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NHS Dentistry

9. Mr. Peter Pike (Burnley): What progress his Department is making with improving NHS dental service provision. [129956]

The Minister of State, Department of Health (Ms Rosie Winterton): The Health and Social Care (Community Health and Standards) Bill will give new duties for primary care trusts to secure primary dental

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services using the £1.2 billion currently held centrally. In the meantime, an NHS support team has started work with primary care trusts to overcome problems in areas where it is hardest to find an NHS dentist.

Mr. Pike: My hon. Friend will know that two additional NHS funded dentists' posts were announced for Burnley last month, but that is just one small step in dealing with a major serious problem in Burnley. Does she recognise that 20 per cent. of calls to NHS Direct in Lancashire are about dental health problems? Where are those people who are entitled to free dental treatment supposed to get the care that maintains their dental health, rather than emergency care, which they can get when it is absolutely essential?

Ms Winterton: I am very much aware of the problems that my hon. Friend mentions. I think that the new support team has already been once to Burnley, but it will return there with an action plan to look at how the situation can be improved. There are short-term measures, but, as I say, in the longer term we have a comprehensive programme in place to ensure that local commissioning of dental services can take place and that the £1.2 billion can be used locally, rather than centrally.

Mr. John Baron (Billericay): The Minister will be aware from recent figures that 1.5 million fewer people are registered for NHS dental treatment than in 1998. Only last month, the British Dental Association said that

Last year, the Audit Commission stated that

The Prime Minister pledged in his 1999 party conference speech that everyone would be able to see an NHS dentist within two years. Four years later, it is obvious to everyone that that is not happening. I ask the Minister one question: why have the Government so disastrously failed to fulfil their promise to dental patients?

Ms Winterton: One of the problems that we face is clearing up the mess left by the previous Tory Government. Conservative spokesmen should know very well that the contract that they introduced, and the way in which they implemented it, led NHS dentists to walk away. We are putting that right. We recognise that there is a short-term problem and we are backing that up with proper resources, while in the longer term we have a comprehensive plan to provide proper primary care dental services, commissioned locally.

Diana Organ (Forest of Dean): Is the Minister aware that it is impossible for a new patient in the Forest of Dean to find an NHS dentist? That problem has been exacerbated recently by the fact that two very good NHS dentists have transferred to the private sector because they say that they cannot cope on their fee level. Is she aware that that is a particular problem for the disabled, the unemployed, children and people on low incomes? If we believe, as we do, that health care should

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be free at the point of need and that we should build capacity in that NHS service, why are we not doing so in dentistry?

Ms Winterton: If my hon. Friend's constituents are facing problems with NHS dentists, she might like to consider whether emergency facilities and dental access services are available, and I certainly undertake to write to her about that. She is right to suggest that, of course, we want a proper system of dental care provision in the longer term. One of the other problems that we have to consider is the number of dentists who are being trained. We have undertaken a dental work force review, so that, in the longer term, working with the professions and the British Dental Association, we can ensure that we improve the number of dentists who come forward in the first place.

Health Care Assistants

10. Helen Jones (Warrington, North): What progress has been made in encouraging health care assistants to retrain as nurses; and if he will make a statement. [129957]

The Minister of State, Department of Health (Ms Rosie Winterton): We have increased the training commissions for health care assistants to retrain as nurses from 1,249 in 1999, to a planned 3,340, starting training this year. That will be matched by an increase in salary support from £11.8 million in 1999 to £122.9 million this year.

Helen Jones : That is very encouraging news and an excellent Government policy initiative. However, may I point out to the Minister that my local trust has simply stopped all secondments for health care assistants to train as nurses without any negotiation or proper communication with its staff? What would she say to the women in my constituency who have paid for their access to higher education courses, got themselves places on nurse training and then found themselves blocked? Are not those exactly the kind of dedicated people whom we want to encourage into nursing? Is it not a short-sighted policy for a trust to be doing that when it is having to recruit nurses from abroad?

Ms Winterton: I can well understand my hon. Friend's concern about this matter. I understand that the trust is reviewing the current situation following the appointment of a new chief executive and a new finance director—[Interruption.]

Mr. Speaker: Order. Opposition Front-Bench Members are being very rough in not allowing the Minister to address the House.

Ms Winterton: I also understand that the idea is to start the secondments again from next year. The strategic health authority is working with the trust to try to resolve the problem. In the meantime, I will certainly

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ask the local work force confederation development group to keep in touch with my hon. Friend about the situation.

Mrs. Marion Roe (Broxbourne): Will the Minister tell the House what action the children's national service framework care group work force team is taking to address the current and projected deficiency in the children's nursing work force, and what measures are being taken to address the retention of specialised nurses in areas such as neonatal and children's intensive care?

Ms Winterton: The hon. Lady is right to raise the issue of specialist nurses, what more we can do to encourage those specialisms, and ensuring a career development path so that when shortages exist we can look at constructive ways of filling them. With regard to the point about the national service framework, I undertake to write to her about the details of the question that she asked.

Nurse Practitioners/Community Pharmacists

11. Dr. Doug Naysmith (Bristol, North-West): If he will make a statement on the enhanced role that he plans for (a) nurse practitioners and (b) community pharmacists in the provision of health care. [129958]

The Minister of State, Department of Health (Ms Rosie Winterton): Nurses and community pharmacists are central to our plans to modernise and improve access to high-quality NHS services. We have a comprehensive strategy to increase the numbers and skills of nurses, developing new roles such as nurse consultants, extending prescribing responsibilities for both professions and expanding the services that pharmacies provide.

Dr. Naysmith : I agree with my hon. Friend about the importance of using the skills of those two professions much more effectively in the national health service. In the case of community pharmacy in particular, what plans does she have to encourage pharmacists to provide places for confidential consultations on their premises, which will go a long way to ensuring that patients are willing to seek the excellent advice that is available and that is currently underused?

Ms Winterton: My hon. Friend is right to raise that issue. There are a number of ways in which pharmacists can play a greater role in primary health care. In our vision for pharmacy, in the new contractual framework that we are designing and in our response to the recent Office of Fair Trading report, we are putting together a series of measures to give primary care trusts, too, the ability to talk with local pharmacists about commissioning services so that exactly that kind of project can be undertaken.

Mr. David Heath (Somerton and Frome): May I ask the Minister to add optometrists to the list of professions that she uses in that way? Is it not sensible not only to use the skills of those professionals both pre-operatively and post-operatively in the management of

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patients, but to extend the use of those professionals, and particularly their high-street facilities, for minor diagnostic tests and screening?

Ms Winterton: There are a number of ways in which we can examine the roles of such professionals, especially through the delivery of primary and preventive health care. Obviously, we are considering closely how that may be done through community pharmacists, but the opportunity to consider other areas that could make exactly such a contribution is always open.

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