The Parliamentary Under-Secretary of State for Health (Mr. Liam Byrne): The Government do not collect that information, as it is for local NHS trusts to determine how best to deliver services. However, the Royal National Institute for Deaf People estimates that the NHS has now fitted more than half a million people with digital hearing aids.
James Brokenshire: What that information does not necessarily show is the times for which people are still waiting to receive digital hearing aids. In my area, people are waiting 12 months or more. With primary care trust funding stretched and increasing demands being placed on the service, it is feared that those times are likely to lengthen further. Does the Minister agree that, at a time when we are focusing on improving rights for those with disabilities, 12 months may be too long for someone to wait to receive a digital hearing aid?
Mr. Byrne: I welcome the Breaking the Sound Barrier campaign, launched today by the RNID. It involves a telephone hearing test. I took the test this morning, and discovered to my surprise that I was not suffering from selective hearing: my hearing is within the normal range.
As the hon. Gentleman knows, digital hearing aids were once an impossible dream, but we are now fitting about one a minute. That is not an accident; it is happening because we have invested £125 million in modernising all hearing aid services throughout the country.
Some primary care trusts do need to do more. I know that in the hon. Gentleman's constituency, the waiting list could be reduced to just 16 weeks if the number of sessions at his local trust were increased by around 20 per week. That will be made much easier by the extra £75 million that will go to his PCT over the next two years.
Mr. Brian Jenkins (Tamworth)
(Lab): I am very glad that my hon. Friend will not be suffering from selective hearing when I repeat the claim made by the hon. Member for Hornchurch (James Brokenshire). When we decided to give away the digital hearing aids that have made such a tremendous difference to the lives of ordinary people suffering from hearing loss or hearing impairment, did we not foresee the queues that would
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arrive at the door? Although we are doing very well, it does not help my constituentshowever much money we put into the system, with the best will in the worldthat we currently lack qualified staff to deal with all the appointments needed to deliver the service effectively. I know that this is a success story, but sometimes, even when there is a success story, we have to say, "Please bear with us". What message can my hon. Friend give me to convey to my constituents? Can I tell them that the waiting times will be reduced?
Mr. Byrne: I thank my hon. Friend for raising a point that he has raised before with Ministers and in the House. We have had to do two or three things to ensure that digital hearing aids are brought within the reach of as many people as possible. We have had to lower the price from £2,500 to just £55, and we have had to invest in more audiologists. The first graduates will leave university next year. We have also had to ensure that there is independent-sector capacity, so that two public-private partnerships are available to support PCTs. None of that would deliver any progress, however, without the extra funds that we are investing in the NHS over the next two or three years.
Peter Bottomley (Worthing, West) (Con): Would the Minister be surprised to learn that the waiting time for a hearing test and then a hearing aid is between six months and four years? Will he please ensure that Ministers know what the waiting times are, rather than saying that they do not know? Will he come to Worthing and listen to an 89-year-old woman, who will not be able to hear him because her hearing has not been tested and she has no hearing aid? Her life is a misery because of the wait.
Mr. Byrne: Digital hearing aids do make an enormous difference to people. They are about 40 per cent. better than other hearing aids. We must do more to ensure that there are enough audiologists to deliver services as quickly as possible. That is exactly why we helped to create a degree for audiologists, it is exactly why we ensured that 350 would take the course, and it is exactly why we established the partnerships giving every PCT an opportunity to develop the capacity to deliver the hearing aids as fast as possible. It is for local NHS managers to use the extra resources that they have been given to deliver the service to the hon. Gentleman's constituents.
David Taylor (North-West Leicestershire) (Lab/Co-op): I think that I heard the Minister say a moment ago that one digital hearing aid was being fitted every minute. A quick calculation will establish that the NHS is spending about £200,000 per minute, and I am pleased that some of it is being devoted to hearing aids. I have impaired hearing myself, with chronic tinnitus.
Is the Minister aware that some of the NHS hearing aids that have become available recently have a facility that suppresses some annoying background noises, such as tinnitus? Does he intend to acquire some of those new hearing aids, and tune them to suppress the background noise that we hear from Opposition Members who whine about a lack of investment in the health service, but oppose every opportunity for proper funding?
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Mr. Byrne: My hon. Friend surely has a point. We know that a policy commission has been set up by the Conservatives under the chairmanship of the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) and everything is apparently up for grabs. I look forward to finding out whether we shall hear any more about the pledge to abolish all targets, including waiting lists, which was point No. 1 in their timetable for action. I also look forward to hearing about the death knell of the patient's passport.
Tim Loughton (East Worthing and Shoreham) (Con): In July 2004, last year's Health Minister acknowledged, in response to my concerns, that waiting times for fitting digital hearing aids were extending. Yet 17 months on, the waiting time to see a specialist audiologist and get fitted in my region of the south-east has risen from 58 to 81 weeks. At the Royal Sussex county hospital in Brighton, the worst wait is for 130 weekstwo and a half years. At that rate, many of our elderly constituents will have appointments with the undertaker before they have appointments with the audiologist. When is the Minister going to get a grip on this scandal, particularly given that he could be using hundreds of qualified professionals in the private sector who could be brought on board now at no extra cost?
Mr. Byrne: Let me take the example of the constituency of the hon. Member for Hornchurch (James Brokenshire). We know that waiting lists there could be brought down to just 16 weeks by moving the number of sessions at the local trust from 54 to about 71. That is not an earth-shattering exercise, particularly when we know that an extra £75 million is going into the PCT over the next two years. We have brought down the price, we have put more audiologists in place and we have helped PCTs to use their resources more effectively, so the conditions are in place for waiting lists to fall very quickly over the next 12 months.
The Minister of State, Department of Health (Ms Rosie Winterton): The regulations covering the new contract were laid, subject to negative resolution, on 9 December and are due to come into force on 1 January 2006. All dentists have received their contract values and primary care trusts have received details of their allocations for dentistry for 200607.
I thank the Minister for that answer. She will be aware that the British Dental Association is concerned about the lack of timely information provided for dentists, particularly in respect of personalised information, which went out from the Dental Practice Board to dentists only on 2 December. According to the BDA, that has led to considerable anxiety among dentists. With the UDAunits of dental activitysystem entirely untested, with inadequate consultation and unsatisfactory
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communication, what extra support will the Minister put in place to ensure that the introduction of the new contracts will not prove to be a catastrophic failure?
Ms Winterton: As the hon. Gentleman may be aware, there have been ongoing discussions with the British Dental Association and dentists over a number of years, and the work has been piloted, with more than 30 per cent. of dentists being involved in the new pilot schemes. The reason why the Dental Practice Board sent out the contract values as late as December is that we wanted to give dentists the most up-to-date information about their activity over the previous year. If we had sent it out earlier, the information would have been out of date. That is why the information went out at that pointit was intended to be helpful to dentists. They now have that information and the PCTs have their allocations. I very much hope that we will move quickly to the new system, which will make a real difference to the way in which dentistry is provided in this country.
Mr. Kevin Barron (Rother Valley) (Lab): I thank my hon. Friend for what she is doing to ensure that NHS dentistry grows in this country, in contrast to its withering away before 1997. Will she ensure that any financial charges incurred by PCTs such as mine in Rotherham that have gone out for the new contract will be paid for by the centre, as has been done in previous years?
Ms Winterton: My right hon. Friend will be aware, I am sure, that the South Yorkshire PCTs have been doing a good job in meeting local dentists and moving them on to the new pilot schemes; they are to be congratulated on that work. As he will also be aware, some £268 million in extra investment has gone into NHS dentistry, which is reflected in the PCTs' new allocations.
Mrs. Iris Robinson (Strangford) (DUP): There is a shortage of dentists in the United Kingdom, and in Northern Ireland in particular. Does the Minister agree that the rural areas suffer the greatest lack of provision, and will she ensure that those areas will be highlighted for the allocation of dental provision?
Ms Winterton: One of the obvious benefits of the new system is that whereas previously if a dentist left the NHS, the money reverted to the centre, now that money will stay with local PCTs, so that they can consider the needs of their local population and think about other ways of providing dentistry if, for example, there is a particular problem in rural areas. I have seen some good examples of PCTs arranging mobile dental units for remote areas where people did not have access to a dentist. The new system allows that kind of provision to be made to reflect local needs.
Under the new contract, a dentist giving a pretty full-time commitment to the NHS would receive about £80,000 in salary. On top of that there will
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be business expenses, for which dentists are likely to receive between £60,000 and £80,000 a year. I should emphasise that under the new contract, we are also guaranteeing the same remuneration for three years, for approximately 5 per cent. less work. I think that that is quite a good deal, and I am sure that right hon. and hon. Members would agree.
Dr. Andrew Murrison (Westbury) (Con): Waiting for the new dental contract has been a bit like waiting for Christmasseveral Christmases, in factbut we must be grateful for what we have. Is it not the case that under that contract, more patients will pay more, National Audit Office concerns about under-treatment will become a reality, perverse incentives will encourage dentists to offer the easier treatments within the three treatment bands, and patients who understand the new system will maximise their benefits at the expense of the more vulnerable and those in greatest dental need?
Ms Winterton: No to almost all of that. The hon. Gentleman might like to apologise for the fact that under the Conservative Government, two dental schools were closed and a contract vastly unpopular with dentists was introduced, putting them on the treadmill that we are now trying to get them off. Under the new system, the maximum that can be paid under the NHS will be cut from £384 to £189. The hon. Gentleman talks about patients paying more, but under the new National Institute for Health and Clinical Excellence guidelines, an oral check-up, preventive health advice and scale and polish will cost £15.50, whereas under the present system if a patient goes to the dentist twice a year, and has a scale and polish and two check-ups, the cost comes to something like £30. It is not true to say that there are perverse incentives. Dentists will have to keep up the same level of activity; that is only right. The contract has been worked out with the dental profession, extra investment is going into the NHS, and it is simpler for patients to understand and dentists to administer.
Mr. Kevan Jones (North Durham) (Lab): I have listened to what the Minister said, but may I raise an issue that was raised with me by my excellent NHS dentist last week, when I was sitting in the chair? This is about charging for missed appointments. Two years ago, my hon. Friend introduced a £5 charge for people who failed to turn up to appointments, which cut by 90 per cent. the number of people who miss appointments. Can she explain why we cannot continue to charge for missed appointments under the new contract?
Dentists are currently paid for every activity that is undertaken, and dentistry is the only part of the NHS in which it is possible to charge for failed appointments. In effect, if a patient does not turn up the dentist automatically loses money, which is why dentists have been able to charge for failed appointments. Under the new system dentists will be paid monthly, so it would not be right for them to be able to charge for failed appointments, because they will not lose income through a patient's not turning up. However, dentists will operate in the same way as doctors, in that they will ensure as much as possible that people keep
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appointments. We will keep the failed appointments issue under review and examine whether it proves more problematic than we expected, but the reason for the change is that dentists will not directly lose money through patients not turning up.
Ms Winterton: The hon. Gentleman is right to point to the fact that more dentists have been undertaking private work, which is why there are difficulties in some parts of the country. For that reason, we made £50 million available to improve access in some areas and invited primary care trusts to increase access. However, the changes that we are introducing from next April will make a real difference. The problem that the hon. Gentleman's area has suffered from is that in the past, when a dentist left the NHS the money did not stay in the local area to enable provision to be sought from elsewhere; rather, it reverted to the centre. Now, the local PCT will have that money and if a dentist leaves the NHSfor whatever reasonit will be able to purchase NHS dentistry from another dentist or to bring in dentists from elsewhere.