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NHS Dentistry

8. Lawrie Quinn (Scarborough and Whitby): If he will make a statement on the number of dentists working in the NHS. [34707]

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The Minister of State, Department of Health (Mr. John Hutton): A total of 20,480 dentists were working across all dental services in England in September 1997. The number of dentists working in September 2001 was 22,440. That is an increase of 1,960.

Lawrie Quinn: I thank my right hon. Friend for that answer and welcome the increase in the number of NHS dentists. Does he agree that in market towns, such as Whitby, where there is great difficulty in gaining access to NHS dentists, people have to travel to larger centres? Will he say what the primary care trust can be expected to do to make it easier for people in rural locations to have access to NHS dentists?

Mr. Hutton: I agree with my hon. Friend that people in some rural areas clearly experience problems in accessing NHS dentistry. That is true in my constituency. I am sure that he will welcome the decision of the local health authority to establish one of the new dental access centres in his constituency on two sites—one in Scarborough, with which I am sure he is familiar, and one in Whitby, too. Next year, when the service begins to operate with full efficiency, it is estimated that it will be able to treat about 3,500 patients in his area. That is an important step forward.

As my hon. Friend probably remembers, the Government's rural White Paper made it clear that we were committed to developing access to NHS dentistry in rural areas. There are three things in particular that we can do. First, we need to continue to invest in dental practitioners' premises in rural areas, and the lion's share of investment is going into such practices. Secondly, we have dental access centres, and the majority of the new 49 DACs serve rural areas. Thirdly, local health authorities, including the primary care trust in my hon. Friend's area, can enter into spot contracts with local dentists to treat unregistered patients on the national health service. That will help my hon. Friend's constituents and others in rural areas in particular.

Mr. James Gray (North Wiltshire): The experience of the hon. Member for Scarborough and Whitby (Lawrie Quinn) matches mine in Chippenham, a town of 35,000 people in which not one national health service dentist practises today. Is the Minister aware of the British Dental Association's commentary on the so-called dental strategy? It says:

Is he proud of that?

Mr. Hutton: I have a great deal of respect for the hon. Gentleman, but he is speaking a load of old cobblers. He might like to look at some of the statistics on NHS dentistry because he will probably be struck, as I was, by the fact that since 1997 the total volume of NHS dental treatment has increased by 1.8 million. That compares strongly with the period between 1992 and 1997, when the number of NHS treatments for dentistry declined. Of course there is a problem. It would be stupid to pretend otherwise and we are taking action to deal with that. The dental strategy is not a waste of time. It is increasing NHS

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access to dental treatment and I am surprised that the hon. Gentleman cannot find it within him to welcome any of the progress that is being made.

Mrs. Betty Williams (Conwy): Although I welcome the increased number of dentists who work in the NHS in England, will my right hon. Friend undertake to hold discussions as soon as possible with the Health Minister in the National Assembly for Wales to compare the success in England with the success stories in Wales?

Mr. Hutton: I am grateful to my hon. Friend for that question. She is aware that such matters are the responsibility of the National Assembly for Wales. However, we keep in regular contact with Jane Hutt, the Health Minister in the Assembly, and we share similar objectives to increase access to NHS dentistry in all parts of the United Kingdom.

Accident and Emergency Services

9. Dr. Andrew Murrison (Westbury): If he will make a statement on waiting times in accident and emergency units. [34708]

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): The NHS plans set a target to reduce waiting times in accident and emergency departments to a maximum of four hours from arrival to admission, transfer or discharge by 2004. The NHS is on track to meet that target with 77 per cent. of all A and E attenders currently spending four hours or less in A and E. In nearly a third of trusts, at least 90 per cent. of people attending A and E are discharged or admitted within four hours. The Government launched the reforming emergency care strategy last October, supported by investment of £118 million. That is helping hospitals around the country to tackle waiting times in A and E departments and to meet the NHS plan target.

Dr. Murrison: I grateful to the Minister for that upbeat reply. I am afraid that the community health councils, which her Government have pledged to abolished, do not agree with her, however, as they said in their report, "Nationwide Casualty Watch" recently. At the Royal United hospital in Bath and Salisbury district hospital, 10 per cent. of my constituents admitted through the casualty department have to wait for four hours or longer on a trolley. What is she going to do about that? Will she condemn the practice of keeping acutely ill patients waiting in ambulances outside casualty departments for long periods of time?

Ms Blears: I am pleased to tell the hon. Gentleman that the Government are taking a series of actions to address the admittedly serious problems in his local hospital. An intervention team was established on 7 January this year. It comprises top-class consultants and physicians who have gone into the hospital to work side by side with the clinicians to help them to change their practices, to improve the length of time that people wait in A and E and to ensure that delayed discharges are treated in a much better fashion.

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I am pleased to say that there have been marked improvements on all those indicators in the past two weeks in terms of trolley waits, waits in A and E and delayed discharge. A great deal of extra investment is going into the service. The hon. Gentleman's local hospital shows, however, that it needs to be matched by reform if we are to get the results that will benefit his constituents and patients in that area. [Interruption.]

Mr. Speaker: Order. The Chamber is far too noisy.

Mr. Alan Simpson (Nottingham, South): May I thank the Minister for the extra investment in the A and E facilities at the Queen's medical centre in my constituency? I hope that she had a chance to see the excellent fly-on-the-wall documentary produced by Channel 4, "The Trust", which illustrated the enormous pressure under which the A and E department is having to work. I am sure that she recognises that some causes of that pressure are not within our control, but will she act on two points that arose from the documentary? First, will she support the QMC's initiative to take a zero tolerance approach towards violence by patients against A and E staff? Secondly, will she hold serious discussion with primary care trusts about the withdrawal of funding for community-based services relating to drugs, mental health and alcohol problems, which result in a disproportionate—

Mr. Speaker: Order. We will now let the Minister reply.

Ms Blears: I am delighted that my hon. Friend is pleased about the modernisation that has taken place in his local A and E department. Some 180 A and E departments throughout the country have been improved as a result of Government investment. I am also glad to reassure him that we have a policy of zero tolerance of violence against every person working in the NHS, and those of us who have visited A and E departments on a Friday and Saturday night will have seen the entirely unacceptable stress under which staff operate.

My hon. Friend is right to say that the problems in A and E are problems of the whole system—of primary care, of delayed discharges and of the need to increase capacity. We must get the whole system working if we are to reduce the pressures on A and E. This Government are about putting investment into the whole NHS system, making sure that A and E departments can provide first class services to the patients for whom they are responsible.

Hywel Williams (Caernarfon): It is not only accident and emergency waiting times that concern us; between 1997 and 2001 the number of people in Wales waiting for treatment for six months or more increased by an enormous 1,000 per cent. In the past, the Secretary of State has told us with some glee that he does not do Wales, but does he not accept that he has some responsibility for that scandal?

Ms Blears: Obviously, those are devolved matters, but it is not a question of us not doing Wales at all. We are delighted to be able to work with our colleagues in the devolved Administrations to make sure that everybody has the chance to access high quality services. I am sure

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that the hon. Gentleman knows that our NHS services are operating under tremendous pressure; A and E departments see 15 million patients every year, which is 30,000 patients every day, and in the vast majority of cases they are providing top-class, first-rate services. Clearly, there is increased pressure, but the Government are tackling that with increased investment in every part of the NHS, including primary care, secondary care and accident and emergency. That is this Government's record, and I wonder whether any Opposition Members would be prepared to match that investment to make sure that we can provide high-quality services for people in every part of the country.

Mr. Andy Reed (Loughborough): I am sure that my hon. Friend is aware of the enormous pressures on Leicester royal infirmary. We welcome the extra investment that will improve its capacity. Is my hon. Friend aware of the fantastic achievement of walk-in centres in reducing the number of admissions to places such as the royal infirmary? Will she ensure that continued funding for such centres, particularly the excellent one in Loughborough, is part of the NHS budget from the centre, rather than the burden being placed on local primary care trusts?

Ms Blears: My hon. Friend makes a characteristically intelligent and analytical remark about the role of NHS walk-in centres. He is absolutely right that such centres, of which there are now 42 throughout the country, with another one set to open this summer, are playing a significant role in reducing pressure on A and E departments because they are able to see many patients with minor illnesses. It is important that we evaluate walk-in centres, which are still pilot projects, before extending the funding nationally. It is vital that we ensure that walk-in centres, minor injury units, NHS Direct and out of hours services provide high-quality services.

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