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Mr. Heath: My hon. Friend is making an incisive speech. Many members of the dental profession have, as he says, reluctantly moved out of the NHS, not because of the financial considerations, but because they are not able to provide the professional service to their patients that they believe they should be providing. That is why they have sought an alternative way of providing a service to their patients.

Steve Webb: My hon. Friend is right. Many dentists who went into dentistry to provide a quality service are finding that they cannot do so within the constraints of the existing NHS arrangements.

What is the root problem? Clearly, the fact that there are not enough dentists. It is not a complex matter. The Government's work force review stated that there were 2,000 dentists short, but that that number would rise to 5,000 over the next few years. Given that it takes about six years to train a dentist, how will we bridge that gap? The work force review did not take account of the impact of the new contracts, which could make matters worse. How many dentists short do the Government believe that we are? What is the grand plan?

The Government said that they wanted 1,000 more dentists by October, but Lord Warner suggested in another place that they were only half way there, yet we are only a few months away. Will the Government hit that target of 1,000 new dentists? They speak of more training places, which are clearly welcome, but the number of people who teach dentists is falling. I hope that the Minister will tell us what she is doing to ensure that the clinical experts who teach the next generation of dentists are there. Like many parts of the NHS, dental schools are in financial deficit. If they have to cut corners and spend less clinical time with new dentists, can we be confident that dentists will be as well trained as they need to be?

The Government strategy is essentially a temporary filling. It is to employ overseas dentists—from Poland, Brazil, India and wherever they can get them.

Daniel Kawczynski (Shrewsbury and Atcham) (Con): In Shrewsbury, we are getting more dentists, but the vast majority are from Poland. As a Polish speaker, I was recently invited to meet them. They are highly qualified,
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hard-working people. However, the Government should do more to train people in this country to provide the service rather than poaching dentists from Poland.

Steve Webb: The hon. Gentleman makes an interesting point. Dentists from this country say that dentists from other countries clearly have different practices and procedures. I think the phrase was, "Brazilians don't do root canal work." Different dentists with different levels of training and different practices are coming into the country. I mean no disrespect to many of the highly qualified dentists who come here, but it is only a short-term response to the problem.

Perhaps an obvious symptom of a system that is not working is what happens when a new NHS dentist service opens in an area. There are queues around the block. Hon. Members will know that I am a regular reader of The Sun, which on Monday printed a photograph of a queue around the block for a new dentist in Manchester. The article states:

What does it say about us when pensioners have to queue for hours simply to get what should be a basic right: entitlement to NHS dentistry?

Ms Thornberry: Will the hon. Gentleman give way?

Steve Webb: No, I have already given way to the hon. Lady.

The Government amendment states that all patients have got a better deal. How can the Minister put her name to it? How has the 70-year-old gentleman from Prestwich got a better deal if he has to queue around the block even to get his name on the list? It is unacceptable, and redolent of what happens in a third-world country. I am embarrassed when British people have to queue around the block simply to register with a dentist.

Mr. Sadiq Khan (Tooting) (Lab): Does the hon. Gentleman honestly expect hon. Members and people outside the House to take him seriously when he takes advice from a Conservative Member, whose party when in government closed at least two dental schools and cut fees, and from The Sun about queues for NHS dentists? Today, I found on the internet at least 10 dentists in Tooting who are willing to take NHS patients.

Steve Webb: Even the Government would think that that was a long way to go to get a dentist.

Mr. Tobias Ellwood (Bournemouth, East) (Con): Unlike in Shrewsbury, the number of dentists in Bournemouth has fallen. It is interesting to note that some hon. Members say that the number of dentists has fallen and others say that it has risen. The places where the number has risen appear to be Labour constituencies—I do not know whether that is significant. However, to revert to standards of dentistry and age, pensioners are especially affected by the number of dentists—that is certainly true of
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Bournemouth. They require more treatment because of their age and the state of their teeth. Does the hon. Gentleman agree that those people have been particularly affected by the lack of dentistry in this country?

Steve Webb: The hon. Gentleman is right. I came across a startling statistic recently—it may or may not be true—which was that one in seven people in this country have no teeth of their own. That would predominantly involve older people, as the hon. Gentleman rightly says, and for those people, quality of access to dental services is not a luxury but an absolute necessity.

Sandra Gidley (Romsey) (LD): A 75-year-old constituent wrote to me recently to say that she had been quoted £3,000 for a pair of dentures, as she could not find a local dentist who would treat her on the NHS. These are the people who can least afford such costs. Is my hon. Friend aware of this happening in other parts of the country?

Steve Webb: We have become increasingly aware of the patchy nature of dental coverage. In some places there have been improvements, but many people still face just the kind of problem that my hon. Friend has outlined.

Two in five children and more than half of all adults are not registered with an NHS dentist. I cannot believe the scale of this. There was a fall of 3 million in the number of people registered between 1997 and 1998.

Annette Brooke (Mid-Dorset and North Poole) (LD): Does my hon. Friend share my concern that, if the NHS Direct helpline provides a parent with young children with the name of a dentist 10 miles away—in my part of the world, that would probably involve two bus journeys, which can take a long time—the parent might not be motivated to register with that dentist?

Steve Webb: My hon. Friend makes a good point, and I shall come in a moment to the issue of NHS Direct pointing people in the direction of dental services that are often not local.

David Wright (Telford) (Lab): Will the hon. Gentleman give way?

Steve Webb: If the hon. Gentleman will forgive me, I want to make some progress.

There has been a dramatic fall in registrations, which is now at best levelling off. At oral questions recently, the Minister of State, Department of Health, the hon. Member for Doncaster, Central (Ms Winterton), said that

So the Government's grand, vaulting ambition is to halt the decline and to hope that that is sustainable. But what is their long-term vision? What is their grand plan? What was their manifesto promise? What is their goal? Where do the Government want to end up?

David Wright: Will the hon. Gentleman give way?

Steve Webb: No, I have said that I want to make some progress.
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One of the problems resulting from the lack of registration is a lack of preventive work being carried out. Surely if we believe in anything, we believe that the best thing of all is to prevent people from getting bad teeth in the first place. It is far cheaper, and far better for the individuals concerned.

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