Linda Gilroy (Plymouth, Sutton) (Lab/Co-op): It is a great pleasure to follow the hon. Member for Mole Valley (Sir Paul Beresford) on one of the rare occasions in an Opposition day debate when someone brings a lifetime of experience to his contribution. The House is a great deal better off as a result of such a contribution than from the petty political point scoring that goes on.
I certainly welcome the Government's record levels of investment, and it is perhaps not surprising that those on the Opposition Front Benches did not refer to that. One reason why the Conservatives ran into difficulties on under-investment in so many public services was that by the end of their time in government they were having to spend 45p in every pound of new taxation on the economics of failure, paying for the national debt, which had risen to unsustainable levels, and financing the high level of unemployment. It is largely thanks to the Chancellor of the Exchequer and our stable economy that we are talking about making some progress in dental care, albeit somewhat belatedly from the point of view of many of us.
The Liberal Democrats rarely try to make even their own sums add up. They pay no tribute to the Government and take no cognisance of how hard it is to get government right, not simply on individual policies, but across the board in running the economy and making sure that money is available for all the necessary investment.
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All Members can give examples of the sort that have been given at length today. The problems go back to the early 1990s. Even last year, when I spoke in an Adjournment debate in Westminster Hall on 20 May, I told my hon. Friend the Minister that the problems seemed to be escalating, although we could see the first signs that there might be light at the end of the tunnel in the work that was going on locally, beginning in the primary care trusts and reflected in the work of scrutiny committees from local authorities across Devon and Cornwall. I congratulate those local authorities on their work in bringing people and PCTs together locally, regionally and nationally to consider what we can do to tackle the extremely difficult problems in the far south-west.
We seem to have been indulging in fanciful word plays today. One idea from Plymouth city council's scrutiny committee was that we might bring the tooth fairy to the rescue. I am not sure what the committee had in mindperhaps it was to bring a ferry full of dentists across the channel to tackle the problem.
At my Adjournment debate, I spoke about the work going on in the primary care trusts in Plymouth, which was an "options for change" field site, and a year later it is fair to say that steady progress is being made. Of course, it would be nice to report that everything in the garden is rosyalthough perhaps I should refrain from using that phrasebut given the context in which we are working, where we have to come to an agreement with people who are independent contractors, the fact that we are making steady progress is something on which the Government should be congratulated.
Plymouth, in common with other hot spots, is receiving support from the Department's dental team. I understand from James Short of the PCT, who is doing a splendid job with his team, that the departmental team visited recently and that they are in the process of agreeing a dental plan for the PCT. That will secure the position of people who already have an NHS dentist, and slowly but surely the PCT is negotiating new NHS contracts to treat new patients.
The south-west peninsula and Plymouth have both achieved the target of 25 per cent. of dentists on local contracts, with the PCT's personal dental services contract. Again, I thank my hon. Friend the Minister for the urgent and immediate attention she gives me and the trust whenever we seek it in dealing with the fine details that can stand in the way of concluding an agreement. Dentists have signed up for three years, which has secured services for more NHS patients in Plymouth. That is not yet enough, but we are in the right direction of travel and, although it will be more difficult over the next year to achieve another 25 per cent. of dentists signing up to NHS contracts, if we succeed we shall be travelling at a speed that should make a difference in some of the difficult situations that my constituents experience.
Mr. Philip Dunne (Ludlow) (Con):
The picture that the hon. Lady paints of Plymouth is much more encouraging than the picture in my constituency, where the direction of travel, far from being positive, is the reverse. To pick up on the comments of my hon. Friend the Member for Mole Valley (Sir Paul Beresford), there is a brain drain to Australia rather than to the UK. When I was knocking on doors just before the election,
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I met a young dentist who had young children and could no longer make a living from his private practice in Bridgnorth, so he was planning to emigrate to Australiaperhaps to indulge in some of the practices to which my hon. Friend referred. That illustrates the problems of providing dentistry, whether private or NHS, in rural areas, which are compounded by the lack of NHS dental facilities. When a new practice opened in Ludlow earlier this year, the local PCT refused to provide details of its telephone number or address for fear of being inundated with applicants for registration, because there were so few available places. That problem in rural areas does not seem to be reflected as much in cities.
Linda Gilroy: As I shall explain in a moment, the far south-west has some of the most difficult problems in the country. It is far from the situation that the hon. Gentleman describes, but I and many of my Labour colleagues work hard with our local PCTs. My PCT has my pager number and I have its mobile number. When there are issues to be sorted out my hon. Friend the Minister is always ready to help. Such things are a top priority for all of us.
It is difficult to achieve change. Plymouth and the south-west remain hot spots. There are difficulties everywhere, but especially at our end of the region: for example, in Devon and Cornwall the ratio of dentists per head of population is 1:3,549; at the other end of our region it is 1:3,081, but in Hampshire the ratio is 1:2,821. There are even more favourable ratios in other parts of the country.
A study by Rabinowitz showed that significant proportions of clinical graduates tend to stay on at the place where they studied. Given the above ratios, I hope that my hon. Friend and her colleagues in the Department of Health, especially the Secretary of Stateshe knows this is comingwill give serious consideration to the expression of interest from the Peninsula medical school in establishing a new dental school alongside its successful training for doctors. Apart from the good socio-demographic reasons that I mentioned, there are strong clinical arguments for a dental school in Plymouth. My hon. Friend the Member for Selby (Mr. Grogan) asked where we would get the academics to train new dentists. Many academics are practising dentistry in the south-west and are not currently deploying their teaching skills. They could easily be brought back in if there were a local dental school in Plymouth, thereby avoiding the poaching of academics, which could be a problem as we expand our dental schools.
The Peninsula medical school makes extensive use of distributive clinical outreach facilities, which enable students to become familiar with current community morbidity patterns, to which the Minister referred in her speech. Plymouth has established a track record in high quality clinical teaching and one of its four centres of excellence in teaching and learningthere are only five such centres in the countryrelates specifically to clinical placement learning. For those and a number of other reasons, which I should be happy to outline to my hon. Friends in the Health team, I hope that we shall be shortlisted for further consideration in the near future.
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I know that Devon and Cornwall Members from all parties will be approaching my hon. Friend on that subject, too.
While my hon. Friend is securing and steadily building NHS dentistry, we can look forward to that programme continuing year on year into the future. We shall look back on the difficult years and be proud of what we achieved to save and secure an NHS dentistry service for our constituents.
Dr. Murrison: Does the hon. Lady agree that it is important for the Minister to tell us whether she intends to establish a new dental school, or whether we will in fact have dental outreach centres from existing dental schools, or satellite institutions, because that is obviously important in the context of Plymouth?
Ms Rosie Winterton: Perhaps it would help if I clarified the current situation. The 170 graduates who are starting from this year will be spread among existing dental schools, but we have invited applications for a new dental school, which will be considered over the next few months.
Linda Gilroy: I thank my hon. Friend for that clarification. One of the problems with setting up a new dental school is that it could mean that it takes longer to bring dentists forward into clinic practice. A further advantage of establishing a dental school in Plymouth would be that we already have shorter learning models in the medical school, so by using a four-year learning model we could bring dentists on stream at the same time as if the increase in the number of dentists was achieved by expanding places in existing schools. Indeed, we could bring dentists on sooner in years to come.
I conclude by welcoming what my hon. Friend the Minister said and the fact that she will make an announcement next week on Harry Cayton's report, to build on the work that the Department has already undertaken to repair the damage that was done to NHS dentistry and to make charging simpler and more transparent for patients and dentists, which will be welcomed by both groups in my constituency.