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Mark Pritchard (The Wrekin) (Con): I applaud the Minister's courage in coming to the Chamber for the debate, given that there is opposition on all Benches, including the Labour Benches, and opposition outside the House to the Government's proposals.

I praise the work of dentists throughout Shropshire, especially in my constituency. I praise also the professionals who work in orthodontics and dentistry at the Princess Royal hospital in my constituency. They all provide a valuable and vital health service for my constituents.

I note that the Government have tried to shift the blame from them to primary care trusts and to dentists. However, it is the Government who will be funding PCTs. Those trusts, with scarce resources, will have to apportion dental contracts accordingly. Given that Shropshire County PCT and Telford and Wrekin PCT are already struggling financially, that does not hold out much hope for my constituents with dental problems for the months ahead. That is clearly of concern to them and to me.

I remind the Minister of the Prime Minister's comments at Question Time today—that we should trust professionals. We have heard that mantra over many months. We were told in the context of the Terrorism Bill that we must trust the professionals. We were told, "The police are asking for X and we should give them X." Why is it that on this issue the Government are not prepared to listen to the professionals? Let us listen to the words of the British Dental Association. It says:

"The Government's aims of securing patient access, improving oral health and raising the quality of patient care will not be achieved by the imposition of this target-driven NHS contract."

If the Government are serious about listening to professionals, let us see them listen to dental professionals on this point.

Mr. Martlew: Will the hon. Gentleman give way?

Mark Pritchard: If the hon. Gentleman's intervention is brief, I shall certainly give way.

Mr. Martlew: I shall be extremely brief. The hon. Gentleman says that we should listen to professionals, and I accept that. Did he vote against part of the Terrorism Bill?

Mark Pritchard: I am tempted to go down that route. I know that Labour Members do not want us to address serious issues on dental care. That being so, I shall stick to the substantive points that other Members have raised. I shall be happy to discuss the point that the hon. Gentleman has raised outside the Chamber at a later stage, at his cost, over a cup of tea.
 
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It has been said that it is the poor who will suffer, and that is absolutely right; and that the elderly will suffer as a result of the proposed changes, and that is absolutely right. In addition, everyday families and single people—in fact, everybody—are likely to suffer in the light of the proposed changes.

The Minister has reminded us of the number of dentists entering or opting in to NHS contracts. The overall net figure, including those who have opted out of NHS contracts over the past few months, or who are likely to do so, shows that there will be a drain away from the NHS. There will be fewer dentists providing NHS treatment. I accept that some centres have opened, and I know that in the neighbouring constituency to mine—Telford—there will be a new centre, but that will not meet the needs of all the constituents in Shropshire. The demand will not be met. Unfortunately, there is a net loss overall.

Martin Horwood (Cheltenham) (LD): I wish to reinforce the point that the hon. Gentleman has just made. When I spoke to my primary care trust last year, it was putting various measures in place—no doubt applauded by the Minister—and hoped to achieve 21,000 new NHS registrations. When I met the members of the trust only a week ago, they told me that they were expecting 14,000 fewer registrations because of the likely impact of the new contract. This is NHS dentistry in crisis.

Mark Pritchard: Absolutely; crisis is an appropriate word. We have a crisis in health care generally, and it is not the fault of the professionals who are working in our hospitals, our dental practices and our primary care sector. On so many of these issues, the fault lies with the Government. We have seen today Ministers smiling and taking these issues lightly, no doubt with extremely healthy teeth. They should take these issues far more seriously and look after my constituents who are unable to access NHS dentists.

The Minister might be aware—I have discussed this previously with her—that the nearest dentist for some of my constituents in, for example, the wonderful market town of Shifnal, is as far away as Lichfield. It is totally unacceptable that young mothers, often having to use public transport, have to change two or three times to access the NHS. As my hon. Friend the Member for North-East Milton Keynes (Mr. Lancaster) rightly said, given that people have paid their taxes, the very least that they might expect is the standard of NHS dental care that they enjoyed over many years. There has been criticism of past Conservative Governments, but at least people could register under the previous Conservative Government with an NHS dentist. People will not be able to do so given the present proposals.

Mr. Kevin Barron (Rother Valley) (Lab): Will the hon. Gentleman give way?

Mark Pritchard: I recognise that my colleague is a distinguished Member on health matters. Unfortunately, one other Member wishes to speak in the debate. That being so, I shall give way on another occasion, perhaps.
 
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Many orthodontists in my constituency have concerns. We are likely to lose an orthodontist place at the Princess Royal hospital, which will result in people waiting even longer to receive orthodontic treatment. Orthodontics should not be an aside to general dental services. There are 550 patients who access orthodontic care at the Princess Royal hospital. They will be unable to access future care if we do not replace the orthodontic practitioner that we have lost over recent weeks. That will lead to a decrease in oral health. As I said earlier in an intervention, I think that in the long term we shall see an increase in gingivitis. Sadly, we may even see an increase in cancers of the mouth that are not picked up by dentists and orthodontists.

In conclusion—I am rushing through to try to be helpful to other Members—the Minister said that the Government would review dental and orthodontic contracts once they had been in place for some months. I ask the Minister for that review prior to the introduction of the contracts. If she is to consult the professionals then, why does not she listen to their advice now? Surely that is a logical position to take.

My constituents are being disfranchised as a result of the Government's policy. They are likely to be more disfranchised from access to NHS dentists as a result of the policies in the new dental contracts. This flies in the face of the Prime Minister's saying in September that all people will have access to an NHS dentist within two years. Clearly, we and my constituents have yet again been misled by the Prime Minister on a key health issue.

3.28 pm

Mr. Stephen Crabb (Preseli Pembrokeshire) (Con): I shall be brief. We have had an interesting debate, and many hon. Members have made my points for me.

I shall draw on the Welsh experience, not just because it is St. David's day, but because many of the things that we have experienced in Wales are now being experienced in England. What has happened in my constituency offers a glimpse of what Members representing English constituencies will face. Pembrokeshire has the lowest rate of adult access to NHS dentistry in England and Wales. Just 15 per cent. of adults are registered with an NHS dentist, and 85 per cent. do not have access to NHS dentistry, which has all but collapsed in west Wales. One by one, dentists have exited the NHS, so their patients have had to sign up to private schemes.

In the past two years, the Pembrokeshire local health board, which is responsible for commissioning, has made great efforts to tackle the problem, to the extent that it has employed dentists directly, but it has fought against the tide. I do not wish to be partisan, but it should be placed on the record that all of this has happened on Labour's watch. What would have happened if the people of Pembrokeshire had been told in 1997 that within eight years they would witness the almost wholesale destruction of NHS dental services?

Martin Horwood: It is a little disingenuous of the hon. Gentleman to say that all of this has happened on Labour's watch, because the peak in NHS dentistry registration occurred in 1992. It started to fall because of the new contract introduced by the last Conservative Government.
 
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