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Dr. Phyllis Starkey (Milton Keynes, South-West) (Lab): As the hon. Gentleman has just mentioned Milton Keynes, I thought that I would update him on the situation. After asking that question, I visited the brand-new practice that has opened by Milton Keynes station. Its wonderful facilities provide well over 7,500 new places for NHS patients through the personal dental services contract. I am immensely grateful to the Labour Government for providing that practice, as are my constituents. I am sure that Liberal Democrat Milton Keynes council will pass that news on to the hon. Gentleman.

Steve Webb: I am delighted for the hon. Lady and her constituents, but I wonder whether she has read the Labour amendment. Being a reasonable man, I did so, thinking that if it was good, solid stuff I might vote for it. It includes a surprisingly long litany of all the good things that the Government have done for dentistry, but in the final sentence it congratulates

I find that incredible. I read Government amendments with the aid of an "out-of-touchness" meter. Most Government amendments are only a little out of touch, but this one is completely off the scale, if the Government genuinely believe that over the past eight years they have improved dentistry for all patients.
 
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Mr. Gary Streeter (South-West Devon) (Con): As usual, the hon. Gentleman is making an excellent speech. Following the last intervention, is he aware that since I raised the lack of NHS dentistry in south Devon two weeks ago, we have not had any more NHS dentists? I am not pleased with the Labour Government, who have failed to deliver on a clear promise in 1999.

Steve Webb: I can feel a Liberal Democrat survey coming on. [Interruption.] Indeed, and a petition—perhaps that will come later.

There is clearly a substantial problem with NHS dentistry, and I am grateful for the hon. Gentleman's friendly intervention.

I remind the House that the rot set in—if I can use that phrase—some years ago. It is widely accepted that the problem started in the early 1990s, when dentistry fees and contracts were changed. The change was well intentioned—instead of dentists simply receiving a set amount for every filling or treatment, there was a per patient element, which undermined the inducement to do more work just for the sake of it. The thinking was right, but the implementation failed because budgets spiralled. Only a couple of years later, dentists' fees were cut and, as a result, they started to leave the NHS. The National Audit Office says that

A long-term problem has therefore developed under successive Governments of both larger parties.

Ms Emily Thornberry (Islington, South and Finsbury) (Lab): Will the hon. Gentleman give way?

Steve Webb: If the hon. Lady would allow me to develop my argument a little, I shall certainly give way.

The situation was probably not helped in 1992 by the previous Government's decision to close two dental schools. The Conservatives sometimes demand more NHS dentistry and more places in dental schools. I do not know whether dental treatment generates amnesia, but they display plenty of it on the subject. In 1997, a bright, shiny, new Government came to power, with all sorts of new ideas. Immediately, they introduced an Act of Parliament—if in doubt, legislate. The National Health Service (Primary Care) Act 1997 created personal dental services—so called because no person can access them—with the aim of trying to tackle the legacy of a decline in NHS dentistry. Two years later, we were given something that everyone fears—a promise from the Prime Minister, who said in 1999 that

It is not obvious how one could see a dentist by phoning NHS Direct, but we were promised that everyone would be able to do so two years after 2001. Six years later, however, NHS dental registrations are at low levels, and there is little sign of an upturn.

Ms Thornberry: Does the hon. Gentleman agree with the hon. Member for Sutton and Cheam (Mr. Burstow) that there is not a magic solution to fix NHS dentistry? Is he likely to give us any magic solutions today, and are there any attempts by the Liberal Democrats to help solve the problems with dentistry? Are we likely to hear,
 
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for example, anything about the introduction of personal dental plans, as promised in their manifesto? I should be grateful to hear something positive from the Liberal Democrats for once.

Steve Webb: I congratulate the hon. Lady on the way she read that out. One of the themes that we will be developing is the fact that the present problems are of long-term origin—

Mr. David Heath (Somerton and Frome) (LD): Deep-rooted.

Steve Webb: Indeed. Because of that, the Government on day 1 in 1997 should have been tackling those problems. For example, it takes five or six years to train a dentist, so if they had got on with it on day 1, we would not now have a shortage of dentists, but only now are they talking about expanding places for dentists. There are no quick fixes—I agree with my hon. Friend the Member for Sutton and Cheam (Mr. Burstow), who researched the matter thoroughly. It takes time to train dentists, which is why the Government's lack of effective action over eight years is all the more culpable.

We had the 1999 pledge and another set of proposals in 2002. Five years through the new Labour Government, we were still in trouble, so we got "Options for Change"—another set of

The more one sees the word "radical", the less is substantively changing. We had had the Health and Social Care Act 2001, primary care trust commissioning and so on. The idea of a new dental contract, which is the key to the whole issue, was due to be implemented in April just gone, but that did not happen. It was postponed, first until October, then until next April. One of the reasons for that was the dental profession's lack of trust of the Government. The failure to negotiate a new dental contract was described by a dentist to whom I spoke recently as the best recruiting sergeant for Denplan that he has ever come across.

Mr. Charles Walker (Broxbourne) (Con): Is the hon. Gentleman aware that despite the Prime Minister's promises, hundreds of my constituents have no access to dentists? They are forced to go private and spend many hundreds of pounds to get treatment that the Government have a responsibility to provide. Is it not a bit rich for the hon. Gentleman to be lectured by the hon. Member for Islington, South and Finsbury (Ms Thornberry) about dentist provision, when you have failed miserably and we are facing yet another of the Prime Minister's—

Mr. Speaker: Order. The Speaker never fails miserably at anything. I call Mr. Webb.

Steve Webb: Thank you, Mr. Speaker. I echo that, but the hon. Gentleman makes a good point. We get the promises and the rhetoric. He may not have read the Labour manifesto of 2005, which promises:

So here we are, eight years on, and what are we to get? A review. Am I missing something here? It has taken so long to get to the point of a review—yet another reform,
 
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yet another radical change. I hope Ministers will tell us what the plans are. Did they know in April, when they published that manifesto, what they had in mind?

Mr. David Drew (Stroud) (Lab/Co-op): I thank the hon. Gentleman, my constituency neighbour, for giving way. What obligation does he think there is on the dentistry profession to work in the NHS? Like him, I believe in the NHS, and it greatly saddens me how many dentists have willingly gone private. They ought to come back into the NHS. How does he think that will happen?

Steve Webb: Many dentists share the hon. Gentleman's and my commitment to the NHS, and are moving out of it with great reluctance. I have come across many who have hung in there while many more have gone private, because they believe in the principle, but the Government have made it impossible for them to carry on.


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