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Mr. John Leech (Manchester, Withington) (LD): I am grateful for the opportunity to contribute to our debate on NHS dentistry, which is a serious concern for a number of residents in my constituency and for people across south Manchester.
I support the proposals tabled by right hon. and hon. Friends, who have called on the Government
"to work with the dentistry profession to ensure that the new contract delivers more dentists spending more time working in the NHS."
I regularly receive correspondence from constituents—I am sure that hon. Members on both sides of the Chamber do so too—whose dentists have sent them letters telling them without prior warning that they are going to stop doing NHS work. Those patients are left to their own devices to find an alternative NHS dentist, which is a far cry from the Prime Minister's pledge in 1999 that everyone would
Figures showing that less than 50 per cent. of people are now registered with an NHS dentist demonstrate the lack of success of the Government's policy on dentistry. One of my constituents in Didsbury is in the unfortunate position of losing two successive dentists. After his local dentist in Didsbury stopped carrying out NHS work, the nearest NHS dentist that he could find was over the border in Cheadle. Not one local dentist in my constituency was able to accept him as an NHS patient. Now he has been told by Cheadle dental practice that it will stop doing NHS work from 1 September. I wonder how many hundreds of residents in Manchester, Withington and will be in the same position?
Who is to blame? Some people might argue that it is the dentists themselves, who not interested in working in the NHS. At least one hon. Member asked why dentists should do NHS work when they can make much more money in the private sector. I do not believe that that is the case. Dentists are not to blame—it is the policies of successive Governments that have failed NHS dentistry. Speaking to dentists in my constituency, it is clear that the majority want to work in the NHS. They want NHS dentistry to be available to all, but it has become impossible for them to carry on working in the NHS. I have already written to Cheadle dental practice more in hope than expectation, urging it to reconsider its decision to end NHS treatment.
I have little reason to be optimistic. This is not about dentists just wanting to make money but about them being unable to deliver a decent service under the NHS contract. In a letter to patients, Dr. Campaigne—I apologise if I have mispronounced his name—of Cheadle dental practice wrote:
"You may well have seen on the television or read in the press that providing quality dentistry has become very difficult within the NHS. I have a loyalty to and from my patients and although
- I have been prepared to support the NHS in the past I find it increasingly difficult to provide the quality of care to which you have become accustomed and which I feel you deserve."
That sums up the situation. Dentists tell us time and time again that the pricing structure means that dentists are unable to spend time with their NHS patients, give advice on preventive care or carry out good-quality work. Without a complete renegotiation of the contract to give dentists time with their patients and put in place effective plans the situation will become worse, not better.
It was the Conservative Government who were responsible for the decline in NHS dentistry in places such as Manchester Withington and Cheadle. A new contract and reductions in fees in the early 1990s started the trend, but it is the failure of the Labour Government to do anything about it that has brought the NHS to a crisis point.
Mr. Ian Austin: I would like to ask the hon. Gentleman a question that I tried to put to his hon. Friend the Member for Northavon (Steve Webb). We have heard a great deal from the Liberal Democrats about the shortage of NHS dentists, but the only proposal in their manifesto on dentistry was for personal dental plans. How many extra dentists would personal dental plans require to be trained, recruited and employed, and how would they be paid for?
Mr. Leech: The hon. Gentleman has been in government for eight years. [Interruption.] Perhaps he has not been in power for eight years, but the Labour Government certainly have, and they have done nothing to deal with the decline started by the Conservative Government.
In conclusion, the Prime Minister's amendment is typical of a Government with their head in the clouds. I am happy to congratulate NHS staff on their efforts, but in dentistry, their work is made harder by a Government policy that appears determined to end NHS dentistry rather provide than NHS dentistry for all. I noted with interest that the amendment says that
"the Government's ambitions for NHS dentistry will deliver a modernised, high quality primary dental service".
The amendment fails to mention that most people will not be able to access that service, and that fewer individuals will benefit from it unless there is a radical shake-up of NHS dentistry.
3.5 pm
Meg Hillier (Hackney, South and Shoreditch) (Lab/Co-op): It has been interesting to listen to today's debate. The hon. Member for Mole Valley (Sir Paul Beresford) in particular made an interesting contribution. I will not focus on the ins and outs of what goes on in a dentist's room but on the wider issues in my Hackney constituency.
First, I shall comment on the opening speech by the hon. Member for Northavon (Steve Webb). In another life, I was a young journalist in the world of housing. When the hon. Gentleman was first elected we were all excited, because he knew a great deal about his subject and could make good, positive policy suggestions on improving the benefits system. When I sat down on the
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green Benches today, I thought that I would hear something interesting about dentistry, an issue that is important to my constituents and me, as well as to everyone in the Chamber. However, we were disappointed by the fluff and nonsense that we heard. There were no facts of any merit and no positive suggestions about what the Liberal Democrats would do. It was simply blatant electioneering, which is sad, because the issue is important for people in my constituency and the rest of Hackney.
The problems with dentistry in Hackney are very different from the problems experienced elsewhere. We have plenty of NHS dentists, but we lack the patients. The startling fact is that less than a third of residents are registered with a dentist. Just over 61,000 people are registered in a population of 222,000, according to the figures produced by the primary care trust. Locally, the PCT is working with dentists. Thanks to the Government's policies, the priorities are to register more children and to promote preventive work. Eight dental practices have already signed up to the new personal dental services contract. The PCT, particularly its visionary and highly effective chief executive, Laura Sharpe, has made a good start in tackling the problems in partnership with the Government. It is easy for people to carp about things they think the Government have not done, so let us remind ourselves of what they have done. There has been an extra £250 million in this financial year alone—an increase of 19 per cent. in investment in dentistry—and a new dental contract has been introduced.
I am delighted that my hon. Friend the Minister of State is willing to listen to points made in our debate, as there is not a simple answer to some of the problems in NHS dentistry. We do not live in the Liberal Democrat world of easy solutions but in the real world of government. I am delighted that under her stewardship we are working on long-term, sustainable solutions to problems. An extra £9 million has been provided by the Government to PCTs for training to help dentists to prepare for the introduction of the new ways of working from October this year.
Mr. Walker: While all that Government investment is much appreciated, is it not the case that much of it is lost on the public, because they would like more dentists in their community and the chance to get on to dental lists and receive treatment?
Meg Hillier: As I said, in my constituency there is no shortage of dentists in the community, but I accept that we must consider the need for information about the availability of dentists. As my hon. Friend the Member for South Swindon (Anne Snelgrove) said, dentists are available, but people are not always aware that they can register with them. I hope that my hon. Friend the Minister will focus on the positive side of the question rather than the negative and untrue points made by the Opposition.
To return to Hackney issues, I am sure that my hon. Friend the Minister and others would agree that the low registration rate is a serious issue for the health of
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Hackney residents across the board. Hackney has the second highest proportion of 0 to 4-year-olds in London—just over 8 per cent. It also has a high population turnover—about 20 per cent. a year. That is well illustrated by a primary school that I visited a few weeks ago in Hoxton in the heart of a large number of council estates in my constituency. In year 6 of that primary school, just under 20 per cent. of the pupils have been there since reception. That is an indication of the challenges facing the promotion of registration and access to dental health in populations such as mine in Hackney, South and Shoreditch.
My hon. Friend outlined the Government's approach to increasing the registration of children, and I am delighted about that, but we have only just over 14,000 children registered in Hackney and we need to increase that. I would be keen to work with her and the primary care trust to ensure that boost. I am delighted that the primary care trust has taken the matter up with such vigour, but it is a challenge nevertheless.
Personally, I support fluoridation. In a previous existence, when I was a member of another Assembly, we discovered that, in London, it is particularly difficult to achieve because of the number of water companies and their geographical spread and cover, which makes it difficult under the new legislation to get an agreement to provide fluoridation across London. That leaves many of London's young people vulnerable to decay, especially in parts of east London, including Hackney, where literacy is not so high, population turnover is high and we have a number of migrant communities.
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