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The Minister of State, Department of Health (Ms Rosie Winterton): The total number of GDSgeneral dental servicesand PDSpersonal dental servicesdentists as at 31 March 2006 was 21,025; a 25 per cent. increase since 1997. The great majority of those dentists are now working under new NHS contracts. In the minority of cases where dentists have chosen not to take up a new contract, primary care trusts are successfully using the funding for these contracts to re-provide services using other dentists.
Vera Baird: Welcome back, Mr. Speaker. I thank the Minister for that reply and, obviously, we have gone round this block a little bit already. In Redcar, there are two PCTs. In Langbaurgh, 17 out of 17 practices have signed up; in Middlesbrough, 21 out of 22 have signed up, with others keen to expand to fill the gap that has been left. We have a 60 per cent. registration rate, so we are doing quite well. Some local dentists have asked me whether it is practical to conduct a review to ensure that, in six months' time, the new contract is delivering what is predicted. Given what has been said already, Redcar's signing-up rate is clearly out of kilter with the rest of the country, so were the media and the Tory Opposition wide of the mark?
Ms Winterton: My hon. and learned Friend is right to congratulate the PCTs in her area on being so successful in negotiations with local dentists. As she suggests, that is not out of kilter with the signing-up rate in other areas. Many patients were unnecessarily worried by the actions of some dentists and dentists' organisations and of Opposition parties. People were told that there would be no NHS dentistry and were encouraged to think that they had to take out insurance provision such as Denplan. In fact, the changes that we have made will lead to improved access for patients and a better deal for dentists.
Mr. Douglas Hogg (Sleaford and North Hykeham) (Con): May I remind the hon. Lady that of the 68 dental practices in Lincolnshire, only 38 have signed the new NHS contract to treat both adults and children, and that there are 115,000 individuals who do not have access to a dentist? Given that, will she reconsider her rejection of my previous proposal that her Department should pay private dental fees, subject to a cap, where no NHS dentist is available?
I am aware that there have been long-standing problems in the right hon. and learned Gentleman's area, but we have also made available extra funding in order to assist with access problems. Our support team is continuing to work with local PCTs, and I know that some progress has been made in commissioning extra dentistry. Action taken by local
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PCTs includes recruitment from abroad, which has been quite successful, particularly recruitment from Spain. I remember visiting the right hon. and learned Gentleman's area and hearing about some of the actions that were being taken. The area is one with which we will continue to work closely to make sure that access improves.
Jeff Ennis (Barnsley, East and Mexborough) (Lab): In Barnsley, 35 out of the 36 dental practices have signed the new contracts. However, at one dental practice, only one of the four dentists has signed a contract. What advice can the Minister offer to my constituents who find themselves without an NHS dentist, particularly in the short term?
Ms Winterton: In the south Yorkshire area the sign-up rate has been about 99 per cent. Where individual dentists have not signed up, the PCTs, certainly in south Yorkshire, are already considering recommissioning dentistry from other dentists. There is no shortage of dentists who are coming forward to take more patients on to their lists. However, I have set up an implementation group to make sure that as the reforms bed down, we are able to iron out any difficulties that occur.
Dr. Richard Taylor (Wyre Forest) (Ind): Can the Minister give us a global figure for the number of dentists who have signed the contract in dispute? Is it true that dentists who believe that the contract is undeliverable have been coerced into signing by threats that payment will be delayed?
Ms Winterton: We gave dentists until 31 March to sign up to the new contract to ensure that the payments could go through, starting in May. To get the data on to the computer system, dentists had to make the decision by 31 March, when the new financial year started. There are areas where around 30 per cent. of dentists have signed in dispute. I have had meetings with representatives of primary care trusts and strategic health authorities and they are confident that many of those disputes can be resolved by the local resolution procedure. In some areas, sets of dentists all decided to sign in dispute, which has caused particular difficulties, but I am confident that through the work that PCTs are doing, they will be able to sort out many of the problems fairly quickly.
Mr. Eric Illsley (Barnsley, Central) (Lab): As my hon. Friend has just heard, the vast majority of dentists in the Barnsley area have signed up to the new NHS contract. However, the gap in finance for orthodontic provision is hugesomething like £800,000and in Barnsley we face orthodontic treatment waiting lists beginning at four or five years from now. Will my hon. Friend look again at the provision for orthodontic treatment in Barnsley?
As my hon. Friend knows, I have had considerable discussion about the position in his local PCT. As I said, we want to ensure that, in the longer term, all orthodontic treatment is provided under the index of need that we have put together so that everything offered on the NHS is clinically necessary.
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We will also have to consider a specialist approach to orthodontic treatment, which is extremely expensive and has, in a sense, grown in a haphazard fashion. We considered whether the surrounding PCTs in my hon. Friend's area would be interested in joining together to provide extra funding. As he knows, it has been agreed to pay for all the treatment that the specific orthodontist has started. The difficulty is what happens in the longer term. We will consider the matter in the implementation group, which includes orthodontists' representatives.
The Parliamentary Under-Secretary of State for Health (Mr. Liam Byrne): The Department's policy on hearing aid services has focused on ensuring that the NHS provides modern digital hearing aids. It is for local commissioners to ensure that their populations benefit from those improvements, using the increasing resources that the Government have made available.
Mr. Swayne: A constituent was referred by his general practitioner to an audiologist on 16 January. On 16 March, he received confirmation of an appointment for August 2007. Given the age profile in my constituency, there is a significant danger that constituents will have an appointment with an undertaker before they get an appointment with an audiologist. Will audiology be included in the 18-week target?
Mr. Byrne: Once upon a time, digital hearing aids cost £2,500 and were an impossible dream for most of the population; only the wealthiest could afford them. RNID estimates that approximately 1.8 million people use hearing aids, 600,000 of whom have already been equipped. We are consulting on rolling out the 18-week target to consultant referrals for audiology departments and we shall publish the results shortly.
Miss Julie Kirkbride (Bromsgrove) (Con): Given the Government's willingness to embrace the private sector for the provision of NHS services, has the Under-Secretary considered improving the supply and speed of audiology services by offering those who need a hearing aid a voucher to have it provided wherever they see fit?
The Government, together with RNID, has spent £125 million on ensuring that audiology departments in every part of the country can fit digital hearing aids as a matter of routine. We have brought down the cost of digital hearing aids from £2,500 to only £67 through a unique partnership with RNID and the private sector. We have put a new generation of audiologists into training, and the first of those graduates come out of college this year. It is down to PCTs to use the record investment that is available to them to ensure that services are delivered. Where there are shortages of capacity, we have ensured that public-private partnerships are available to shore up supply. If that sounds like a comprehensive programme, it is because it is one.
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