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The new contract in 2006 gave primary care trusts the power and the responsibility to shape local dentistry services to fit the specific needs of their communities. Many have risen to that new challenge and are providing excellent NHS dental services. I could give many examples; some have been given in the Chamber this evening. South Tyneside primary care trust, like much of the north-east, has a history of ensuring good access to NHS dentistry, but now the PCT is working with local
dentists to improve the quality and efficiency of the services that it provides. The aim is to improve services for patients while providing best value for money.
Although places such as South Tyneside are good, other areas are not as good, as we have heard today. Where progress is uneven, we need to go further. That is where Professor Jimmy Steele's review has proved so valuable. It has helped us to understand further the modern landscape of dentistry and the needs of the population, and that the focus of modern dentistry must be on prevention, the maintenance of oral health and quality. It also helps us to understand that different generations can have very different needs. We are asking our dentists for different approaches in light of that. We are starting to test the recommendations. PCTs that tender for new contacts so as to increase access to dental services are starting to place qualitative measures in their contracts. Depending on the results of piloting, we will start to roll out the Steele recommendations on quality to all contracts for dental services.
In the past two years, funding for NHS dentistry has increased by the best part of £400 million a year. That is extra money going to the front line, and that gives more people better access to high-quality dental care. However, the issue is not only about spending more; it is about spending better. The national dental access programme is helping PCTs to get the most out of existing services, looking at how things are organised on the ground and offering advice and guidance on how they can be improved within existing budgets.
The last time I stood at this Dispatch Box to debate dentistry was in December last year. I assured the House that access to NHS dentistry was about to increase. If I remember correctly, the Opposition did not share my confidence. Well, I am delighted to say that I was correct. The NHS information centre's latest statistics show that the number of people who have been able to see an NHS dentist has risen by 720,000 over the past year. I hope the House will believe me now when I say that the growth in access will continue in the years to come. We are on course to achieve and, indeed, surpass the Opposition's rather unambitious target of an extra 1 million people. Trust the Government and this party to do the job properly. Trust this nurse. People should always trust the nurse when she is telling them what we will achieve.
We are well on the way towards replacing the access lost when a minority of dentists decided not to accept the new contracts in 2006, but we aim to go much further. Every strategic health authority is committed to making sure that by March 2011 everyone who wants a dentist can access an NHS dentist. We are committed to implementing Professor Steele's recommendations to improve both the quality of dentistry for patients and the working lives of dentists.
In the time that we have left, I will endeavour to answer as many as possible of the questions that hon. Members raised. As is traditional, if I fail to answer any questions we will write to the Members who participated in the debate. The hon. Member for North Norfolk (Norman Lamb), speaking from the Front Bench for the Liberals, made a positive contribution and spoke
about quality, prevention and inequalities. He reminded us of the importance of good negotiations with the BDA, and I take note.
My hon. Friend the Member for Staffordshire, Moorlands (Charlotte Atkins), who is known for championing dentistry in the House, and in particular fluoridation, spoke about TLC 4 Smiles for herself. She also mentioned a Mr. and Mrs. Keen, who were making a valued contribution to dentistry in her area. May I say to all in the House and to any journalists who may be present that I have only the one job. On this occasion I can also vouch for my hon. Friend the Member for Feltham and Heston (Alan Keen).
The hon. Member for Mole Valley (Sir Paul Beresford), who spoke from his experience as a dentist and brought much experience to the Health Committee and the all-party group on dentistry, referred to the BDA survey. That survey also stated that relations between PCTs and dentists was very good indeed, citing 87 per cent. of cases that were reported. That report was published yesterday and we should acknowledge its findings.
I thank my hon. Friend the Member for Carlisle (Mr. Martlew) for his comments on the improvements that have been made. He mentioned the important matter of charges, which is dear to the hearts of all Members, especially those on the Labour Benches. All children and about 30 per cent. of adults are exempt from charges.
The hon. Member for New Forest, East (Dr. Lewis) raised with typical forcefulness and passion the subject of regulations. I should point out that those regulations were passed in the House on a free vote. I cannot go further as the matter is subject to a judicial review.
The hon. Member for South-East Cornwall (Mr. Breed) highlighted important topics. From next spring the PCT responsible for Saltash is commissioning new services that will offer care to all sections of the population. He also mentioned that the new dental school in the south-west peninsula, part of the development of a dental education centre, is under construction in Truro. For the first time, dentists will be trained in Cornwall.
Speaking from the Opposition Front Bench, the hon. Member for Hemel Hempstead (Mike Penning) stated that should the Conservatives be in government, dentists would be required to work in the NHS. I should be grateful if he would explain how long they would be required to do so and how he intends to achieve that.
Mike Penning: If someone is trained by the NHS at taxpayers' expense, they will have to have a built-in loyalty to the NHS. We have said, and not just today, that they will have to work in some shape or form for five years in the NHS in order to pay back its contribution to their training.
Ann Keen: Those are very interesting comments, indeed. That proposal is similar, of course, to registration, because registration was in fact a payment to register. Our dentists today recall patients, and they have continuity of care.
Mr. Lansley:
We have been very clear about our proposal and have made it before: a five-year tie-in for NHS, state-trained dentists so that they remain in the
NHS. The Liberal Democrats agree with us, and it is practised in Scotland. Will Ministers agree with that proposal?
Ann Keen: The registration was a payment. What we are still able to do is-
Mr. Martlew: Will my hon. Friend give way?
Mr. Martlew: I am sorry to interrupt my hon. Friend, but the Opposition would not give way to me. Does she know anything about the policy on making dentists work for five years? Will it apply to doctors as well? Would that not seem fair? Are the Conservatives going to make doctors work for five years for the NHS?
Ann Keen: My hon. Friend makes an excellent point. The proposal is certainly news to Government FrontBenchers today, but I think that we should expand on it; perhaps it is something that we should look at. It will be interesting to see how negotiations on it go with the BDA. Perhaps the Opposition will keep us informed, because much has been said today about the professionalism of our dentists. In fact, accusations have been made about the number of extractions that are deemed unnecessary.
We admire our dentists and congratulate not only them on the real hard work that they do, but all the team who play such a role, including hygienists and, in particular, dental nurses. We note also their approach to health inequalities and their serious work with us and Professor Steele to implement the new contract. I have heard nothing from Opposition Members about inequalities.
Mr. Lansley: In my speech I made it very clear that we want people to have greater access to preventive care, and we have made it clear that we will allow people to visit dental hygienists without the requirement of a dentist's referral via a prescription. Will the Minister agree with that proposal?
Ann Keen: I am not sure that the hon. Gentleman would be able to achieve that, because regulation might come into play. He cannot make such statements just to please himself this evening; he has to be able to fulfil them. [ Interruption. ] I am sorry, but he does have to look at his subject area again, because it is just not possible to make that proposal tonight.
We are talking about a team of people who work in our primary care system and are respected and valued in the community. Interesting points have been made today about dentists being asked to work up to five years for the NHS, and it would be very interesting to see how that might be expanded to include other health professionals and members of the health service work force.
We want to congratulate all the dentists who have worked with the contract. It was a difficult contract to introduce, and it has been difficult for some people to implement, but our PCTs, along with our commissioners, are working for dentistry to be accessible for all. We have made a commitment that by 2011 all those who want a dentist will have access to a dentist.
We have heard tonight, yet again, from a Conservative party that pays lip service to everything-
Mr. Patrick McLoughlin (West Derbyshire) (Con) claimed to move the closure (Standing Order No. 36).
Question put forthwith, That the Question be now put.
Question put accordingly (Standing Order No. 31(2)), That the original words stand part of the Question.
The House divided: Ayes 210, Noes 277.
AYES
Afriyie, Adam
Ainsworth, Mr. Peter
Alexander, Danny
Amess, Mr. David
Arbuthnot, rh Mr. James
Atkinson, Mr. Peter
Bacon, Mr. Richard
Baldry, Tony
Baron, Mr. John
Barrett, John
Beith, rh Sir Alan
Bellingham, Mr. Henry
Benyon, Mr. Richard
Beresford, Sir Paul
Binley, Mr. Brian
Bone, Mr. Peter
Bottomley, Peter
Brady, Mr. Graham
Brazier, Mr. Julian
Breed, Mr. Colin
Brokenshire, James
Brooke, Annette
Browning, Angela
Bruce, rh Malcolm
Burns, Mr. Simon
Burrowes, Mr. David
Burstow, Mr. Paul
Burt, Lorely
Butterfill, Sir John
Cable, Dr. Vincent
Campbell, Mr. Gregory
Campbell, rh Sir Menzies
Carswell, Mr. Douglas
Cash, Mr. William
Chope, Mr. Christopher
Clappison, Mr. James
Clark, Greg
Clarke, rh Mr. Kenneth
Clegg, rh Mr. Nick
Clifton-Brown, Mr. Geoffrey
Cormack, Sir Patrick
Cox, Mr. Geoffrey
Curry, rh Mr. David
Davey, Mr. Edward
Davies, David T.C. (Monmouth)
Davies, Philip
Davis, rh David
Djanogly, Mr. Jonathan
Dodds, Mr. Nigel
Donaldson, rh Mr. Jeffrey M.
Dorrell, rh Mr. Stephen
Dorries, Nadine
Duddridge, James
Duncan, Alan
Ellwood, Mr. Tobias
Evans, Mr. Nigel
Evennett, Mr. David
Fallon, Mr. Michael
Featherstone, Lynne
Field, Mr. Mark
Foster, Mr. Don
Francois, Mr. Mark
Fraser, Christopher
Gale, Mr. Roger
Garnier, Mr. Edward
Gauke, Mr. David
George, Andrew
Gibb, Mr. Nick
Gidley, Sandra
Goldsworthy, Julia
Goodman, Mr. Paul
Goodwill, Mr. Robert
Gove, Michael
Gray, Mr. James
Green, Damian
Greening, Justine
Gummer, rh Mr. John
Hague, rh Mr. William
Hammond, Mr. Philip
Hammond, Stephen
Hancock, Mr. Mike
Hands, Mr. Greg
Harris, Dr. Evan
Hayes, Mr. John
Heald, Mr. Oliver
Heath, Mr. David
Heathcoat-Amory, rh Mr. David
Hemming, John
Hendry, Charles
Herbert, Nick
Hoban, Mr. Mark
Hogg, rh Mr. Douglas
Holloway, Mr. Adam
Holmes, Paul
Howard, rh Mr. Michael
Howarth, David
Howell, John
Hughes, Simon
Huhne, Chris
Hunt, Mr. Jeremy
Hunter, Mark
Hurd, Mr. Nick
Jack, rh Mr. Michael
Jackson, Mr. Stewart
Jenkin, Mr. Bernard
Jones, Mr. David
Kawczynski, Daniel
Kennedy, rh Mr. Charles
Key, Robert
Kirkbride, Miss Julie
Knight, rh Mr. Greg
Kramer, Susan
Laing, Mrs. Eleanor
Lait, Mrs. Jacqui
Lamb, Norman
Lancaster, Mr. Mark
Lansley, Mr. Andrew
Laws, Mr. David
Leech, Mr. John
Leigh, Mr. Edward
Letwin, rh Mr. Oliver
Lewis, Dr. Julian
Lidington, Mr. David
Lilley, rh Mr. Peter
Loughton, Tim
Mackay, rh Mr. Andrew
Maclean, rh David
Main, Anne
Malins, Mr. Humfrey
Maude, rh Mr. Francis
McCrea, Dr. William
McIntosh, Miss Anne
McLoughlin, rh Mr. Patrick
Mercer, Patrick
Miller, Mrs. Maria
Milton, Anne
Mitchell, Mr. Andrew
Moore, Mr. Michael
Murrison, Dr. Andrew
Neill, Robert
Newmark, Mr. Brooks
O'Brien, Mr. Stephen
Öpik, Lembit
Ottaway, Richard
Paice, Mr. James
Paterson, Mr. Owen
Penning, Mike
Penrose, John
Prisk, Mr. Mark
Pritchard, Mark
Pugh, Dr. John
Randall, Mr. John
Redwood, rh Mr. John
Reid, Mr. Alan
Rennie, Willie
Rifkind, rh Sir Malcolm
Robathan, Mr. Andrew
Robertson, Hugh
Robertson, Mr. Laurence
Rosindell, Andrew
Rowen, Paul
Ruffley, Mr. David
Russell, Bob
Sanders, Mr. Adrian
Selous, Andrew
Shapps, Grant
Simmonds, Mark
Simpson, David
Simpson, Mr. Keith
Smith, Chloe
Smith, Sir Robert
Soames, Mr. Nicholas
Spelman, Mrs. Caroline
Spicer, Sir Michael
Spink, Bob
Steen, Mr. Anthony
Streeter, Mr. Gary
Stuart, Mr. Graham
Stunell, Andrew
Swayne, Mr. Desmond
Swinson, Jo
Swire, Mr. Hugo
Syms, Mr. Robert
Tapsell, Sir Peter
Taylor, Matthew
Taylor, Dr. Richard
Teather, Sarah
Thurso, John
Timpson, Mr. Edward
Tredinnick, David
Turner, Mr. Andrew
Tyrie, Mr. Andrew
Vaizey, Mr. Edward
Vara, Mr. Shailesh
Viggers, Sir Peter
Villiers, Mrs. Theresa
Walker, Mr. Charles
Wallace, Mr. Ben
Willetts, Mr. David
Williams, Mr. Roger
Williams, Stephen
Willis, Mr. Phil
Willott, Jenny
Wilshire, Mr. David
Wilson, Mr. Rob
Winterton, Ann
Winterton, Sir Nicholas
Yeo, Mr. Tim
Young, rh Sir George
Younger-Ross, Richard
Tellers for the Ayes:
Bill Wiggin and
Mr. Stephen Crabb
NOES
Abbott, Ms Diane
Ainger, Nick
Anderson, Mr. David
Armstrong, rh Hilary
Atkins, Charlotte
Austin, Mr. Ian
Austin, John
Bailey, Mr. Adrian
Baird, Vera
Banks, Gordon
Barlow, Ms Celia
Barron, rh Mr. Kevin
Battle, rh John
Bayley, Hugh
Beckett, rh Margaret
Begg, Miss Anne
Bell, Sir Stuart
Benn, rh Hilary
Benton, Mr. Joe
Berry, Roger
Betts, Mr. Clive
Blackman, Liz
Blackman-Woods, Dr. Roberta
Blizzard, Mr. Bob
Blunkett, rh Mr. David
Borrow, Mr. David S.
Brennan, Kevin
Brown, Lyn
Brown, rh Mr. Nicholas
Brown, Mr. Russell
Browne, rh Des
Bryant, Chris
Burden, Richard
Burgon, Colin
Butler, Ms Dawn
Byrne, rh Mr. Liam
Cairns, David
Campbell, Mr. Alan
Campbell, Mr. Ronnie
Caton, Mr. Martin
Cawsey, Mr. Ian
Challen, Colin
Chapman, Ben
Chaytor, Mr. David
Clapham, Mr. Michael
Clark, Ms Katy
Clarke, rh Mr. Charles
Clarke, rh Mr. Tom
Clelland, Mr. David
Clwyd, rh Ann
Coaker, Mr. Vernon
Coffey, Ann
Cohen, Harry
Connarty, Michael
Cooper, Rosie
Cooper, rh Yvette
Corbyn, Jeremy
Crausby, Mr. David
Cruddas, Jon
Cryer, Mrs. Ann
Cummings, John
Cunningham, Mr. Jim
Cunningham, Tony
David, Mr. Wayne
Davidson, Mr. Ian
Davies, Mr. Dai
Davies, Mr. Quentin
Dean, Mrs. Janet
Denham, rh Mr. John
Devine, Mr. Jim
Dhanda, Mr. Parmjit
Dismore, Mr. Andrew
Dobbin, Jim
Dobson, rh Frank
Donohoe, Mr. Brian H.
Doran, Mr. Frank
Drew, Mr. David
Eagle, Angela
Eagle, Maria
Efford, Clive
Ellman, Mrs. Louise
Engel, Natascha
Ennis, Jeff
Etherington, Bill
Farrelly, Paul
Field, rh Mr. Frank
Fisher, Mark
Fitzpatrick, Jim
Flello, Mr. Robert
Flint, rh Caroline
Flynn, Paul
Follett, Barbara
Foster, Mr. Michael (Worcester)
Francis, Dr. Hywel
Gardiner, Barry
Gerrard, Mr. Neil
Gilroy, Linda
Godsiff, Mr. Roger
Goodman, Helen
Griffith, Nia
Griffiths, Nigel
Grogan, Mr. John
Gwynne, Andrew
Hain, rh Mr. Peter
Hall, Mr. Mike
Hamilton, Mr. David
Hanson, rh Mr. David
Harman, rh Ms Harriet
Harris, Mr. Tom
Havard, Mr. Dai
Healey, rh John
Hendrick, Mr. Mark
Hepburn, Mr. Stephen
Hesford, Stephen
Hewitt, rh Ms Patricia
Heyes, David
Hill, rh Keith
Hodge, rh Margaret
Hodgson, Mrs. Sharon
Hood, Mr. Jim
Hoon, rh Mr. Geoffrey
Hopkins, Kelvin
Howarth, rh Mr. George
Howells, rh Dr. Kim
Hoyle, Mr. Lindsay
Humble, Mrs. Joan
Iddon, Dr. Brian
Ingram, rh Mr. Adam
Irranca-Davies, Huw
James, Mrs. Siân C.
Jenkins, Mr. Brian
Johnson, rh Alan
Johnson, Ms Diana R.
Jones, Helen
Jones, Mr. Kevan
Jones, Mr. Martyn
Jowell, rh Tessa
Kaufman, rh Sir Gerald
Keeble, Ms Sally
Keeley, Barbara
Keen, Alan
Keen, Ann
Kelly, rh Ruth
Kemp, Mr. Fraser
Kidney, Mr. David
Kilfoyle, Mr. Peter
Kumar, Dr. Ashok
Ladyman, Dr. Stephen
Lammy, rh Mr. David
Laxton, Mr. Bob
Lepper, David
Levitt, Tom
Lewis, Mr. Ivan
Linton, Martin
Lloyd, Tony
Love, Mr. Andrew
Lucas, Ian
Mackinlay, Andrew
Mahmood, Mr. Khalid
Malik, Mr. Shahid
Mallaber, Judy
Marshall-Andrews, Mr. Robert
Martlew, Mr. Eric
McAvoy, rh Mr. Thomas
McCabe, Steve
McCafferty, Chris
McCarthy, Kerry
McCarthy-Fry, Sarah
McCartney, rh Mr. Ian
McDonagh, Siobhain
McFadden, rh Mr. Pat
McFall, rh John
McGuire, rh Mrs. Anne
McIsaac, Shona
McKechin, Ann
McKenna, Rosemary
McNulty, rh Mr. Tony
Meacher, rh Mr. Michael
Merron, Gillian
Michael, rh Alun
Miliband, rh David
Miliband, rh Edward
Miller, Andrew
Mitchell, Mr. Austin
Moffatt, Laura
Mole, Chris
Moon, Mrs. Madeleine
Morden, Jessica
Morgan, Julie
Morley, rh Mr. Elliot
Mudie, Mr. George
Mullin, Mr. Chris
Munn, Meg
Murphy, rh Mr. Paul
Naysmith, Dr. Doug
Norris, Dan
O'Brien, rh Mr. Mike
O'Hara, Mr. Edward
Owen, Albert
Palmer, Dr. Nick
Pearson, Ian
Plaskitt, Mr. James
Pound, Stephen
Prentice, Bridget
Prentice, Mr. Gordon
Primarolo, rh Dawn
Prosser, Gwyn
Purnell, rh James
Rammell, Bill
Raynsford, rh Mr. Nick
Reed, Mr. Andy
Reed, Mr. Jamie
Reid, rh John
Riordan, Mrs. Linda
Robertson, John
Robinson, Mr. Geoffrey
Rooney, Mr. Terry
Roy, Lindsay
Ruane, Chris
Ruddock, Joan
Russell, Christine
Ryan, rh Joan
Sarwar, Mr. Mohammad
Seabeck, Alison
Sharma, Mr. Virendra
Shaw, Jonathan
Sheerman, Mr. Barry
Sheridan, Jim
Simpson, Alan
Singh, Mr. Marsha
Skinner, Mr. Dennis
Slaughter, Mr. Andy
Smith, rh Mr. Andrew
Smith, Ms Angela C. (Sheffield, Hillsborough)
Smith, rh Angela E. (Basildon)
Smith, Geraldine
Snelgrove, Anne
Soulsby, Sir Peter
Southworth, Helen
Spellar, rh Mr. John
Stewart, Ian
Stringer, Graham
Tami, Mark
Taylor, Ms Dari
Taylor, David
Thornberry, Emily
Timms, rh Mr. Stephen
Tipping, Paddy
Todd, Mr. Mark
Touhig, rh Mr. Don
Trickett, Jon
Truswell, Mr. Paul
Turner, Dr. Desmond
Turner, Mr. Neil
Twigg, Derek
Ussher, Kitty
Vaz, rh Keith
Vis, Dr. Rudi
Walley, Joan
Waltho, Lynda
Ward, Claire
Wareing, Mr. Robert N.
Watson, Mr. Tom
Watts, Mr. Dave
Whitehead, Dr. Alan
Wicks, rh Malcolm
Williams, rh Mr. Alan
Williams, Mrs. Betty
Wilson, Phil
Winnick, Mr. David
Winterton, rh Ms Rosie
Woolas, Mr. Phil
Wright, Mr. Anthony
Wright, David
Wright, Mr. Iain
Wright, Dr. Tony
Wyatt, Derek
Tellers for the Noes:
Mr. John Heppell and
Mary Creagh
Question accordingly negatived.
Question put forthwith (Standing Order No. 31(2)), That the proposed words be there added.
Main Question, as amended, put and agreed to.
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