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Julia Goldsworthy (Falmouth and Camborne) (LD): I thank everyone who spoke for their contributions and for exhausting all the puns that can be made about teeth and dentistry. As a new Member, I fear that I might bite off more than I can chew if I attempt any more.
Many concerns have been expressed about a shortage of access to NHS dentists. We must remember that the problems began under the Conservatives with changes in contracts and a reduction in fees, which forced many dentists to take on more private work. That was not helped by the closure of two dental schools. I do not know what persuaded the Conservative Government that that was a good idea.
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However, after eight years of a Labour Government, it is no exaggeration to say that NHS dentistry remains in crisis. As the Minister agreed, more than half the population are not registered with an NHS dentist. As she also conceded, dentists continue to drift away to the private sector. Given her words and the underlying problems, the evidence that has been provided here today is not reflected in the wording of the amendment. I welcome the fact that the Department will publish its response to the charging review, but I ask the Minister to publish the report so that we can see to what exactly the Department is responding. I was interested to learn that the Department is scoping the fundamental review of dentistry, which was promised in the Labour manifesto. The fact that such a review is necessary contradicts the words of the amendment.
The necessity for the fundamental review and the fact that it will be scoped before it happens suggest that the Government are rowing away as quickly as possible from their general election manifesto pledge.
The access problems have been shown by contributions from hon. Members of all parties. I should like to add my experience to that of other hon. Members. Like my hon. Friend the Member for Cheltenham (Mr. Horwood), I tried to find a dentist in my area who could offer me treatment under the NHS. I thought that I would ascertain whether the Prime Minister's pledge held up and whether I would be referred to an NHS dentist if I phoned NHS Direct. I gave NHS Direct a call and looked at the NHS website. Of a total of 15 practices in my constituency, only four are accepting new NHS patients. None offers occasional or emergency treatment for non-registered patients. Three were ruled out because they accepted new NHS patients from only their immediate area, where I do not live. I live in Camborne and there was only one option for me. I rang that practice directly and was told that I would have to wait between two and eight months. The person to whom I spoke said that they were very sorry, but they could not tell me how long I might have to wait to be registered. If I put my name down, they would try to get back to me. That would depend on what vacancies came up and when they were advised by the primary care trust to register more people.
Julia Goldsworthy: Yes, it is worrying. When I spoke to NHS Direct, I asked about the provision for emergency treatment. I was told that there was one dental access centre 11 miles away and that I would not be given a contact number because I would have to be triaged over the telephone to determine whether it was appropriate to give me access even to try to book an appointment. I am not sure how it is possible to triage over the telephone.
That shows the difference between different areas. I turned up at my dental access surgery
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and was given an appointment in 24 hours, in which time I was treated. I advise the hon. Lady to speak to her primary care trust.
Julia Goldsworthy: Unfortunately, I do not think that I shall be able to move to Swindon to receive such treatment. However, the Government have a responsibility to provide a minimum standard across the entire country. I hope that the example that I have given will highlight the fact that there are many access problems, as we have already heard today.
Richard Younger-Ross (Teignbridge) (LD): Like the hon. Member for South Swindon (Anne Snelgrove), I too had an abscess, two weeks earlier in the election campaign. My dentist actually got out of bed on a Sunday morning and treated me so that I could continue to work. My agent had an abscess just after the election, however, and was told that she would have to wait two weeks for treatment on the NHS. She ended up having to go private because no relief was available through the national health service.
The Government's amendment to the motion states that there has been extra investment and that the head count of dentists has increased. I would be interested to know how those dentists are splitting their time between NHS and private work, and what the full-time equivalent is of NHS dentistry provision. I am concerned that there appear to be mismatches between the Government's figures and people's real experiences on the ground, such as those highlighted by my hon. Friend the Member for Manchester, Withington (Mr. Leech).
My hon. Friend the Member for Harrogate and Knaresborough (Mr. Willis) has helpfully passed on to me a written answer to a parliamentary question, which gives a very healthy head count of dentists in North Yorkshire. In contrast, the reality that my hon. Friend has experienced on the ground is completely different. He has been contacted by a practice in Ripon that has had to take 1,000 registered patients off its books because the PCT cannot provide the additional funding that it needs to recruit another dentist. So the Government's figures might appear warm and encouraging on paper, but they bear no relation to people's experiences on the ground.
I am worried about the many unknown factors that need to be investigated before these problems can properly be addressed. At present, the problems are not properly understood. For example, we do not yet know when all the dentists will be switching over to the personal dental services contracts, as negotiations with the British Dental Association have broken down once before. Furthermore, it is not yet clear whether the switch over to the new contracts will result in improved capacity for dental services, or whether the dentists who have already moved over to the PDS contracts have increased their ratios of NHS patients and treatments. Surely it will be vital to know whether the new contracts will help to address the problems that I have outlined.
Fears have also been expressed by the National Audit Office that there will be a reduction in NHS services as a result of the introduction of the new contracts, similar
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to that of the early 1990s. A further unknown factor relates to the recruitment of overseas dentists. While they are indeed filling a cavity in dental provision, we do not know how well PCTs are absorbing the cost of recruiting and inducting them. With so many PCTs already in deficit, this issue needs to be investigated further.
It is great news that the Government are planning to increase the number of new dentists by increasing the number of students being trained, but how will those extra places be filled when many dental schools are already in financial deficit and having huge problems recruiting academic dental staff?
Mr. Jamie Reed: I am interested in the point that the hon. Lady has just made about dentists being recruited from overseas to provide dental services in the UK. Is she suggesting that there should be an embargo on such recruitment?
Julia Goldsworthy: Of course I am not saying that. I am saying that we do not have enough information about the factors that could be affecting this problem. I am worried that there is a lack of understanding among patients as to what they are entitled to. This is reflected in the number of calls that have been made to NHS Direct. As my hon. Friend the Member for Northavon (Steve Webb) pointed out earlier, toothache is the fourth most popular reason for calling the service, yet one in 11 people who call for that reason are not given a nearby treatment centre for their problem.
Andrew Gwynne (Denton and Reddish) (Lab): I am grateful to the hon. Lady for giving way. She might not be aware that Cheadle is in Stockport, as is part of my constituency. The picture that has been painted by Opposition Members, in a blatant electioneering exercise, does not necessarily correspond with my experience, or with the conversations that I have had with health officials in Stockport. Is the hon. Lady aware that 60 per cent. of adults and 70 per cent. of children in Stockport are now registered, which represents a real improvement, contrary to what the hon. Member for Manchester, Withington (Mr. Leech) suggested? That is way above the national average, which is to be welcomed
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