Access to NHS Dentistry — [Clive Efford in the Chair]

Part of Backbench Business – in Westminster Hall at 2:44 pm on 10 February 2022.

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Photo of Wera Hobhouse Wera Hobhouse Liberal Democrat Spokesperson (Justice), Liberal Democrat Shadow Leader of the House of Commons, Liberal Democrat Spokesperson (Women and Equalities) 2:44, 10 February 2022

I congratulate Peter Aldous on securing this debate. He is almost an hon. Friend: we work on many cross-party issues together, so even though we are on different sides, I call him my friend.

It is important to say that this is not a debate to criticise dentists. It is about criticising a system that does not work. I want to pay tribute to all the dentists in my constituency, who have worked very hard, particularly during the pandemic, to keep the oral health of my constituency in as good shape as possible, but they have really struggled.

Oral health is an essential component of everybody’s health and wellbeing. Dentists play a crucial role in the early detection of a number of diseases, as we have heard, including mouth cancer. Problems accessing NHS dental services are on an unprecedented scale in every community. Morale among NHS dentists is at an all-time low, and 40 million NHS dental appointments have been lost since the start of the pandemic. All this has been made worse by the pandemic, but the dental crisis in our country far predates covid. It is a result of chronic underfunding and an unsustainable target-based dental contract.

My constituents have been contacting me about access to NHS dental services since I became elected. The biggest concern is that they simply cannot find an NHS dentist. One constituent told me:

“My disabled partner and I have been told that our dental practice will no longer do NHS dentistry for us after 35 years. We are on income support and cannot afford the private fees that are quoted to us.”

Another constituent told me that they could not find a dentist in Bath that could take their child. The closest practice they could find was a 40-minute car journey away. When another constituent needed fillings, she was given two temporary ones and told that anything more would incur private fees. She told me she was afraid to eat. This is the extent of my constituents’ misery.

According to a Healthwatch survey carried out in November, no NHS dentists in Bath and North East Somerset reported that they were taking on NHS patients. No practices reported that they were able to take on children under 18, and no practice reported that it would be able to take on new patients in the next three months. What is happening in Bath is happening across the country.

The single biggest problem with dentistry in the UK is that it has become privatised over decades. I do not want to accuse any particular party of this. It has been going on for a long time, and that privatisation has started to take over. There are around 12,500 dental practices in the UK, of which 30% are private, 15% are mostly private, and 15% are evenly mixed. That means that just 40% are NHS practices, but many of these have elements of private provision.

Fewer than 40% of adults in Bath and North East Somerset have seen an NHS dentist in the two years leading up to June 2021. Those who cannot afford private dental care often do not go until it is too late, and they end up needing emergency care. It is not that there are not any dentists in the UK. I know that there is a problem with the distribution of dentistry, but the biggest problem is that, increasingly, dentists do not want to work for the NHS.

The current crisis will not improve unless we make it viable for dentists to provide NHS treatments and make NHS dentistry a place where people want to work. Bath and North East Somerset, Swindon and Wiltshire CCG has lost 9% of its NHS dentists in the last year alone—the highest proportion in the south-west and over twice as high as the national average. Dentists in my constituency have told me that they want to provide NHS treatment but just cannot make it viable under the current conditions. They are hugely worried about the increase in the percentage of the pre-pandemic treatment levels that they are now expected to meet, and the mental health toll on our dentists is enormous.

The Minister has committed to reforming the system. This is welcome, but the pace of change is too slow and practices cannot increase the number of patients they are seeing on promises alone. Not only must the Government reform the current contract; it must do so urgently. The bottom line is funding. The Government must provide adequate resources as a matter of urgency to reverse the alarming decline of NHS dentistry and guarantee its long-term sustainability.

The current situation is nothing short of a scandal and simply unacceptable. Healthy teeth should not be a privilege only for those who can afford to pay for private dental care. More than 70 years ago, the founding fathers of the welfare state envisaged a country where the gross injustices between rich and poor would be eliminated for good. Let us not turn our backs on the principles on which our NHS is based. Oral health is as much a matter of access and equality as the rest of NHS care. To Richard Fuller, we Liberal Democrats absolutely understand the importance of being prudent with the public purse, but equality should never be sacrificed on the altar of balancing the books.