NHS: London

Part of the debate – in the House of Lords at 7:49 pm on 10th October 2007.

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Photo of Lord Colwyn Lord Colwyn Conservative 7:49 pm, 10th October 2007

My Lords, I thank my noble friend for initiating this debate and welcome the noble Lord, Lord Darzi, to his position on the Front Bench. In the few minutes available to me, I ask the Minister to consider the provision of dental services in London and the rest of the country. I remind him of Prime Minister Blair's pledge in 1999 that, by September 2001, everyone would have access to an NHS dentist, no matter where they lived. Seven years later, fewer than half of British adults are registered with an NHS dentist.

The introduction of the new contract in 2006 gave primary care trusts responsibility for commissioning NHS dental services using a fixed budget set by central government. The new contract was introduced to improve access to NHS dentistry, but a recent survey of NHS dentists has shown that only one in five dentists is taking new NHS patients; four out of five restrict access to NHS treatment in some way; 80 per cent say that no new treatment capacity is available in their area; and half of all dentists are having problems meeting their NHS output targets and face financial penalties. Forty percent of dentists would like to leave the NHS; 95 per cent were less confident in the future of the NHS than two years ago; 93 per cent of dentists believe that the new contract has done nothing to boost a more preventive approach; and 97 per cent believe that the new contract has failed to get them off the treadmill. A year after the introduction of the new contract, fewer patients are able to access an NHS dentist, fewer dentists are providing NHS care and nearly 400 contracts are still in dispute.

In the 24 months up to December 2007, 51.6 per cent of the population of London strategic health authority saw an NHS dentist, compared to 55.7 per cent nationally. Uptake in London is higher among children and in this period 65.3 per cent of children visited an NHS dentist compared to 47.8 per cent of adults. This compares poorly with the national average where, in England, 70.5 per cent of children and 51.5 per cent of adults visited an NHS dentist. There is a variation in uptake across the capital, the highest being Hounslow, where 69.4 per cent saw an NHS dentist and the lowest being Kensington and Chelsea, where just 21.6 per cent saw an NHS dentist. There are 50 dentists per 100,000 population in London compared to a national average of 41 dentists per 100,000 in the rest of the country.

I have carefully read the Minister's recent reports: A Framework for Action, published in July, and, last week Our NHS, Our Future. The Minister is a doctor, not a politician, so in his new position I am sure that he will have been looking for some practical answers to the serious problems in the dental services and the difficulty of access to an NHS dentist. In his summary letter to the Prime Minister, he said:

"My aim is to convince and inspire everyone working in the NHS, and in partner organisations, to embrace and lead change... I have spent the last three months visiting different NHS organisations and hearing the views of staff. This report is based on those views, visits and discussions".

That is very commendable, but then I find that in the 133 pages of A Framework for Action and the 54 pages of Our NHS, Our Future, I cannot find a single word—not a single reference—to any part of the dental service. The clinical working group membership lists 124 medical specialists and advisers—not a single dental expert or dental viewpoint. There are about 120,000 people working in NHS dentistry, including nurses, receptionists, practice managers and technicians. Do they not deserve any recognition or representation, or planning for their future? Are the Government planning to remove dental treatment from the NHS?

I shall look forward to future debates with the Minister. He will be a great asset. But in this House his remit includes dentistry, and I am not going to let him forget it.