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House of Commons
Tuesday 18 January 2005
The House met at half-past Eleven o'clock
PRAYERS
[Mr. Speaker in the Chair]
Contingencies Fund 2003–2004
(2) the Distribution of the capital of the Fund at the commencement and close of the year; together with the Report of the Comptroller and Auditor General thereon.—[Joan Ryan.]
Oral Answers to Questions
HEALTH
The Secretary of State was asked—
Dentistry
1. Mr. Anthony D. Wright (Great Yarmouth) (Lab): What steps are being taken to increase the number of dentists in areas of deprivation. [208901]
The Minister of State, Department of Health (Ms Rosie Winterton): We are radically reforming national health service dentistry, with £368 million of extra investment from April. We have also allocated another £59 million to help primary care trusts with the most severe access problems and we are recruiting the equivalent of 1,000 additional dentists by October 2005.
Mr. Wright: I thank my hon. Friend for that response. The closure of one of the dental schools under the previous Administration created this long-term problem. However, we have a positive message to send from my Great Yarmouth constituency, where one of the dentists, John G. Plummer, has recruited 14 new dentists, but is still awaiting approval from the Department of Health for the issue of a new contract under the personal dental services system. Can my hon. Friend tell us when we may expect a favourable reply on that submission?
Ms Winterton:
I absolutely agree with my hon. Friend: it was in fact the closure of two dental schools that led to some of the shortages in dentistry, and that is why we announced earlier this year that we would be training another 170 dentists a year from April next year.
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On my hon. Friend's point about his constituency, I understand from discussions with him that the application has been approved in principle and that some final details are awaited. I hope those will follow before the end of the week. I am pleased that dentists in his constituency are showing enthusiasm for the new system, which is of course backed up by about £74,000 allocated from central Government to assist in dealing with access problems, which means that about another 22,000 patient registrations will become available in his constituency.
Sir Paul Beresford (Mole Valley) (Con): It is fairly well known that I have an interest in this matter. I assume that the Minister agrees with many of us on both sides of the House that the best improvement for dental health in deprived areas would be fluoridation. Given that assumption, can she tell me, at the second time of asking, when the long-awaited appropriate regulations will land on the desk of the House?
Ms Winterton: I certainly agree with the hon. Gentleman about the benefits of fluoridation. The regulations are in draft and they will be published soon.
Ms Joan Walley (Stoke-on-Trent, North) (Lab): The real way forward for improving the amount of dentistry in areas of deprivation is to have more training places for dentists. Will my hon. Friend note that consultation on a new dental school in Coventry and Stoke-on-Trent has just finished? Will she give me an assurance that she will look carefully at representations from north Staffordshire and give some indication that there will be ministerial approval for a school of dentistry, as a satellite in Stoke-on-Trent?
Ms Winterton: I agree that where undergraduates train is important, as they often congregate in their own area. Through a working group with the Department for Education and Skills, chaired by the chief dental officer, we have been looking at how we can expand the number of places. Building completely new dental schools is not necessarily the answer because of timing, but we are considering satellite schools from existing dentistry schools so that where there are access problems we can work with the existing schools to ensure that there is proper training and people can stay in the area once they have graduated.
Sir Peter Tapsell (Louth and Horncastle) (Con): Is the hon. Lady aware that although the Louth and Horncastle constituency is not an area of deprivation, it is seriously deprived of dentists? There is not a single NHS dentist in my constituency who is prepared to accept a new patient on his list, and as many elderly people constantly move into my constituency to retire that is creating a real crisis.
Ms Winterton:
I am aware of the problems that the hon. Gentleman has outlined. Indeed, I visited the area a few months ago. We are asking each PCT, through the strategic health authority, to produce plans to increase the provision of NHS dentistry. As I said, we have backed that up with £59 million of investment to tackle severe access problems. I know that plans are being drawn up in his area and that international recruitment
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is also being considered to ease some of the problems. I suggest that the hon. Gentleman contact his PCT to ask for the plans and to ask about the additional resources that it will have been allocated to deal with the current access problems.
Mrs. Joan Humble (Blackpool, North and Fleetwood) (Lab): Further to that reply, is my hon. Friend aware of the exciting and innovative plans that Blackpool PCT has recently announced to recruit more dentists? What advice and support can she give the PCT to ensure that those plans come to fruition?
Ms Winterton: I am certainly aware of the plans proposed by Blackpool PCT. We have already allocated £192,000 to the PCT in my hon. Friend's constituency to ease the problems there. The PCT is considering not only bursary schemes for new students, but making funding available to dentists to expand their premises, for example, or to buy new equipment. It has set up a very good helpline locally to ensure that people have proper information about what is available. Already, that has meant that 4,000 new registrations are available to local people. We will continue to do all that we can to assist her local PCT, and if we can give assistance in terms of international recruitment, we will certainly do so.
Mr. Andrew Lansley (South Cambridgeshire) (Con): When the Minister was replying to the hon. Member for Great Yarmouth (Mr. Wright), she neglected to tell him about the situation in Great Yarmouth—there are fewer dentists today than in 1997, 10 per cent. less of the adult population is registered with an NHS dentist, and if people who live in Great Yarmouth wish to register with an NHS dentist they must go to Lowestoft to do so. Will the hon. Lady simply tell the House whether, when the Prime Minister said in 1999 that within two years everyone would be able to see an NHS dentist, he meant that, five and a half years on, 39 per cent. of the British public would be registered with an NHS dentist? Dentistry is simply disappearing throughout the country, as we are hearing from hon. Members.
Ms Winterton: It is bit rich of the hon. Gentleman to wash his hands of responsibility. The Conservative party closed two dental schools and introduced the deeply unpopular contract in the 1990s that led to dentists walking away from the NHS. We are trying to reform the system of dentistry and we are backing that up with extra investment. I am very well aware of the problems that my hon. Friend's constituency has faced. That is exactly why we have taken the measures that we proposed and exactly why those involved are now looking to recruit 14 new dentists for his constituency.
We will take no lecture from the Opposition about NHS dentistry. We are trying to clear up the mess that they left behind, and we are making good progress in doing so. There is further to go, but we have made clear commitments through extra investment, local access plans and ensuring that there will be local commissioning of NHS dentistry in future.
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Mr. Lansley: The hon. Lady and her friends will have to take a lecture from the British electorate before too long. On 7 December, on the last occasion that we were present for Health questions, she said that the general dental services contract was on course. Within a month, the Government had to abandon that, so it has been delayed further. She said that dentists were voting with their feet, but I do not think that she meant that, three hours after Ministers came to the House, the British Dental Association would walk out of negotiations on the contract with the Government.
It is fine for the Minister to talk about the contract in the last century, but what about the contract for the 21st century? When the BDA walked away, it said:
"This was a decision we never wished to make and it is a highly regrettable position to find ourselves in. We have been proactive in our discussions with the Department of Health but the traffic has almost been entirely one way. To continue would be to devalue NHS dentistry and to let down the dentists we represent."
Under this Government, NHS dentistry is devalued and dentists are let down—[Interruption.]
Mr. Speaker: Order. We are still on Question 1. I appeal for brief questions and brief answers.
Ms Winterton: We do not deny that problems remain with NHS dentistry, but we are taking radical steps to reform it and to introduce local commissioning. We have responded to the points made by the National Audit Office report and said that we will delay the implementation of the new contract until April 2006. That does not mean that dentists are not already moving over because some 3,500 have taken up the new contract. We have 500 applications in the pipeline and want to ensure that they are processed before we move to general commissioning. After our announcement last week, John Renshaw, the chair of the BDA, said:
"This is a sensible move by the Department of Health, which could provide breathing space to allow us to sit down again and resolve outstanding issues."
I do not think that that sounds like a vote of no confidence.
Mr. Peter Pike (Burnley) (Lab): My hon. Friend knows that Burnley is an area of deprivation. It also has a big shortage of NHS dentists and a record of poor dental health. She has visited east Lancashire and knows that its primary care trusts are working with the Government to try to address those problems. However, I am sure that she will be dismayed to hear that last week the Taylor dental practice on Colne road in Burnley decided to leave the NHS. Will she check with the PCT about why things are working in the opposite direction to what it and she are trying to achieve?
Ms Winterton:
I will certainly check on that. When I visited my hon. Friend's area, it was obvious that the PCT had good plans that were backed up with extra resources. I think that some 40,000 extra registrations are planned throughout east Lancashire. I know that the plans are there, but I shall certainly examine his point about a specific dentist moving out of the NHS and find out whether we can do anything to rectify that situation.
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Mr. Paul Burstow (Sutton and Cheam) (LD): The number of children registered with NHS dentists has fallen every year since the last general election. Today, little more than a half of children are registered with an NHS dentist—the number is lower still in some of the poorest areas. Does the Minister agree that given that the BDA walked out of the contract negotiations and that primary care trusts are not up to the job of delivering dental services, the Government's approach is not radical, as the Minister would like the House to believe, but ramshackle and it is not delivering good dental services? The approach is complacent, which is consequently doing harm to the nation's teeth.
Ms Winterton: The hon. Gentleman is quite wrong to say that local PCTs are not getting on with the job of moving people on to the new contract because they are already doing that. It does him no credit to decry local efforts that are backed up by extra funding. People are working extremely hard to draw up local plans, which are backed by funding. There are more dentists than ever before—and although there is a problem with some moving away from the NHS, we are undertaking reform so that funds and powers exist locally to ensure that there is proper NHS dentistry provision.
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