---

Mr. Russell Brown (Dumfries and Galloway) (Lab): Has the local dental association in Cheadle taken steps to meet regularly the primary care trust to discuss the difficulties that they face? In very few areas of the country are local dental associations doing so.

Steve Webb: The hon. Gentleman will be aware that primary care trusts are taking on the commissioning role for dentistry, so it seems implausible that they are not having such dialogue. When we talk to dentists, however, we get feedback that they feel beleaguered and cannot cope. It is not a lack of commitment to the NHS, but a feeling that they cannot do the right thing by their patients by staying in the NHS.

Mr. David S. Borrow (South Ribble) (Lab): Will the hon. Gentleman give way?

Steve Webb: I shall conclude my remarks in a moment.

One of the most worrying findings of the research undertaken by Mark Hunter and the team was that most of the dental practices to whom they spoke were taking on children only if their parents were existing patients. Given the drop in adult registrations, we are storing up trouble for our children.

Several hon. Members rose—

Steve Webb: I am about to conclude my remarks.

One of those dental practices would only take children under the age of three. We have therefore reached an extraordinary stage. What strikes me most is that dentists are telling us that they must turn away people who come to register, and who are in genuine need, because the provision and capacity are not there. The fact that the Government can table an amendment
 
29 Jun 2005 : Column 1310
 
saying that everybody is getting a better service marks an extraordinary level of complacency and shows that they are not in touch.

In conclusion, this is a long-term problem that started under the previous Government but has been neglected for far too long under this Government. If it takes five or six years to train a dentist, action should have started years ago. Desperate measures are now being taken to fill the gap while dentists come on-stream. The normal understanding is that the NHS is based on two basic principles: that there is universal local access and that it is free at the point of use. That is not the experience of the majority of our constituents with regard to NHS dentistry, and this Government should be held to account for it.

1.4 pm

The Minister of State, Department of Health (Ms Rosie Winterton): I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:

"welcomes the Government's record levels of investment in the National Health Service, with expenditure set to rise to over £92 billion in 2007–08; congratulates the Government and NHS staff for improvements in primary care; notes that the Government's ambitions for NHS dentistry will deliver a modernised, high quality primary dental service; congratulates the Government on supporting this with a record level of investment, which has been increased by 19 per cent., or £250 million a year, over 2003–04 levels; further welcomes the increase in NHS primary care dentists from 16,700 in 1997 to 20,192 in April, the creation of 53 dental access centres across England treating some 400,000 patients a year and an NHS support team to improve access to dentistry in areas where there are problems, and the introduction of additional capital grants of £35 million to fund   practice improvements; and further congratulates the Government for this investment and programme of reform that has delivered a better quality of life for staff, and improved services for all patients, regardless of their ability to pay, true to the founding principles of the NHS."

I know that NHS dentistry has been a key concern of many right hon. and hon. Members in recent years and I am glad of the opportunity to explain to the House the situation and what the Government are doing to reform and modernise NHS dentistry for the benefit of patients and dentists.

First, I want to set out some basic facts about dentistry. The number of dentists registered with the Dental Practice Board has risen from 16,700 in 1997 to more than 20,100 at the end of April 2005. Courses of NHS treatment have risen from 24.6 million to 32 million in 2004–05. In addition, the oral health of the UK population, which the hon. Member for Northavon (Steve Webb) mentioned, is improving. Dental decay for 12 to 15-year-olds, for example, is at its lowest levels since records began—levels that are lower than those in all European countries.

Sarah Teather (Brent, East) (LD): Is the Minister aware that my constituency is part of the North West London strategic health authority, which has among the lowest levels of children registering with an NHS dentist anywhere in the country, with more than half not registered with an NHS dentist?

Ms Winterton: Yes, I am aware that that is the situation in the hon. Lady's constituency. Interestingly,
 
29 Jun 2005 : Column 1311
 
it is true that many parts of London do not have shortages of dentists, as my hon. Friend the Member for Tooting (Mr. Khan) pointed out. One problem is getting people to register, and encouraging people to register where they are not doing so is part of many of the oral health and public health strategies that we are considering.

At the height of NHS dentistry registration, 58 to 60 per cent. of people were registered. A certain number of people have always not registered and the task is to ensure that they do so in future. That must be combined with water fluoridation policies, because in areas where water is fluoridated, the number of children without tooth decay has risen by 15 per cent. As right hon. and hon. Members know, the Water Act 2003 allows fluoridation of the remaining water supply where there is local support, which will further improve the oral health of the nation.

David Wright: Does my hon. Friend agree that local partnerships are crucial in delivering services? The quality of the local PCT is critical. In Shropshire, Mike Prendergast has done a tremendous job in developing a dental action plan, and new practices are opening up on the sites of regeneration projects. One very large new dental practice is opening in Telford in the next few months, with five of six new dental chairs providing thousands of new places for NHS patients. Can she therefore confirm that partnerships are important, and that we need to be positive about encouraging people to register? Some of the stories of doom and gloom are problematic.

Ms Winterton: My hon. Friend is right. When I visited his constituency, it was encouraging to see the action that the primary care trust was taking, in partnership with other agencies. There is no doubt that, for example, local authorities can be helpful in examining local action plans with primary care trusts to see what they can do, even in planning terms, to assist with registration. As he said, thousands of new places are coming on stream in his area, with encouragement from him. It makes a difference locally to know that Members of Parliament are working with primary care trusts.

Simon Hughes (North Southwark and Bermondsey) (LD): Can the Minister give the figures behind the increased number of registered dentists? Do they confirm that the number of foreign-born or foreign-trained dentists is growing considerably as a proportion of the total? If, as I believe, that is the case, would the Minister be willing to go with me to talk to the dean of Guy's, King's and St Thomas's dental school, just across the road at London Bridge? The school wants to train more people, and more people want to be dentists, but we are still withholding opportunities from those who want to train here, work here and service the NHS here.

Ms Winterton: We have already increased the number of training places, as can be seen from the number of new dentists. There is no doubt that more are working for the private sector, and I shall say more about that shortly. As for international recruitment to the NHS, I hope that it is increasing, because part of our strategy is to provide better NHS care. Those people are very
 
29 Jun 2005 : Column 1312
 
welcome. They are doing an excellent job in all parts of the country, and I hope that all Members of Parliament will encourage the trend.

The hon. Gentleman suggested that I meet the dean of the dental school. From next October, a further 170 places are being found at dental schools. As the hon. Gentleman knows, it takes about five years to train a dentist. That is the reason for our strategy.

Despite the changes in the number of dentists and the improvement in oral health, there are undoubtedly problems in the NHS. The Government are determined to implement a plan of action, which I shall describe. The speech of the hon. Member for Northavon was, I have to say, full of holes, but the crowning moment came when he set out the roots of the problem created by the Conservatives. As he said, the contract that they introduced was extremely unpopular with the dental profession. It gave dentists incentives to undertake invasive treatment rather than adopting a preventive approach—the drill-and-fill treadmill, as it is known. Dentists' fees were cut in 1992 and two dental schools were closed. The drift to the private sector began, and I am sorry to say that it has continued.

---