HL Deb 19 May 2004 vol 661 cc770-2

2.50 p.m.

Baroness Gardner of Parkes asked Her Majesty's Government:

Whether the degree of access for patients to National Health Service dental services is satisfactory.

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

My Lords, the Answer is no. That is why the Government are undertaking the most radical overhaul of NHS dentistry since 1948 through legislation in the Health and Social Care Act 2003, which transfers responsibility for commissioning NHS dental services to primary care trusts. In addition, we have targeted £59 million to improve access to NHS dentistry across England: £50 million to primary care trusts for specific local initiatives, and an additional £9 million specifically targeted to the 16 most challenged areas for dental access, supported by the NHS dentistry support teams.

Baroness Gardner of Parkes

My Lords, I thank the Minister for that reply. Is he aware that the British Dental Association has carried out extensive consultations on the Government's proposals for the future and has come up with very unfortunate results? The profession as a whole believes that there is a failure to address chronic underfunding in the NHS and it has many other objections. However, all the results add up to serious misgivings and an overwhelmingly negative view of the Government's proposals. The consultation reveals that 57 per cent of dentists oppose the proposals and that only 15 per cent support them. Nine out of 10 dentists think that they will increase their private work and 60 per cent of them personally intend to reduce their provision of NHS services or to opt out of the NHS altogether. Is that not a very discouraging result of the consultation? What further consultations and changes do the Government propose to address these issues to reassure members of the dental profession?

Lord Warner

My Lords, it is worth reflecting on the fact that pretty extensive consultation took place with the professionals' negotiators before the legislation was put before the House in the Health and Social Care Bill. There has been extensive consultation on the new base contract and the other transitional arrangements, all of which add up to strong protection for three years so that dentists lose no income. The Government are considering the results of that consultation. My honourable friend Rosie Winterton will be responding to it in the not-too-distant future.

Lord Clement-Jones

My Lords, with only three-fifths of adults and two-fifths of children in this country registered with an NHS dentist, there is clearly a crisis of confidence among the dental profession. That is why it is so difficult for adults and children to register with an NHS dentist. What the Minister has said does not really address that crisis of confidence, when the BDA survey shows a huge lack of confidence in the future in terms of contractual obligations. Dentists fear that a treadmill is being created and they have doubts about the PCTs' capacity to cope in those circumstances. What are the Government going to about it?

Lord Warner

My Lords, the noble Lord mentioned treadmills but the treadmill problems of dentistry go back to the debacle of the 1990s contract and the shambles after that, which led to a fee cut and the flight of dentists from the NHS. That was not under this Government. We have been putting more money into dentistry. The fees paid to dentists are up. The numbers of NHS dentists are up by 4,000 since 1997. We have invested £90 million in dentistry during the past year. Oral health in children is improving and the number of people who need an intervention after initial assessment is also up since 1997. We accept that there are problems, but it is not all doom and gloom.

Baroness Masham of Ilton

My Lords, why is Scarborough in North Yorkshire having such a problem in recruiting dentists when it is such a pleasant place to live?

Lord Warner

My Lords, I must pass on the bad news to the noble Baroness that among the 16 hotspots are places such as the Isle of Wight and the New Forest. Pleasant places to live do not always attract NHS dentists.

Baroness Hooper

My Lords, will the Minister reassure me? I understand that in spite of the Government's funding proposals, which sound quite generous, some primary care trusts may be deliberately delaying the processing of applications for numbers—that is, numbers with a capital "N"—to be added to the list of dentists because they are worried about the costs. Is that a general reaction or an isolated occurrence?

Lord Warner

My Lords, the new contract has not been agreed with the profession or introduced, so I am not sure that PCTs could be worried about the cost of the new contract. Certainly, more money has been put into PCTs during the past year and the allocations have now been agreed for the current year. It is down to PCTs to design as best they can the dental services fit for their particular area.

Lord Skelmersdale

My Lords, it is all very well blaming the last Conservative government, but I rather thought that this Government had been in power for seven years. Why has it taken them so long to grasp this particular nettle, which, as we have heard, has resulted in a dentistry desert in this country?

Lord Warner

My Lords, if a previous government shut two dental schools, it is quite difficult to increase the supply of dentists very quickly. That is what we were faced with. Despite that, we have increased the number of places in existing dental schools. We have increased the number of dental hygienists and dental therapists. As I have said, the number of NHS dentists has increased by 4,000 since 1997.

Baroness Oppenheim-Barnes

My Lords, is the Minister aware that on this very morning a lady telephoned the Jeremy Vine radio programme to say that she had had to extract her own teeth after drinking three pints of lager because there were no NHS dentists anywhere near her and no list would accept her?

Lord Warner

My Lords, I am afraid that I did not hear the Jeremy Vine programme this morning. I was opening another of the Government's success stories—the UK stem cell bank.

Lord Colwyn

My Lords, is the Minister aware—I am sure that he is—that the NHS dental workforce review was announced in 2001 by his noble friend Lord Hunt and is still not published? The dental profession is waiting patiently. Those in the NHS need to be convinced that it is a service in which they want to continue to work. Will he give us a date for publication as a matter of urgency?

Lord Warner

My Lords, I have said on previous occasions that we are working assiduously on the dental workforce review. I am assured that it will be published shortly.

Baroness Gardner of Parkes

My Lords, will the Minister assure me that not too many cases will be the same as that sent to me by a dentist about his son, who qualified here at Guy's, did his all vocational training and went to work in Australia, where he continued to work in dental practice? When he applied here to have the right to practise as a dentist, he was told that he will have to wait for at least six weeks. If we really need people in the NHS as urgently as we do, why would there be such a delay for a very well qualified—British qualified—dentist?

Lord Warner

My Lords, I know that the noble Baroness knows that we are always keen to have such talented dentists as herself coming from Australia. I shall certainly look into the particular case that she raises and let her know the answer.

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