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Mr. Mark Francois (Rayleigh) (Con): I want to speak about clinical dental technicians, who specialise in making dentures, especially for senior citizens. The Minister knows that they are subject to a regulatory review by the General Dental Council and that they want to be brought within a new regulatory framework to remove the anomalous situation under which they have operated for many years. They have two key requests. First, they want a reasonable transition period. Secondly, if retraining must occur, they ask whether it can take place on a part-time basis in the United Kingdom to allow them to retrain in a way that does not destroy their livelihood. Does the Minister agree that that is reasonable and will she make that point to the GDC?
Ms Winterton: I hope that the hon. Gentleman understands that the GDC makes its own rules about what it considers to be appropriate training and registration requirements. However, he is right to point out that there are many opportunities under the new system not only for dental technicians but for dental therapists and hygienists. As we change the way in which dentistry is provided, we can increasingly make better use of different skills in the dental team. I believe that, when we consider the role of dental nurses and hygienists in future, they can increasingly take on some of the minor work that dentists currently do, leaving dentists to do the more complex work. However, I shall consider the hon. Gentleman's points and I am sure that the GDC will be aware of his comments.
Steve Webb (Northavon) (LD):
The Minister was about to consider access. Will she clarify a point about the position after 1 April? Will two people who live next door to each other, one registered with an NHS dentist and the other not, have different rights of access to NHS dentistry after 1 April? Does being on an NHS dentist's list now grant more rights than not being on such a list?
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Ms Winterton: The person who is currently registered with an NHS dentist will remain attached to that dentist on a dental list. That is not the same as registration because people currently fall off the register. We want to stop that because it has caused difficulties in the past. However, the person who is currently registered will remain attached to his dentist. I hope that the changes that we are introducing will free capacity and that the person next door who is not registered with a dentist can get registered. We are aiming for that. That is why it is so important that primary care trusts have the power to commission locally, examine the needs of their population and commission accordingly.
Since 1999, we have set up 53 dental access centres in areas where there was a clear shortage of NHS dentists. Those centres mostly provide urgent treatment but some provide routine treatment. Compared with 2003, we are now investing an extra £250 million every year in NHS dentistry, with a further £65 million to follow next year. We have recruited the equivalent of more than 1,400 whole-time dentists to work in areas with the greatest access challenges.
I am sorry that the hon. Member for South Cambridgeshire (Mr. Lansley) chose to denigrate the contribution of Polish dentists. In many areas of the country, they do an excellent job. In areas of particular shortage, we have been able to assist the position through careful international recruitment and carefully passing people on to those areas. I am sure that many Conservative Members are grateful for their contribution.
Daniel Kawczynski: I am pleased that the Minister has acknowledged in the Chamber the tremendous work that Polish dentists do in the United Kingdom. Almost all the new dentists in Shrewsbury have come from Poland. I speak to many Polish NHS dentists in their mother tongue and they tell me that they will return to Poland after a couple of years. That is a tremendous problem.
I hope that I shall be able to reassure the hon. Gentleman later in my speech that there are dentists coming from all different quarters. NHS dentists are now offering to do more NHS work, and others are coming in through the international qualifying examination. Some of them may well wish to stay for only a short time, and that can be helpful in that they take different skills back to other parts of the European Union. I do not have a problem with that; it
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does not mean that we are going to experience a shortage. Indeed, in some ways, quite the opposite is the case.
Linda Gilroy (Plymouth, Sutton) (Lab/Co-op): When I was out on a Saturday morning recently knocking on doors, as we do at the weekends, I met a Swedish dentist who thanked us for helping with his planning permission. May I thank the Minister for the £28.4 million investment that has been made in Plymouth, and ask her how soon she expects the new dentists to come on stream following that extra investment in dental training?
Ms Winterton: Obviously it takes some time to train a dentist. We have recruited extra dentists over the past year, as well as announcing 170 more dental training places from September last year. In January, I announced the creation of a new dental training school in the south-west of England, and I suspect that that is what my hon. Friend was referring to. I was pleased that a good bid was put in by her area, and that we were able to make that announcement.
Mr. Eric Martlew (Carlisle) (Lab): Does the Minister agree that the reason why we can recruit dentists from all over Europe is that even those dentists who work for the NHS are among the highest paid in Europe?
Ms Winterton: My hon. Friend is absolutely right. I believe that 12 new dentists have been recruited to his area recently. A dentist with a fairly high commitment to the NHS can expect to earn about £80,000 a year, with practice expenses on top of that. That is not a bad deal.
Mr. Andrew Turner (Isle of Wight) (Con): I am grateful to the Minister for working to bring 14 new dentists to my constituency. However, even with those new dentists, registrations have gone down since she came to the Isle of Wight. In two years' time, when the 24,000 people who have asked to register with those new dentists have done so, about 50,000 people in my constituency will still not be registered with an NHS dentist. Is that satisfactory?
Ms Winterton: As the hon. Gentleman said, I have visited his constituency. I know that there were considerable problems there, and I am glad that we have been able to assist him. His was one of the first areas that our support team went into to help with recruitment. I do not think that there were any NHS dentists there before that, but we managed to recruit eight into the area. I shall explain later how, under the present system, there will be room for extra capacity as the changes bed in, as well as the ability to have funding at local level to commission NHS dentistry if there are needs in the local area.
I want to explain how we are introducing a radical shake-up in regard to how NHS dentistry will be delivered in the long term. To go back to the basics of the plan, from April this year, primary care trusts will for the first time be able to commission and develop primary dental care services in ways that reflect the needs of their local populations. For the first time, they
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will have the financial power to commission new services when a dentist leaves the area or reduces their NHS commitment. That was one of the problems in the hon. Gentleman's constituency. For the first time, we will have a system of dental charges that is simple and transparent for patients, and a remuneration system that no longer encourages the drill and fill treadmill.
The new contract that we are offering to dentists will mean that a committed NHS dentist can expect to earn about £80,000 a year, with practice expenses on top of that. That £80,000 will be guaranteed for three years, for 5 per cent. less work. In return, dentists will be expected to carry out an agreed number of courses of treatment over the yearagain, at least 5 per cent. below the levels in the old contract.
John Penrose (Weston-super-Mare) (Con): I am sure that dentists will be pleased to hear those figures. However, will the Minister explain how the technical application of the new contract has led to the situation in my constituency about which I wrote to the Secretary of State on 19 January? The single major NHS dentist in the area, whose practice covers 22,000 people, expects to lose 30 per cent. of those patientsthat is, 6,500 peopleas of 5 April, as a result of incorrect base-lining and problems with the calculations. I wrote to the Secretary of State about this on 19 January, and the clock is ticking. That dentist needs an answer.
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