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The Minister of State, Department of Health (Ms Rosie Winterton): Leicester city council wrote to the Secretary of State regarding information for the public about dentistry changes. Right hon. and hon. Members have asked questions and written letters to me about NHS dentistry in Leicestershire.
Mr. Robathan: Will the Minister take this as another representation on behalf of me and 50 per cent. of my constituents, who cannot get an NHS dentist? Is she aware that the British Dental Association believes that 60 per cent. of NHS dentists will reduce their NHS work under the new contract? How does that square with the Prime Minister's pledge that everyone would have access to an NHS dentist by 2001? Does the Minister imagine that we will get there before this discredited Government are thrown out of office?
Ms Winterton: I would hope that dentists will not reduce their commitment to the NHS, particularly as an NHS dentist can be paid about £80,000 a year for a reasonable commitment to the NHS. On top of that, I told the House previously that there would be £60,000 towards their business expenses, but I was wrong. The figure is about £80,000. That is guaranteed for three years for 5 per cent. less work. I do not think that that is a bad deal for NHS dentists, and I hope that Members representing Leicestershire will encourage their dentists to sign up and stay with the NHS.
Sir Peter Soulsby (Leicester, South) (Lab): While commenting on NHS dentistry provision in Leicestershire, will the Minister join me in praising the excellent work done by the NHS dental access centre, which is based in the city of Leicester but provides services across the whole of Leicestershire? Those services go to many thousands of people who, until the centre was provided by the Government, did not have access to NHS dentistry. In praising its work, will she also make a commitment to providing it with the necessary resources to meet the considerable demand for its very welcome services?
My hon. Friend is right to praise the work of dental access centres, which have considerably improved access for patients, particularly those requiring emergency treatment. The point about the changes we are making in NHS dentistry is that the money that was previously handled nationally will remain at local level, particularly if NHS dentists choose to leave the NHS. It
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will then be up to local PCTs to use that money to commission dentistry from elsewhere. That also takes into account the fact that they have been supporting and will continue to support dental access centres.
Mr. Stephen Dorrell (Charnwood) (Con): Does the Minister agree that the central purpose for which the NHS was established was to secure equitable access for those who need health care? Measured against that text, is it not true in Leicestershire, as it is all over the rest of the country, that access to NHS dentistry has gone backwards over the last eight years? The words she uses are familiar to me; I read them out from that Dispatch Box 10 years ago. When will the Government do something about improving access to NHS dentistry, rather than allow the position to continue to go backwards?
Ms Winterton: I am surprised that the right hon. Gentleman was reading out exactly the same words from the Dispatch Box, considering that he closed two dental schools and last week we announced that we are opening them. We are training another 170 dentists and investing more in NHS dentistry. I am not denying that there have been and continue to be problems. In his area, however, one of the PCTs has seen registrations increase by 13 per cent. over the past year, and there has been nearly £500,000 of additional investment in personal dental services. We are reforming radically the way in which NHS dentistry is delivered in this country. Under his Administration, if a dentist left the NHS, the money reverted to central Government. Under our system, the money stays at local level so that PCTs can increase access, making sure that those who want to work in the NHS do so and are properly rewarded.
Mr. Andy Reed (Loughborough) (Lab/Co-op): My hon. Friend knows that I have raised concerns in relation to Charnwood and North West Leicestershire PCT in the past. Is she aware, however, of a campaign that seems to be scaring many of my constituents? On Friday, I received a letter from the PCT, which it has had to write to me and other Members of Parliament for the area, in which it claims that such campaigns are causing unjustifiable alarm to many patients and should not be allowed. Does she agree that although there are problems, it is much better to have a rational debate than to make wild claims on both sides? The real problems need to be addressed to make sure that PCTs are in a position to provide services if dentists remove themselves from the NHS.
Ms Winterton: My hon. Friend is absolutely right. The chief executives of virtually all PCTs in the area wrote to the local dental committee pointing out that the posters being displayed in surgeries could result in patients unnecessarily taking up offers of private dentistry. They have requested that the local dental committee does not encourage dental practices to display those posters, and have been very clear that the offer made to dentists is reasonable. If dentists do not want to take it up, however, they will commission services either from other NHS dentists in the area or from about 1,000 new dentists coming through not only our international recruitment exercise but qualifying examinations taken via the international route. If NHS dentists choose to
Steve Webb (Northavon) (LD): In Leicestershire, roughly one child in three is not registered with an NHS dentist. Of the remainder, many are at dentists who will not take adults on the NHS but continue to accept children. When the Government ban that mixture, what will happen to those children?
Ms Winterton: Let us be clear. The reason we have made this change is that many Members complained that dentists were saying, "We will take your children if you register privately." That was wrong and disgraceful, and that is what we have changed. That does not prevent PCTs saying to individual dental practices that if they want to take children only on the NHS, if the PCT agrees, they can do so. That was the difficulty that we were facing. Practices will still be allowed to take children only on the NHS if the PCT agrees.
David Taylor (North-West Leicestershire) (Lab/Co-op): The Minister mentioned the international recruitment initiative, and some dentists have come from some of the least well-off countries in the expanded EU. Will she say a little about the protocols and codes of practice in place to ensure that we do not bridge gaps here at the expense of creating cavities there?
Ms Winterton: We are always keen to ensure that our international recruitment programmes have the agreement of other Governments. When I visited Poland, where we have recruited some 250 dentists, I met representatives of the Polish Government and dental executive groups. They agreed that there was no problem with dentists coming to this country, and that it was not causing a shortage in their country. The same applies to the international qualifying examinations. As I have said, about 1,000 dentists will qualify over the next few months.
Dr. Andrew Murrison (Westbury) (Con): Does the Minister recollect the picture of 1,000 people queuing for a dentist that appeared last summer on the front page of the Leicester Mercury? She will know that local dental committees believe queues will lengthen as a result of the new contract, that units of dental activity underpinning it have been miscalculated, and that her failure to pilot courts disaster. Is it not the case that, tragically, the Leicester Mercury photographer will need an even wider-angled lens for his next picture of queues in Leicestershire than the one he employed in the summer?
Ms Winterton: In fact, we have spent about five years piloting the new ways of working. That is why we know that dentists like it. It would be interesting to hear which parts of the policy the hon. Gentleman would change. Would he change an offer to dentists of approximately £80,000 a year plus £80,000 towards their business expenses? Would he ask us not to guarantee it for three years? Would he say that we do not need 5 per cent. less activity for that purpose? Would he not have opened a new dental surgery
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