NHS Dentistry

Question

15:36:00

Asked by

To ask His Majesty’s Government what steps they are taking to improve access to NHS dentistry.

My Lords, we are tackling the challenges for patients trying to access NHS dental care by providing 700,000 more urgent dental appointments per year, with integrated care boards delivering those extra appointments from 1 April 2025, which is not long away. We will recruit new dentists to the areas that need them most and to rebuild dentistry in the long term we will reform the dental contract with the sector and shift to focus on prevention and the retention of NHS dentists.

I very much welcome the 700,000 extra appointments, which will begin to make an impact on the 2.2 million people who now need urgent care, but did the noble Baroness read the leader in the Times on Monday which said “the scandal of NHS dentistry has dogged successive governments without resolution”? It mentioned the 30,000 children each year who go to hospital to have rotten teeth extracted under anaesthetic and the 18 million adults and children who cannot access an NHS dentist. Does she agree that at the root of this problem is the 2006 dental contract, which has driven dentists out of the profession? When might a new contract be introduced? Given that the most effective public health measure is to add fluoride to the water supply where it does not exist naturally, when will she roll out the programme that has begun in the north-east?

As the noble Lord suggests, tooth decay is the main reason that five to nine year-olds are admitted to hospital. That is a scandal, and one that we are seeking to tackle. My ministerial colleague, Stephen Kinnock, has made reform of the dental contract an early priority and continues to collaborate with the British Dental Association and other representatives on what is, of course, a shared ambition to improve access to treatments for NHS dental patients. I wish I could give an exact date to the noble Lord; I am not in a position right now to do so. On water fluoridation, as the noble Lord said, an extra 1.6 million people across the north-east will benefit from a water fluoridation scheme following quite a lengthy process and that will start in 2027-28.

My Lords, dental problems put extra pressures on A&Es, particularly at the weekend when it is difficult to get access to a dentist. Does she recall that a group of dentists has suggested that we should create 40 mini-A&E centres around the country, under the NHS, open seven days a week? I believe that suggestion worked its way through to the Minister. If she is not able to give an immediate answer, would she write and put the reply in the Library for others to see?

As I said, it will be ICBs delivering the extra 700,000 urgent dental appointments each year. They will be best placed locally to decide how to do it. It may well be through the means that my noble friend said, but the duty on them will be to ensure that those are available. The appointments will be most heavily weighted towards the areas where they are needed most, although appointments will be available across the country. I welcome my noble friend’s suggestion but how the extras are provided will be a matter for local decision-making.

My Lords, can the Minister comment on whether serious consideration will be given to debt relief for newly qualified dentists? They could then work as salaried employers for the NHS and deliver more than the 700,000 appointments we are aiming at, because we have such a long backlog. That would really support children’s dental care immediately.

I welcome the suggestion from the noble Baroness, and I will raise that with the Minister, Stephen Kinnock. What I can say is that strengthening the dental workforce is absolutely central, as we have to rebuild NHS dentistry in this country. Integrated care boards have started already to recruit for dental posts through a golden hello scheme. That means that up to 240 dentists will receive payments of £20,000 across three years to work in those areas that need them most. Already, as of 10 February this year, 35 dentists have commenced in post, a further 33 dentists have been recruited, and hundreds of job posts are currently advertised. There is a long way to go, but we have made a very strong start.

My Lords—

My Lords—

My Lords, we will hear from the noble Lord, Lord Rennard, next and then the noble Lord, Lord Glenarthur.

My Lords, the promised extra 700,000 appointments will mean just two extra appointments a month for each NHS dentist in England. The Health and Social Care Select Committee concluded in 2023 that the current dental contract is not fit for purpose, so will a new dental contract stop penalising dentists who take on more units of dental activity or patients with more complex dental needs?

The noble Lord makes a very strong case for reform of the dental contract. The Minister concerned is very alive to the points he makes but, again, I will draw his attention to them. I do not quite recognise the figure that the noble Lord referred to on the number of extra appointments. If I can give just one example: out of 700,000 extra appointments, in the Midlands that will mean 143,424 extra appointments. I also emphasise that it is 700,000 extra appointments every year. If the noble Lord would let me have the figures to which he referred, I would be very happy to look into them.

My Lords, there used to be a number of eminent dentists in your Lordships’ House. I am thinking of Lady Gardner of Parkes and Lord Colwyn. I believe there are none now, so do the Government have any plans to fill this gap and ensure that the dental service is represented in your Lordships’ House?

There is a cavity that needs filling. I defer to the usual channels, the senior leadership, the leaders of all parties, the Convenor of the Cross Benches, and all the other bodies that decide who should be in this House.

My Lords, I say to the noble Baroness that when it comes to comedy, she is doing an excellent job as a Minister.

Oh!

I am sorry—I hope she takes that in the way it was intended. She is a wonderful comedian and a wonderful Minister. How about that? Hopefully, I have redeemed myself in the eyes of the Minister. One of the frustrations of the past on this issue has been the battle between the Treasury and the department over the unit of dental activity—the UDA—as the noble Lord, Lord Rennard, said. That is how much dentists are paid for each patient they see. Can the Minister tell your Lordships about the conversations that her department is having with the Treasury? For example, how willing is it to raise the UDA in dental deserts to encourage local dentists who exist in those areas but do not see NHS patients? What conversations is the department having also with dental charities in the shorter term to help fill some of these gaps?

I can assure the noble Lord that I took his comments in good heart, which is exactly how they were intended. He touches on an important point, which is that this is not just about the number of dentists but about how many units of NHS dentistry they are doing. Again, we are very aware of that—which goes to the noble Lord’s question earlier as well—and we are seeking to resolve it through the reform of the contract. We have found that the previous Government’s dental recovery plan did not go far enough, because it has left many people still struggling to get an NHS appointment. The noble Lord asked about conversations with the Treasury, but perhaps some of that speaks for itself in that we have a rescue plan providing more urgent dental appointments. We are reforming the dental contract and not waiting to make improvements, because we are already increasing access and incentivising the workforce to deliver more NHS care.