HL Deb 08 September 2003 vol 652 cc4-7

2.44 p.m.

Baroness Gardner of Parkes

asked Her Majesty's Government:

Whether the availability of National Health Service dental treatment satisfies the needs of patients.

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)

My Lords, no. That is why, a year ago, the Government published the report of the Options for Change working group, representing all stakeholders, including the British Dental Association and patients' groups. The proposals will be implemented through the Health and Social Care (Community Health and Standards) Bill that we will debate later today. The changes will enable primary care trusts to commission the NHS dental services that their communities need and provide incentives for dentists to offer dentistry to NHS patients.

Baroness Gardner of Parkes

My Lords, I wish the Minister a happy birthday. I am sorry that I have to be so nasty on his birthday, but is it not time that the Government stopped talking about dentistry and did something about it? Here is yet another paper and yet another consultation, but I have been asking questions about this matter since we got a Labour government in 1997 and, indeed, long before that. Going back to 1997, we have heard constant promises that dentistry is going to improve, yet we have seen a situation in Wales where 600 people have been queuing because a dentist is prepared to accept national health patients. Really, yet another paper is not good enough or soon enough.

Lord Warner

My Lords, I am grateful to the noble Baroness for her good wishes. I can think of no better way of spending my birthday than in the company of your Lordships.

On the subject of whether things have got better or worse, I should point out to the noble Baroness that the number of dentists working in general dental services increased by 30th September 2002 to 18,400, compared with 16,700 in 1997. The action that we are taking in the Bill will totally reconstruct the remuneration arrangements for dentists, which are fully supported by the British Dental Association. We are taking positive steps by moving the Bill in your Lordships' House today.

Lord Clement-Jones

My Lords, I add to the good wishes expressed by the noble Baroness, and hope that the Minister will find time for some celebration today, despite the Second Reading of the Health and Social Care (Community Health and Standards) Bill.

Many dentists are concerned about the proposals in the Bill to transfer responsibility for dentistry to primary care trusts, on the basis that the funding of dentistry will be much more uncertain, and there is no duty on primary care trusts to ensure universal access to NHS dentistry. How do the Government therefore propose to prevent a continual movement of dentists into the private sector?

Lord Warner

My Lords, we have already taken some initiatives with personal dental services pilots, which now provide about 2 per cent of NHS dentistry and cover nearly 1,000 dentists, who are providing on a salaried basis to patients. The proposals in the Bill are warmly welcomed by the British Dental Association, and we will transfer to the base budgets of primary care trusts the £1.2 billion of financial resources currently held centrally for primary dental services.

Baroness Sharpies

My Lords, has there been an increase in hygienists since 1997?

Lord Warner

Yes, my Lords, there has.

Lord Campbell-Savours

My Lords, my noble friend has just given the House some interesting information—that there has been a dramatic increase in the number of dentists available since 1997. If that is the case, why is there a crisis in some parts of the country, such as Cumbria?

Lord Warner

My Lords, the answer to my noble friend is that not all dentists are spending all their time on NHS treatment. Part of the problem with the present remuneration system, which as I recall ran pretty well unchanged under the previous Conservative government, is that the money follows the dentists wherever they happen to locate themselves. That is what we are changing in the Bill that we will be debating today.

Lord Trefgarne

My Lords, is there any plan for dentists to be able to call themselves "doctor", even if they do not have a doctorate, as is the case with general practitioners?

Lord Warner

My Lords, I am not aware of any plans being cooked up in Richmond House.

Baroness Finlay of Llandaff

My Lords, given the shortage of dentists working in the NHS and the knowledge that it is the younger dentists who lend to work in the NHS, are the Government taking any measures to avoid penalising those dental schools that find themselves over-supplied with people for the first year as a result of the high level of achievement at A-levels, where all the students have achieved the entry requirements?

Lord Warner

My Lords, a working group is considering the whole issue of workforce planning, and we shall make its report available in the not-too-distant future. That may be one of the issues that the group considers but, if not, I shall check and write to the noble Baroness.

Lord Colwyn

My Lords, would the Minister agree that the provision of dental services is very much dependent on those who serve? When is the English workforce review, which was promised and announced by the noble Lord, Lord Hunt, in 2001, likely to be finalised and reported?

Lord Warner

My Lords, I am advised that it will be published before the end of this year.

Lord Wedderburn of Charlton

My Lords, has my noble friend recently tried to find a National Health Service dentist?

Lord Warner

My Lords, I have been so well looked after by dentists in the past that I have actually had no need for dental treatment.

Earl Howe

My Lords, may I add my good wishes to the noble Lord alongside those of other Members of the House? Some four years ago, the Prime Minister, in his party conference speech, said that everyone would be able to see an NHS dentist within two years. Can the Minister say what percentage of adults in England and Wales are now registered with an NHS dentist?

Lord Warner

My Lords, I cannot give an exact figure, but I think that it is worth recalling that the Prime Minister's pledge has led to many of the current reforms which we will be debating further in the Health and Social Care (Community Health and Standards) Bill. However, our report suggests that about 90 per cent of the callers to NHS Direct are being advised of available sources of NHS dentistry within locally agreed standards and that about 16,000 people a month are taking up that advice and getting an NHS dentist.

Baroness Greengross

My Lords, can the Minister assure us that as the availability of dentists in the local NHS improves, older people and those who wear dentures will not be excluded? As people get older their jaws change and their need for dentists is just as great as when they were young. However, as they get older it is increasingly difficult to find someone who will look after them.

Lord Warner

My Lords, the changes which are being introduced will enable primary care trusts to organise and fund the dental services that their localities need. So if there is a very large number of elderly people, they will be able to put in place a suitable NHS dental service.

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