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Mr. Andrew Lansley (South Cambridgeshire) (Con): I beg to move,
That this House supports the achievement of good oral health through the provision of NHS dentistry; calls, therefore, on the Government to fulfil its commitment that everyone should have access to NHS dentistry; is alarmed that the British Dental Association regards the new dental contract as 'a shambles' and is concerned that many dentists will reduce their commitment to NHS dentistry; and further calls on the Government to withdraw the National Health Service (General Dental Services Contracts) Regulations 2005 and the National Health Service (Personal Dental Service Agreements) Regulations 2005 and immediately to re-open negotiations with the dental profession on dental services contracts which are piloted and linked to patient registration and capitation payments, support for preventative work and the achievement of good oral health.
In September 1999, the Prime Minister said that by 2001 everyone would have access to NHS dentistry just by calling NHS Direct. Six years after he made that pledge fewer people than ever are registered for NHS dentistry. In those six years we have seen queues forming outside the premises of NHS dentists who are opening up their registrations. We may not see that in future because the Government propose that people will not be able to queue outside NHS premises to be registered; they will have to register by letter or by telephone—queuing is too embarrassing. Indeed, the situation has now become so bad that the public are queuing outside private dentists.
Mr. Anthony Steen (Totnes) (Con): Patients in Torbay are being told that they must not queue outside any new NHS dentist. I am advised that they have received letters informing them that it would be embarrassing for the primary care trust to have people queuing because it knows that so many people want dental treatment and that there are so few NHS dentists. Is that not outrageous?
Mr. Lansley: It is outrageous.
I visited Torbay before the last general election and talked to the secretary of the local dental committee. If I recall correctly, the number of patients registered in south Devon was under 30 per cent.—among the lowest in the country. Indeed, the number in my constituency was also among the lowest in the country.
Bob Spink (Castle Point) (Con): A Castle Point dentist and a local dental committee secretary, Mr. Foreman, states in a letter dated 21 January:
"Under the terms of the new contract our CACV has been reduced by some 80 per cent. from our historic NHS gross average."
Dentists in Castle Point do a great job and we must fund them properly. We must stop ill-thought-out cuts. Does my hon. Friend agree that the Government's policy is a shambles and will reduce the number of NHS patients?
Mr. Lansley: My hon. Friend is absolutely right. It is not only me who thinks that the policy is a shambles. The British Dental Association also thinks that it is a shambles. The association said that Ministers conducted the contract negotiations leading to a new dental contract with "extraordinary ineptitude". It described it as a "shambolic process". It has been a shambles. Over recent years, dentists have reduced their commitment to the NHS because they have been on a treadmill of drill and fill. We have known for years that change is necessary. That was why the Conservative Government, before the 1997 general election, introduced legislation that established primary care trusts and personal dental services contracts.
The Government have pursued a new dental contract based not on new ways of working but on targets. They propose a target-driven process that does not recognise the needs of the profession or of patients.
Damian Green (Ashford) (Con): My hon. Friend and the Minister might be interested in an e-mail that I received a few days ago from a constituent. It reads:
"Since I moved to Ashford some 40 years ago I have attended the same dental practice. Last Tuesday, after my six-months check-up, I was advised that due to Government contract changes I would not be able to make a new appointment."
That is what dentists believe and that is what their patients believe. Contract changes are driving people away from the NHS.
Mr. Lansley: I am grateful to my hon. Friend for that intervention. His experience is the same as mine in Bar Hill in my constituency, where a dental practice has walked away from a new dental contract. That experience is mirrored throughout the country.
Mr. Graham Stuart (Beverley and Holderness) (Con): I thank my hon. Friend for visiting the town of Hornsea in my constituency. As he knows, it is an isolated rural town. It is the largest town in the country without an A-road into it. The threat, when he visited the town, concerned community hospitals. That threat still remains. However, there are three dental practices in the town, two of which have announced in the past week that, thanks to the Government's shambolic handling of dental contracts, they are leaving the NHS. Seven thousand fewer of my constituents are now registered with NHS dentists than before the Prime Minister's promise was made.
Mr. Deputy Speaker: Order. I should have added that the length of interventions will have some impact on opportunities to participate later in the debate.
Mr. Lansley:
I am grateful, Mr. Deputy Speaker, but I am grateful, too, to my hon. Friend the Member for Beverley and Holderness (Mr. Stuart) for making that important point. Apart from persistent inequalities in terms of dental outcomes and dental health, inequality is increasingly apparent in terms of access to NHS dentistry, all of which is a condemnation of the Government.
1 Mar 2006 : Column 264
Ed Balls (Normanton) (Lab) rose—
Mr. Lansley: How can I resist the hon. Member?
Ed Balls: I am grateful to the hon. Gentleman for reminding us of a previous Conservative Government with his reference to funding issues. On the "Today" programme this morning, the Leader of the Opposition confirmed that it was his party's policy to introduce a third fiscal rule—the proceeds of growth rule—which would mean that spending would fall as a percentage of gross domestic product under a Conservative Government. Does the hon. Gentleman expect the NHS and dentistry to be carved out of that rule, or does he expect it to apply to them too? If so, public spending would fall as a percentage of GDP on dentistry services.
Mr. Lansley: I am grateful to the hon. Gentleman, whose point comes from the bottom of page 2 of the Labour party briefing—we will see if we reach the rest of those listed. One would have thought that the hon. Gentleman could at least write his own interventions. We made clear before the election what we intended to do about dentistry, and our proposals would have made an enormous difference. I do not know whether the hon. Gentleman in his previous occupations had occasion to read "Proposals for modern oral health", which was published in October 2004 by the Conservative party, but before the election we set out proposals based on registration
The Government, however, propose to abolish registration. We proposed, too, a shift from fee-based remuneration to capitation. The Government propose to retain an activity-driven system, instead of introducing a system in which finances are driven by the number of patients on a practice list. We proposed a low-cost monthly payment scheme for non-exempt adults—the Government propose to increase the charges for patients—and oral health promotion focused on children. The Government, however have enabled primary care trusts—and, in some respects, they have encouraged them—to refuse children for treatment and exempt adult contracts for dentists. Finally, we proposed an
"evidence-based schedule for NHS dentistry designed by the National Institute for Clinical Excellence".
At least the Government have begun to introduce that proposal.
Ed Balls: Will the hon. Gentleman give way?
Mr. Lansley: No, of course not. If the hon. Gentleman does not have anything original to say, I am not going to help him.
Mr. Douglas Hogg (Sleaford and North Hykeham) (Con): Will my hon. Friend include in his policies a commitment that the Government of the day should fund private dental care if someone is wholly unable to obtain NHS dentistry because none is available?
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