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House of Commons

Tuesday 14 June 2005

The House met at half-past Two o'clock


[Mr. Speaker in the Chair]


London Local Authorities and Transport for London Bill

Order for Second Reading read. To be read a Second time on Tuesday 21 June.

London Local Authorities Bill [Lords]



Message to the Lords to acquaint them therewith.

Oral Answers to Questions


The Secretary of State was asked—


1. Mr. Gary Streeter (South-West Devon) (Con): What assessment she has made of the provision of NHS dentistry in south Devon. [3669]

The Minister of State, Department of Health (Ms Rosie Winterton): South Hams and West Devon, and Plymouth primary care trusts have received £238,000 capital and £102,000 revenue, 22 per cent. of practices have moved over to the new pilot contracts, and there are three new Polish dentists working in the area. Taken together, these developments are all helping to improve local access.

Mr. Streeter: Eight years into a Labour Government, six years after a specific promise from the Prime Minister and one year after a debate in Westminster Hall on dentistry in Devon, why is not a single dental practice in south Devon taking on new NHS adult patients? How much longer will my constituents be kept waiting for the NHS dentistry that they deserve?

Ms Winterton: As the hon. Gentleman pointed out, and as I am the first to admit, there have been problems in the area, which is exactly why we have targeted it for
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extra resources. As I said, the extra money has already led to new registrations. There have been 8,000 in the Plymouth area, but in the South Hams and West Devon area, the number will increase in line with the new money, with the new dentists coming into the area and with the gradual introduction of personal dental services contracts.

Mr. Adrian Sanders (Torbay) (LD): Is the Minister not aware that the number of dentists leaving NHS practice is rising faster than the number of new ones coming in? Only last week, a Torquay practice stopped taking NHS patients or even providing NHS treatment for children.

Ms Winterton: I am of course aware that there continue to be some problems in particular areas, but, in fact, after a dip in 1998, the number of registrations is rising. That will take time to reach all parts of the country, which is exactly why we have introduced special access funding, why we are changing the system for delivering dentistry and why we have said that we will recruit another 1,000 dentists by this October. The hon. Gentleman's area is benefiting from that extra recruitment, although the registrations will take a little time to come through.

Alison Seabeck (Plymouth, Devonport) (Lab): I know that my hon. Friend is very aware of the problems facing the south-west and our difficulty in accessing dentists, but I also know that her Department is working hard to implement a range of measures designed to increase dentist numbers. What we ultimately need is a sustainable approach, so we need to train more dentists. Will she therefore welcome a bid from Plymouth for a new dental school?

Ms Winterton: My hon. Friend is right to say that our reforms are making a gradual difference. Progress is slower in some parts of the country than in others, but as well as increasing investment by £368 million from this year, recruiting an extra 1,000 dentists and changing the way that dentists work, a further major part of the reforms is our training of another 170 dentists a year from this October. This year, those 170 places will go to existing dental schools, but from next year we will welcome bids for some 91 places from existing schools, from new dental schools and, in some cases, from satellite schools, so that such schools can not only train dentists on site, but put them out into the community.

Richard Younger-Ross (Teignbridge) (LD): A private dental practice in Teignbridge has secured nine new NHS dentists with the support of the district council, the PCT and myself. If we can do that, why cannot the Government?

Ms Winterton: The hon. Gentleman will acknowledge that we had a meeting about that matter and that I was able to assist him in ensuring that his local primary care trust could put the contract through. The extra funding and commissioning at local level has meant that such changes can take place. That, combined with international recruitment, has made a difference in areas such as his.
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Mr. Andrew Lansley (South Cambridgeshire) (Con): Three months ago, I met Mr. Ian Stuckey, chairman of the south Devon dental committee, and it was clear from our discussions that, with no base contract, no progress made on the contract with dentists and no information about the future charging review, many dentists have no incentive to offer new NHS registrations. Frankly, the Minister is pouring money into a bath with the plug out. Will she tell the House when she is going to publish the review of patient charges that she received 15 months ago?

Ms Winterton: I received Harry Cayton's report on patient charges in March 2004 and we are considering its implications. We now have approximately 5,300 dentists working under the new pilot contracts, which are similar to the contract that will eventually be produced, and we are reflecting on some of the implications of the charges in those pilots. We will publish our response to Harry Cayton's report shortly.

Mr. Lansley: In south Devon, as we heard from my hon. Friend the Member for South-West Devon (Mr. Streeter), the proportion of people registered for NHS dentistry collapsed from more than 50 per cent. in 1997 to fewer than 30 per cent. now. The Minister is very fond of targets, so will she tell us what is her target for the proportion of people who should be registered for NHS dentistry?

Ms Winterton: At its height, the number of people registered with an NHS dentist was about 55 per cent., but because of the changes in the re-registration of 1997, it fell to 49 per cent. The number went down over the next few years, but is now back up, we believe, to 49 per cent., so there has been a levelling off. It is early days, so the extent to which it is sustainable is not yet clear, but the changes that we have introduced are making a difference. As to the publication of the report and the continuation of those changes, I have already said that we shall respond shortly. I remind the hon. Gentleman that there are about 5,300 dentists working in the new wave in 2,000 practices across the country. I would certainly like anyone who wishes to register with an NHS dentist to be able to do so. That is the aim of our changes.

Steve Webb (Northavon) (LD): South Devon falls within the South West Peninsula strategic health authority, which has seen a dramatic fall in the proportion of children registered with an NHS dentist. In 1998, about two thirds were registered, but it is now fewer than half. Coming to this subject afresh, I sense a lack of urgency—to put it charitably—on the part of the Minister. After taking 15 months to consider a report, she talks about whether the levelling off will be sustainable. When will we get back to the rates that she inherited and when will we get them back to a decent level?

Ms Winterton: Investing £368 million more in dentistry, allowing dentists to move over to the new ways of working—resulting, as I said, in 5,300 new dentists in 2,000 new practices—recruiting an extra 1,000 dentists by October this year, introducing an expansion of dental training with 170 new dentists starting this year: I do not believe that all that shows a
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lack of urgency. Rather, it shows that we are tackling the problem. Progress is not as quick as we would all like and there are particular areas in the country with special problems, which is why we have established support teams working with local primary care trusts to improve local access. Nevertheless, we have introduced a radical reform that has shifted the balance of power from the centre to local areas. That means that money stays in local areas and it is increasing. We are also using international recruits and increasing the number of dentists by 1,000 from this October.

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