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Dentistry

7. Mr. Charles Walker (Broxbourne) (Con): What measures she is taking to ensure adequate provision of NHS dentistry in Hertfordshire. [3675]

The Minister of State, Department of Health (Ms Rosie Winterton): The Bedfordshire and Hertfordshire strategic health authority was allocated £446,000 capital and £1,039,000 revenue in 2004 to increase provision of
 
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NHS dentistry. That money has been distributed to local primary care trusts and they are using it to provide an extra 63,000 registrations.

Mr. Walker: Is the Minister aware that many people in my constituency are struggling to find a dentist and that some people in need of emergency dental care are having to go private? Teeth are not like aching bones: people cannot wait six months, or six weeks, or even six hours in some cases, as when a root canal is needed. They need a dentist there and then, but because of waiting lists or difficulty finding a dentist, people are having to go private and spend a lot of their own money. I should be grateful if the Minister would assure my constituents, such as the Andrews, that the money they have spent going private will be refunded by the NHS, because they are not getting a service to which they are entitled.

Ms Winterton: I am sorry to hear about the hon. Gentleman's constituents' difficulties. As I said, extra money has been allocated to the strategic health authority to provide 63,000 additional registrations. One of the difficulties in his area is that it has been slow to move to the initial stage of personal dental services, whereby it is possible to provide more emergency access. However, the changes being made at local level will aim, through PDS, to provide precisely the type of emergency treatment that he mentioned.

Mr. Peter Lilley (Hitchin and Harpenden) (Con): Can the Minister say whether the alarming financial deficits that the Bedfordshire and Hertfordshire strategic health authority faces, which were known to Ministers before the election but which have been revealed only since, will affect dentistry, in addition to causing reductions in accident and emergency services and ward closures and threatening the business case for a new hospital? Why was information about the financial crisis not revealed to the electorate in Hertfordshire before the election?

Ms Winterton: The money allocated for NHS dentistry can be spent only on NHS dentistry, so the other matters that the right hon. Gentleman mentioned will not be affected by it.

Sir Paul Beresford (Mole Valley) (Con): As the House knows, I have a faint interest in this matter. The Minister makes great play of PDS contracts, which many dentists see as restrictive. They are waiting for the broad-based contract, because they want to run a mixed service, which provides a greater spectrum of opportunities and a variety of choices to their patients. Does the Minister have trouble with that, and if not, will she get on with providing the draft contract for dentists and their advisers to look at?

Ms Winterton: I read the comments that the hon. Gentleman made in the Adjournment debate on the subject and I think that he misunderstands the concept of the new PDS contract. There is no reason why dentists cannot combine the new contract with private work. Let us suppose that 30 to 50 per cent. of a dentist's time is taken up with general dental services work; changing from GDS to PDS does not mean that the dentist will have to stop doing other types of work under
 
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the contract. The new contracts are about a different way of working. They do not exclude a dentist from doing other work.

As I have said on other occasions, the new contract that we will introduce will be based on the PDS contracts that are being piloted, perhaps with some refinements. We shall publish details shortly.

8. Mr. Andrew Turner (Isle of Wight) (Con): What proportion of people in (a) Hampshire and the Isle of Wight strategic health authority area and (b) the Isle of Wight are not registered with an NHS dentist; and what the equivalent figures were in 1997. [3676]

The Minister of State, Department of Health (Ms Rosie Winterton): Figures for those not registered with an NHS dentist are not available for specific areas, because some patients are not registered where they live. I hope that that makes sense.

Mr. Turner: I thank the Minister for that superb get-out. I also thank her genuinely for the work that she has done since 3 March last year to facilitate the provision of more dentists in my constituency. Is she not faced with an impossible task? In his first term of office, the Prime Minister promised that, within two years, everyone who wanted it would have access to an NHS dentist. How could he make that promise knowing that it could not be delivered? Did he not know, or did he not care?

Ms Winterton: My right hon. Friend the Prime Minister said that access to an NHS dentist would be through NHS Direct, that is exactly why we set up 53 dental access centres throughout the country. Right hon. and hon. Members should accept that there will be some people who do not register with an NHS dentist for whatever reason, as the hon. Gentleman knows.

I thank the hon. Gentleman for the kind comments that he made about my visit to the Isle of Wight. There were some real difficulties at that time. I hope that the 11 new dentists who are working on the Isle of Wight are starting to make a difference to the local situation. To go back to a point that was made earlier by the hon. Gentleman, the primary care trust has examined the tackling of emergency access, which is very welcome. It concentrated on that first and it is now moving to increasing the number of registrations, which is helped by the extra money, by our support team going in and by the 11 new dentists who are situated in the area.

Sandra Gidley (Romsey) (LD): Recent inquiries show that not one dentist in my constituency was taking adult patients on the NHS. Bearing in mind that most people would prefer to register with a local family dentist, how far does the Minister think that it is reasonable to expect people to travel to access such a dentist if they can find one?

Ms Winterton: There are some guidelines about mileage. I think that it is about 20 miles in rural areas and 5 miles in cities. I return to my point that some people do not register with a dentist where they live; many of them register where they work. I am not aware of the action plans of the hon. Lady's PCT.

Sandra Gidley: Three PCTs.
 
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Ms Winterton: Or the three PCTs, as the hon. Lady is saying. I am not aware of the action plans that they have in place. I am prepared to look into the matter and write to her. There is no doubt that they will be able to benefit from the extra money that we are investing in NHS dentistry. If they wish to, they can have international recruits. The Department will work with them to secure extra dentists for the area. As we move to the new way of working, I believe that the hon. Lady's constituents will benefit. It will allow for extra registrations.

Sir George Young (North-West Hampshire) (Con): Is the Minister aware of proposals to invest in a new medical school in Southampton to increase the supply of NHS dentists in Hampshire, which will address the problems that we have just heard about? Is the hon. Lady able to give those proposals her support?

Ms Winterton: As I said to my hon. Friend the Member for Plymouth, Devonport (Alison Seabeck), the 170 extra places that we have made available for undergraduates are being placed in the existing nine dental schools. We recognised that we had to put right the situation, given that the previous Conservative Administration had closed two dental schools. We had to rectify that. About 78 of the places will continue to be in existing dental schools. We are receiving bids from existing dental schools and places where people want to open a new dental school. We think that this will amount to the opening of at least one new dental school. It may be that some of the places will be in satellite schools of some of the dental schools in different areas. As the right hon. Gentleman says, one of the difficulties is getting dentists into certain areas. They can tend to cluster around dental schools. Some interesting ideas have been put forward about how satellite schools can be opened to ensure that dentists are in some of the areas where there have traditionally been shortages.

Smoking

9. Ms Angela C. Smith (Sheffield, Hillsborough) (Lab): What steps her Department is taking to help people to stop smoking. [3677]

The Parliamentary Under-Secretary of State for Health (Caroline Flint): We have in place a comprehensive package of measures, including those set out in the "Choosing Health" White Paper, to help smokers quit. The NHS will improve its services to help people to stop smoking permanently. Smoke-free environments will become the norm at work and in leisure time. We have introduced proposals for hard-hitting warnings on cigarette packets and for further restrictions on tobacco advertising. We have taken tough action against shops that sell cigarettes to children and have achieved further reductions in tobacco smuggling. As a result of our actions, by 2003, there were 1.2 million fewer smokers in England.

Ms Smith: I thank the Minister for her response, and congratulate the Government on those results. However, the appalling statistic is that over 1,000 people a year die as a result of passive smoking. Does she not
 
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agree that it would sensible to extend the proposed legislation to ensure that all pubs offer a smoke-free environment, not just those that provide food?

Caroline Flint: I thank my hon. Friend for her question, and I welcome her to the House. I congratulate the North Sheffield primary care trust, because in April to December last year 1,032 people set a quit date with its services, and at the four-week follow-up, 470 of them had successfully quit. That is a huge change on the position many years ago, when the services and support to quit smoking were not available on the NHS.

My hon. Friend asked why there is not a full ban. The public generally supported restrictions on smoking at work, and believed that it was right that food should not come with smoke. Among smokers and non-smokers, there was much less support for a complete smoking ban in pubs and clubs that do not serve food. We are trying to balance the rights of the minority with the rights of the majority who want smoke-free environments, and the proposals in the White Paper "Choosing Health" reflect the views of people in England. It is a complex issue, but in England, over 99 per cent. of enclosed workplaces will become completely smoke-free, and people who want a smoke-free environment in which to enjoy their social life and go about their business will be able to have one.

Mr. Nigel Dodds (Belfast,North) (DUP): May I ask the Minister whether she is satisfied with measures aimed at schools and colleges to help prevent young people and children from taking up smoking in the first place?

Caroline Flint: I would imagine that schools and colleges would come within the remit for enclosed workplaces, but we will consult in more detail on the measures that we plan to introduce in the draft Bill, including provisions on practical application. I look forward to hearing different views on the way in which we should tackle the issue. I would draw the hon. Gentleman's attention to the work that we are doing to make schools and colleges smoke-free and to ensure that young people and children are aware of the dangers of smoking. He will know of our recent campaign on the dangers of second-hand smoking. Unfortunately, a large number of adults still smoke in front of their children or while they are in the car with children. We must make sure that all parents are aware of the dangers of such behaviour and can take action themselves.

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