health Minister engage with colleagues in the Scottish Government to ensure that my constituents are given the best support possible to access the dental services they deserve?

  • Judith Cummins – 2022 Speech on NHS Dentistry

    Judith Cummins – 2022 Speech on NHS Dentistry

    The speech made by Judith Cummins, the Labour MP for Bradford South, in the House of Commons on 20 October 2022.

    I thank the Backbench Business Committee for granting this important debate and I thank my co-sponsor, or co-conspirator, the hon. Member for Waveney (Peter Aldous).

    If you might indulge me this once, Madam Deputy Speaker, I did, in preparing for this debate, look up my past remarks on this issue; a sort of compendium of forecasting doom for NHS dentistry that, as it turns out, is entirely accurate. As we have heard, Members from across the House and across the country are raising concerns on behalf of constituents who are simply unable to access an NHS dentist. The current system remains unfit for purpose. Recent BBC research found that in the south-west, the north-west and Yorkshire and the Humber, just 2% of dental practices were taking on NHS patients.

    Peter Dowd (Bootle) (Lab)

    Is my hon. Friend aware that not a single dental practice in either the current former Prime Minister’s constituency or the Health Secretary’s constituency is accepting new NHS patients? Should it not spur on the Government that the former Prime Minister’s constituents and the current Health Secretary’s constituents cannot get access to NHS dentistry?

    Judith Cummins

    I am indeed aware of that fact, as my hon. Friend the Member for Bolton South East (Yasmin Qureshi) raised it with me yesterday. Sadly, she cannot be here today to make that very point, so I thank my hon. Friend for doing so.

    In Bradford, 98% of dentists are closed to NHS patients, forcing people to go either to accident and emergency or to go private, whether they can afford to or not, often taking out a payment plan because they do not have the luxury of an NHS dentist available to them. In Bradford, 16% of three-year-olds and over a third of five-year-olds are now suffering with visible signs of tooth decay. In Yorkshire and the Humber, over 2,700 children under 10 had teeth extracted in hospital between 2020 and 2021. In fact, children born in Bradford are eight times more likely to be admitted to hospital with dental decay before their sixth birthday than if they were born in the former Prime Minister’s region. The truth is that NHS dentistry in its current form is just not working anywhere for anyone.

    How did we get to this position? The answer is threefold: a contract not fit for purpose, dramatic underfunding and an exodus out of the NHS workforce. During my time in this place, Minister after Minister after Minister has stood here accepting that fundamental reform of the contract is needed. And yet we are still waiting. After years of delay, the Government announced in July some small contract changes, but unfortunately those quick wins completely failed on the fundamentals. NHS dentists in my constituency tell me that the financial uplifts are minor to the point of insignificance. The Government are conducting a polish and a clean when what is needed is root canal treatment. Will the Minister tell us exactly why the Government have not delivered the long-awaited full-scale contract reforms? Is it still their intention to conduct those reforms? If so, when can we expect them? If not, why not?

    It is important to put on the record that the issue here is not a shortage of dentists. The number of registered dentists is at a record high. We have the dentists, but they are working in private practice. Until the Government fix the problems with the contract, which sees highly qualified and experienced dentists squeezed out of the system, they are simply pouring water into a bucket with a giant hole at the bottom of it.

    My next point is on funding cuts. We saw funding to NHS dentistry fall by around a third in real terms over the last decade and that was before the cost of living crisis. In January, the Government announced a £50 million catch-up fund for dentistry, funded from clawback, that gave practices three months to offer urgent care appointments to deal with the pandemic backlog. I warned the Government at the time that their strategy was flawed and that the funding to tackle the covid backlog would prove to be unusable and the system unworkable. ITV recently revealed that approximately £14 million of the promised £50 million was actually spent. That is just 28% of the funding allocated, which delivered only 18% of the 350,000 appointments it was meant to. In Yorkshire and the Humber, my region, only 16% of the allocated funding was actually spent. The shortfall was clawed back by the Government once again and not reinvested back into dentistry in my region. That is less than a third of the money spent, not because it is not needed, but because the Government set up a system that was unworkable.

    We need targeted funding to address an acute problem in areas of high need. The successful Bradford project that I developed with former Ministers back in 2017 really worked. It was a transformative project that meant we got 4,200 extra NHS dental appointments for people who had not had a dentist appointment for over two years. In the long term, however, we need fundamental change, and a comprehensive reform of the contract to push prevention is absolutely critical to that reform. Good oral health must not be restricted by either postcode or wealth. Going to A&E cannot be an alternative to NHS dentistry.

    Although I welcome the Minister to his new role and, indeed, welcome the Secretary of State’s new emphasis on dentistry in her ABCD of priorities, whoever the Secretary of State is, in whatever Government, they should learn the lessons of targeting and invest in NHS dentistry, as prevention really is better than the cure. We simply cannot go on like this. The public are fed up to the back teeth with inaction and excuses.

  • Paul Beresford – 2022 Speech on NHS Dentistry

    Paul Beresford – 2022 Speech on NHS Dentistry

    The speech made by Paul Beresford, the Conservative MP for Mole Valley, in the House of Commons on 20 October 2022.

    First, I must congratulate my hon. Friend the Member for Waveney (Peter Aldous). This is the second time that I have heard him pronounce on NHS dentistry—I think he has done it more often than that—and he is becoming something of an expert. I wonder whether the British Dental Association might give him an honorary medal or something for that. I also have an interest—a very part-time interest—that means that I have to speak on this; otherwise, the profession would ask me what the heck I was doing. I welcome my hon. Friend the Minister to the Government Front Bench to become our voice on dentists and dentistry. It might not last as long as he anticipated a few days ago, but it is a dubious honour and one in which he will find many friends and many on the other side of the argument.

    The problem we face is that there are not enough dentists. Many suggestions will come from the debate, so I will just skip through a few. The problem is not so much that there are not enough dentists—there are not enough dentists prepared to do NHS dentistry. That has been exacerbated by covid, but it is far from new. It has been a problem to a greater or lesser degree for more than five decades. I arrived in this country in 1970, produced my certificate from my university in New Zealand, got it rubber-stamped by the General Dental Council and went straight into business. I cannot see why we cannot do that now. I was one of a stream of New Zealand and Australian doctors and dentists. Once we moved into the common market, that stream was shut off.

    The practice of dentistry is complex and intricate if it is done properly. A small group of members of the all-party parliamentary group for dentistry and oral health recently visited King’s College dental school. I think it was enlightening for many to discover how complex and difficult dentistry is. The staff provided our members with a high-speed drill with a tungsten carbide bit and virtual molars. It is just as well that they were virtual molars—I have never seen so much tooth destruction in my life.

    As I said, the problem has been exacerbated by the covid backlog, and that will be with us for some time, but we are—I hope—looking at the long term and the short term. I will touch on the short term. Some with dental interests such as the organisation My Dentist are campaigning to increase the number of NHS dentists and other groups providing facilities, surgeries and so on. But there are—I hope that the Minister is aware of this—many dental firms working hard to pull dentists out of the NHS and into the private sector.

    As has been said, we must maximise the output from our dental schools. I am sure this has been done. I have heard calls for new dental schools; we have heard one today. Dental schools are enormously expensive organisations to build, stock and run. I was just in New Zealand, where there is a new school on the same site as the old one. It is fantastic, but it took years to build, stock and run it. A new school probably takes two to four years to set up and then it is four to five years before the graduates emerge. As with how a person gets their driving licence and then learns to drive, a dentist gets their certificate from the school and then starts to learn dentistry. In the short term, it would be faster and more productive if the General Dental Council were given the ability to enable overseas dentists with good English from competent overseas dental schools to enter the United Kingdom as practising dentists, without having to go through the insulting rigmarole and costs of further exams. It is an insult to most people from most of the top university dental schools to have to sit examinations here when the competence of their own schools is at least as good as those here. It would take only a small movement to enable that to happen.

    A large-ish number of elderly-ish dentists who are about to retire have pulled out of dentistry because of the bureaucratic overload. Many have retired because of the strain of the job. The regulatory strictures of the Care Quality Commission in particular have added to that. Of course, that applies to small practices. The CQC is necessary. We must have it, but its extensive, detailed, time-consuming form filling has been the final straw for many dentists, especially those in small practices. Many have just retired in disgust. For my tiny part-time practice, I pay an independent company £150 a month to help me ensure all regulations are met and documented as met. It is time-consuming, expensive and unnecessary. I would therefore rather like to see an opportunity for the GDC, with outside help, to look at the bureaucratic requirement and consider whether it could ease and reduce the strain on practitioners. When it has finished with that for the dentists, it could also start looking at how hospitals and medical surgeries are treated.

    Negotiations on the revision of the contract have been mentioned. It is a massive gripe among the profession in England, because of the use of the semi-mythological coinage called “units of dental activity”. They are a mythical thing. How many dentists get them to actually come together and work, and balance them so they are fair, is beyond me. Negotiations on the revision of the contract have been going on for many years. There have been many trials and heaps of tribulations. Over the past decades, dentistry has moved forward. Materials and techniques have been developed and adopted. The service available on the NHS dental menu has enlarged with that, but I question that some items on the menu are not strictly health, especially when alternatives are an option and would ease the strain on NHS dentists. If we accept that there is an NHS dental emergency, then I suggest the Government, for a short period of time, run a simple separate contract on a reduced NHS menu of strictly dental health items. A simple fee per item would remove arguments about those mythical units of dental activity. A simple contract could specifically target the NHS patients looking for a check-up and simple dental health care, particularly if it involves pain relief. At the same time, we ought to accept, because of the change in the nature of dentistry, that mixed private and NHS services are here to stay and should be encouraged, as that actually helps the NHS service.

    Finally, on two really positive points, one has already been mentioned and that is teaching children, even little children, how to brush their teeth. When I first came here, I spent a lot of time in east London. When I mentioned a toothbrush, the blank stares made it quite apparent that they just did not have a toothbrush, let alone use one. The excitement, in the schools that I and other dentists have been into, of little children with toothbrushes and toothpaste is really worth watching. And the mess is phenomenal!

    My final point is on fluoridation. We have now got to the stage where we can install fluoridation in our water supplies. We are an absolute disgrace in the western world. Much of the western world has 60%, 70% or 80% of their water supplies fluoridated, while we have 10%. The obstructions have been taken away and I ask the Minister to rapidly move forward with that. The payback period will be obvious after about two years and will make a tremendous difference, along with toothbrushing, as it progresses. We can be a nation with some of the best teeth in the world if we have 100% fluoride and if we teach every child, “This is a toothbrush and this is toothpaste—get on with it!”

  • George Howarth – 2022 Speech on NHS Dentistry

    George Howarth – 2022 Speech on NHS Dentistry

    The speech made by George Howarth, the Labour MP for Knowsley, in the House of Commons on 20 October 2022.

    May I, too, express my gratitude to the Backbench Business Committee for the opportunity to debate this important matter today?

    On 22 September, during a statement by the Health and Social Care Secretary, I raised these problems on behalf of the people of Knowsley and the Liverpool city region, and described the experiences they are having. I cited BBC research that showed that, to use the Secretary of State’s own term, Liverpool city region is a “dental desert”, with not one dental practice taking on NHS patients. In response, she said that she had

    “set out in the plan today what we are seeking to do with dentists. First of all, it is the role of the local NHS—the ICB—to take responsibility for such provision, and I expect it to do so.”—[Official Report, 22 September 2022; Vol. 719, c. 839.]

    Earlier this week, my office carried out a survey of dental practices in Knowsley to measure what, if any, progress had been made since that exchange. We found that, of the 13 dental practices in Knowsley, it is still the case that none—I repeat, none—is accepting new NHS adult patients, and only two are accepting children under the age of 18. I am therefore bound to conclude that no progress has been made in the ensuing weeks.

    Also on 22 September, I urged the Secretary of State to take measures in the short, medium and long term to address this disgraceful situation. Since then, the British Dental Association has pointed out that

    “the Government needs to show real ambition to bring NHS dentistry back from the brink.”

    Although the new Administration—goodness knows there will be another new Administration shortly—has placed dentistry as a top ABCD—ambulances, backlogs, care, doctors and dentists—priority, no new proposals have been made

    “to halt the exodus of dentists from the NHS”

    to care for patients. Moreover, the British Dental Association points out that the key issues of contract referral, chronic underfunding and growing oral inequalities have yet to be addressed. This is not just a matter of cosmetic treatment, important though that may be in many cases. As the association pointed out, this is also about how to spot oral cancer earlier, which is one of the fastest rising types of cancer and claims more lives than car accidents. That is a particular concern for Knowsley. As the British Dental Association went on to say:

    “People in the most deprived communities are significantly more likely to die from it than those in more affluent areas.”

    Our dentists are in many cases the first medical professionals to detect cases. Access to NHS dental treatment can in such cases be the difference between life and death. Knowsley is one of the most deprived boroughs in the country and it is consequently in a very vulnerable position regarding the early detection of oral cancer.

    The motion contains good points that I would happily endorse, but I am concerned that in terms of specific actions it calls for a progress report in three months’ time. My concern—I do not make this point to be at all mischievous—is that I do not know, and nobody in the House will be able to tell me, who is likely to be the next Secretary of State for Health and Social Care, and whether they will have a different strategy on NHS dental care. So we need something to be done more speedily. The Government have to take responsibility for the current turmoil, but the fact is that there is so much uncertainty and such issues are simply not being dealt with.

    The motion does not address what the Government could be doing in the short term to alleviate the problems confronting people in Knowsley and elsewhere. I have two suggestions on short-term action that could and should be taken. First, I urge the Secretary of State to introduce a procedure to enable those in need of urgent NHS dental treatment to be referred to a suitable dental practice, preferably locally. My constituency office recently dealt with the case of an 18-year-old constituent who needed urgent root canal treatment on two front teeth, which she was unable to afford. The problem was exacerbating an existing mental health problem. Since she was in constant pain and probably barely able to eat and drink, I contacted NHS North West. I am grateful that it was able to make arrangements for her to receive the treatment she needed at a local dental practice. I suggest that that approach, which I just happened to stumble across, should be added as a matter of urgency for those in need of urgent dental treatment.

    Secondly, I am aware that many NHS patients have been culled by dental practices, often on the basis that they were not making use of the service on a regular enough basis. I cannot give accurate figures for Knowsley, but I suspect that thousands of people are former NHS patients. However, no appeal process is available to such patients, who have just been struck off and there is nothing that they can do about it, other than pay to be treated privately. I am aware of one case involving a Knowsley resident who, as a result of extremely debilitating, extended cancer treatment, was unable to contemplate much-needed dental treatment. When he felt strong enough to do so, however, he tried to make an appointment as an NHS patient, only to discover that he had been struck off the list.

    My second short-term suggestion is therefore to urge the Secretary of State to institute an appeal process whereby such patients could apply to NHS England in order for it to prevail on the medical practice concerned to reinstate NHS patients who had good reasons for not being able to visit the dentist during lockdown, or who could not do so for medical reasons, such as those I have referred to. On the medium term and longer term, and the national problems to which I referred, I simply urge Ministers to enter into meaningful discussions with the British Dental Association to help to resolve the issues that I are so bedevilling NHS dental services nationally.

    I hope that Ministers will accept that I have tried in my approach to deal with this important matter as constructively as I can. I sincerely hope that they will respond in a similar way and try to help to resolve the short-term problems that my constituents are experiencing in ways that can be easily implemented.

  • Peter Aldous – 2022 Speech on NHS Dentistry

    Peter Aldous – 2022 Speech on NHS Dentistry

    The speech made by Peter Aldous, the Conservative MP for Waveney, in the House of Commons on 20 October 2022.

    I beg to move,

    That this House is concerned by the growing crisis in NHS dentistry; notes that nine out of ten dental practices in England do not accept new NHS patients; regrets the number of dentists moving away from NHS practice; welcomes the Government’s commitment to levelling up health outcomes and dental health across the country; calls on the Government to take urgent steps to improve retention of NHS dentists and dental accessibility for patients; and further calls on the Government to report to the House on its progress on the steps it has taken to address the NHS dentistry crisis in three months’ time.

    I thank the Backbench Business Committee for granting this debate, and the hon. Member for Bradford South (Judith Cummins) for her work in helping to secure it. I also highlight e-petition 564154, signed by 11,067 people, calling for an independent review of the NHS dental contract.

    Colleagues have been securing debates on the state of NHS dentistry for the past two years. This crisis has been brewing for a long time, and the situation can be likened to that of a house built on shallow and poor foundations that has come crashing down with the earthquake of covid. The King’s Fund describes NHS dentistry as being on “life support”, while the British Dental Association describes it as undergoing a “slow death”. In its monthly report for October, Healthwatch repeats that NHS dental care continues to be one of the main issues it hears about from the public, who across the country are clamouring for NHS dentistry that is both affordable and accessible.

    In Suffolk, there are 70 dental practices with NHS contracts, but not one is taking on new patients. Locally, there has been some welcome support in that, in Lowestoft, a local practice was granted additional units of dental activity that allowed it to see emergency patients until the end of September, and in July the Dental Design Studio was awarded a contract to deliver NHS dentistry for up to eight years. However, very quickly both practices were fully booked up and have had to turn away patients. There is a need for root and branch reform, and I shall briefly set out the issues that need to be included in a blueprint plan for NHS dentistry.

    Dr Andrew Murrison (South West Wiltshire) (Con)

    I congratulate my hon. Friend on securing this debate. Would he agree with me that the fundamental problem with NHS dentistry at the moment is the 2006 contract and the units of dental activity? Does he share my disappointment at the statement made in the summer about how to resolve the situation based on the consultation launched last year, and furthermore, does he hope that UDAs will be expunged from all of this so that dentists can be properly rewarded for the job they do and thus return to the NHS?

    Peter Aldous

    I thank my right hon. Friend for that intervention, and I agree wholeheartedly with him on that point. I will come on to it as I set out what I believe needs to be done to improve the situation, but I think he and I are very much on the same page on that issue.

    First, I will address the issue of funding. There is a need to secure a long-term funding stream. In recent years, the NHS dental budget has not kept up with inflation and population growth. Since 2008, NHS dentistry has faced cuts with no parallel elsewhere in the NHS, and the British Dental Association states that it will take £880 million per annum to restore the service to 2010 levels. I acknowledge the budgetary challenges that the Chancellor faces, but the reform process is doomed from the start without an appropriate level of investment. There is a need for a protected budget, and any funding that is clawed back must be kept in dentistry.

    Secondly, a strategic approach should be adopted towards recruitment and retention, with a detailed workforce plan being put in place.

    Jeff Smith (Manchester, Withington) (Lab)

    I congratulate the hon. Member and my hon. Friend the Member for Bradford South (Judith Cummins) on securing this debate. There is a crisis in south Manchester and across the country in trying to access NHS dentists. There are highly trained dentists from abroad who can help. I have some constituents who were trained at the dental faculty of the University of Hong Kong, which is among the top three faculties in the world—it has an English curriculum—but they cannot get registered or access the licence exams. I understand that the Government have said they are going to simplify the registration process. Would he join me in urging the Government to act very quickly to make that happen?

    Peter Aldous

    I thank the hon. Gentleman for his intervention, which came at an appropriate time. Indeed, he may well have been reading my speech, because that was the next point I was coming to. In the short term, we need to be stepping up recruitment from abroad. Although the legislation tabled earlier this month to streamline the process of recognising overseas qualifications is welcome, that will not address the problem on its own, and I hope that when he responds to the debate, the Minister will address that issue. In the longer term, we must improve dentistry training ourselves and ensure that it is available throughout the country. In that regard, the proposals being worked up by the Universities of East Anglia and of Suffolk are to be welcomed.

    Thirdly, as my right hon. Friend the Member for South West Wiltshire (Dr Murrison) said, there is a need for a new NHS dental contract. It is welcome that discussions have started on revising the contract, but there is a worry that the Government are looking only at marginal changes, when ultimately a completely new contract is required. At present, the NHS contract is driving dentists away from doing NHS work. Its target-based approach is soul destroying for so many, and it needs to be replaced with an agreement that has prevention at its core.

    That leads me to the fourth and penultimate component of a new system of NHS dentistry: the public promotion of the importance of good oral health, and looking after our teeth from the cradle to the grave. Denplan proposes that the Government and NHS should lead a public education campaign to emphasise the importance of oral health. There should be provision in the aforementioned new contract for dentists to go into schools, as well as into care and nursing homes. When economic conditions allow, let us be imaginative and exempt children’s toothbrushes and toothpaste from VAT. That can embed good oral healthcare at an early stage of life. It is welcome that the Health and Care Act 2022 facilitates the roll-out of water fluoridation projects, and the Government should work proactively with water companies to ensure that is universal.

    Finally, there is a need for clear transparency and full local accountability for overseeing and commissioning NHS dentistry services. I acknowledge the hard work and great effort of those working at NHS England, but we need to replace a system that is inaccessible, opaque, and confusing. The Health and Care Act provides us with the means of doing that, and it is welcome that from next April, many integrated care systems will be taking on responsibility for local NHS dentistry. That is the right approach, as good oral healthcare is essential for good general health and wellbeing, and inextricably linked to primary, mental and emergency care. It is vital that those involved in dentistry are represented on integrated care boards.

    Across the country there are a multitude of dental deserts. If we do nothing, if we apply the odd sticking plaster here and there, those will turn into one large Sahara. We owe it to those we represent to ensure that does not happen. That means that we need as a matter of urgency a blueprint plan for new NHS dentistry. That will not be delivered in one fell swoop, but we need clearly to lay down the route path and start taking meaningful strides down it. With that in mind, the motion calls on the Government to embark on that journey and report back on their progress in three months’ time.

  • Jeremy Corbyn – 2022 Comments on Pay for Nurses

    Jeremy Corbyn – 2022 Comments on Pay for Nurses

    The comments made by Jeremy Corbyn, the Independent MP for North Islington, on Twitter on 21 October 2022.

    Nurses’ pay must rise with inflation. That is the bare minimum.

    Applause on our doorsteps rings hollow without solidarity on the picket line.

    If nurses go on strike, they will have my full support.

  • Feryal Clark – 2022 Speech on East Kent Maternity Services – Independent Investigation

    Feryal Clark – 2022 Speech on East Kent Maternity Services – Independent Investigation

    The speech made by Feryal Clark, the Labour Health spokesperson, in the House of Commons on 20 October 2022.

    I thank the Minister for advance sight of her statement. I thank Dr Bill Kirkup and his team for the report. Today marks another milestone for another group of families in their fight for justice. The heartbreak they must feel is unimaginable, and my thoughts remain with them during what must be an incredibly difficult time.

    Sadly, this is another example of women’s voices not just being ignored but being silenced. When women in East Kent were told that they were to blame for their babies’ deaths, they were being told that their voices just did not matter. At a time when women are at their most vulnerable, they were let down by the very people they were relying on to keep them safe.

    After responding to the Ockenden review of Shrewsbury and Telford, I find myself having to repeat something that I never thought I would need to say again at this Dispatch Box: no woman should ever face going into hospital to give birth not knowing whether she and her baby will come out alive—no one. It is not a case of a few bad apples. What happened at East Kent, as with what happened at Shrewsbury and Telford and at Morecambe Bay, was years of systemic negligence that cost lives. As we have heard, up to 45 babies could have survived had they received better care. That is 45 lives that were cut needlessly short and 45 families made to suffer the most devastating heartache.

    Although I am heartbroken for the families that the review had to take place, it is vital that it did. Nobody who allowed this culture of neglect to set in should escape accountability. Such a review has been necessary again because, for too long, people turned a blind eye and tolerated the intolerable. That is why it cannot be allowed to sit on the Department’s shelf and gather dust. We must see action if we are to give women the care that they need and deserve.

    There is a pattern of avoidable harm in maternity units across the country. There were nearly 2,000 reported cases of avoidable harm at Shrewsbury and Telford. Half of maternity units in England are failing to meet safety standards. Pregnant women were turned away from maternity wards more than 400 times last year. One in four women is unable to get the help they need when in labour. That is why it is important that the Government fully accept all the recommendations in Dr Kirkup’s review without delay.

    This is a collective failure and we must all learn lessons from it. In the wake of the Ockenden review, the right hon. Member for Bromsgrove (Sajid Javid) announced an extra £127 million of funding for maternity services to help to deliver the reform that is clearly needed. Where is that money? Where has it been spent, what has it been spent on and how will its impact be measured?

    Underpinning the issues in maternity care, and across the NHS, is the workforce. More midwives are leaving the profession than are joining, and there is now a shortage of more than 2,000 midwives in England. We just do not have the staff needed to provide good and safe care. Even the Chancellor agrees: last week, he signed a report as co-chair of the all-party parliamentary group on baby loss that describes maternity and neonatal services as

    “understaffed, overstretched and letting down women, families and maternity staff”.

    He went on to call for safe levels of staffing. Will the Minister deliver on the Chancellor’s promise?

    The Government must provide the staff that maternity services desperately need to provide safe care across our NHS, as Labour has a plan to. All women are asking for is to have the confidence that they will be safe—that really is not much. It is high time that the Government delivered it.