I am not sure whether the hon. Gentleman will be reassured by the information that I am about to give him. The point that I am making is that the help that the NHS is trying to give is based on factors that may not reflect reality. The NHS website states that none of the 18 practices registered in Cheadle is accepting new NHS patients, yet a ring-around revealed that two of them actually are. The concern is that the facts are not right. How many patients looking to register with a dentist will go to the trouble of ringing dozens of practices to see whether, on the off chance, the facts might not be right? That needs to be addressed.
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Concerns about access have also been illustrated by Members such as the hon. Member for Plymouth, Sutton (Linda Gilroy), who is lobbying for a new dental school in Plymouth, which I wholly support, and that reflects a need to get as many dentists as possible into the area because registrations are currently so low. Urgent action is required to rebuild NHS dentistry so that more people know what access they might have to services, as the hon. Member for South Swindon (Anne Snelgrove) pointed out, and so that they can access the services that they need. Will the Minister promise to investigate further how to fill in the current gaps in knowledge so that real and immediate progress can be made?
Linda Gilroy: I have listened carefully to the hon. Lady's comments, as I listened to the opening speech of her hon. Friend the Member for Northavon (Steve Webb), and I have yet to hear her welcome any of the investment, including that which will help the dental school, for which we in Plymouth hope, to materialise. Will she now do so?
I also want to draw the Minister's attention to the contents of the Liberal Democrat manifesto for the previous election, which called for closer work with the dental profession to ensure that it is on board with reforms that will deliver more dentists working for the NHS.
The drill-and-fill payment system, which has caused so many problems, should be scrapped as soon as possible and free dental check-ups should be introduced to help promote good dental health, as they will pick up more than just cavities.
Danny Alexander (Inverness, Nairn, Badenoch and Strathspey) (LD):
Is my hon. Friend aware that free eye
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and dental check-ups are to be introduced in Scotland as a result of the influence of Liberal Democrats in coalition government? The contrast between what is occurring in Scotland and what is occurring in England is testament to the influence that Liberal Democrats can have when we get into government.
Julia Goldsworthy: The Government cannot expect to make adequate progress, no matter how much they invest, unless they understand the scale and nature of the problems that they face. I commend our motion to the House.
The Parliamentary Under-Secretary of State for Health (Mr. Liam Byrne): We have had an excellent debate this afternoon, which has forensically deconstructed the motion tabled by the Liberal Democrats via a survey of the battle lines of the Cheadle by-election. Some of us also caught at least an inkling of what the Liberal Democrat alternative is.
The Minister of State, my hon. Friend the Member for Doncaster, Central (Ms Winterton), set out some inescapable points that helpfully framed our debate and illuminated the background to many of the excellent contributions that we have heard. She reminded us that dental decay is at the lowest level among children since records began, and that the figures for 12 to 15-year-olds are the best in Europe. She also reminded us that the number of dentists is up 20 per cent. since 1997 to more than 20,000, and that courses of treatment are up by 7 million a year.
One of my hon. Friend's many great strengths, however, is her frankness, and she was frank with the House when she said that our ambition is to go further still. The Government amendment encapsulates that way forward. It sets out an ambition to meet the challenges and build on the progress about which we have heard. Most importantly, however, it addresses seriously the fundamental question: where do we go from here?
Among the contributions that we heard was the opening speech of the hon. Member for Northavon (Steve Webb), which boiled down to two points: the progress made and how to put in place capacity for the future.
I noted that when referring to progress, the hon. Gentleman again used figures relating to the key year1998in which the registration rules changed, and the registration period was reduced from 24 to 15 months. The figures for the succeeding years show a very different pattern. They show an increase of 180,000 in the number of registrations, compared with a 2.1 million drop under the last Conservative Administration.
The hon. Gentleman also spoke of establishing capacity for the future. I hope he agrees that the Government's approachinvestment coupled with devolution of commissioning to local health professionals, international recruitment coupled with investment in training places for the future, and, most important, the creation of new contractual arrangements allowing NHS and private dentists to increase the capacity that they offer the NHSrepresents the way ahead.
Let me ask the Minister a serious question about accountability. He mentioned the
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devolution of commissioning to PCTs. On a number of occasions during the debate when we criticised Government action, the reply was "It's the PCTs". We do not elect the PCTs; we elect Ministers. Where will the democratic accountability in dentistry be when commissioning is decentralised?
Mr. Byrne: We need only remind ourselves of what was said by my hon. Friend the Member for South Swindon (Anne Snelgrove) to understand the impact that can be made by working in partnership with PCTs. My hon. Friend the Member for Plymouth, Sutton (Linda Gilroy) made a similar point.
The hon. Member for Mole Valley (Sir Paul Beresford) made an extremely well-informed speech, characterised by an enduring commitment to the principles of NHS dentistry. He was right to emphasise the importance of fluoridation: areas with fluoridated water have experienced declines of around 15 per cent. in tooth decay among children. He also emphasised the importance of the new contract, recognising the opportunity that it represents. I hope that during the consultation and the affirmative resolution procedure in both Houses, he will do his best to make his views known.
The hon. Members for Rochdale (Paul Rowen) and for Cheltenham (Mr. Horwood) described some of the access problems in their constituencies. I think that their speeches implied the same conclusion that the hon. Member for Manchester, Withington (Mr. Leech) appeared to reach. I think that they were all arguing in favour of the new contractual arrangements that my hon. Friend the Minister of State will announce next week. I take issue only with the allegation by the hon. Gentleman that the Government had done nothing to address the inheritance of 1997. An extra £250 million is not an empty promise; the recruitment of 1,000 extra dentists is not an empty promise; a 20 per cent. increase in the number of training places is not an empty promise. All those things make a difference, not just in the country generally but in the hon. Gentleman's constituency. For a start, he will have an extra £144,000 in access money.