HL Deb 16 July 2004 vol 663 cc72-4WS
Lord Warner:

My right honourable friend the Secretary of State for Health has made the following Written Ministerial Statement today.

We are committed to rebuilding National Health Service dentistry to ensure better access to NHS dental care and to improve oral health in England. We want to see a better deal for patients, dentists and the NHS. We are aware that in some areas it can still be difficult, especially for adults, to access NHS dental care.

There are over 19,000 dentists in primary care, which is more than ever before. But they are spending less time on their NHS work, which leaves some people unable to get the routine treatment they want on the NHS unless they are prepared and able to travel.

We have already announced funding of £59 million to tackle access problems and have set up an NHS support team to work with the hardest pressed areas. However we recognise that more needs to be done and that is why I am today outlining the Government's plans to recruit more NHS dentists in the short term, to invest in dentistry and to reform the system for the long-term benefit of the oral health of the people of England.

To address short-term access problems we will recruit the equivalent of more than an additional 1,000 whole-time NHS dentists by October 2005.

This objective will be achieved by a range of measures:

securing extra NHS capacity from dentists who currently work partly in the NHS and partly in private practice;

attracting dentists back from career breaks and flexible working;

an international recruitment programme, already under way, targeting dentists from the European Union, including the new accession countries;

clearing the backlog of dentists waiting to sit the international qualifying exam by December 2004—to allow dentists who have qualified outside the EU to practise here.

In addition, NHS dentistry will benefit from extra investment:

we will fund 170 extra undergraduate training places in England from October 2005. This 25 per cent increase will be supported by capital investment of up to £80 million over four years with the first £20 million available in 2005–06 and revenue costs which will reach £29 million per annum by 2010–11;

funding for dentistry will increase by 19.3 per cent (excluding the impact of additional superannuation costs) in 2005–06 compared to spending on dentistry in 2003–04. This compares with growth of 17.8 per cent in overall NHS revenue resources over the same two-year period. At October 2005 the Government will be investing £1.6 billion in dentistry (including £50 million superannuation costs) compared to £1.3 billion in 2003–04;

financial resources for primary dental services will be devolved to primary care trusts from 1 October 2005. The financial year 2004–05 will be a preparatory year and we will be consulting PCTs now on indicative financial allocations for dentistry for 2004–05 and 2005–06, as well as issuing proposed 2005 contract values for dentists, based on their most recent gross earnings.

The additional investment will provide a sound foundation on which PCTs can rebuild a NHS dental service fit for the 21st century.

Long-term change is also required to modernise the dentistry profession and this is why we are introducing new contracts for dentists. We have already made legislative changes. The measures in the Health and Social Care (Community Health and Standards) Act 2003 represent the most radical reform of NHS dentistry since 1948. Our proposals for NHS dentistry will underpin a modernised, high-quality primary dental service provided through contracts between PCTs and dental practices. The service will be properly integrated with the rest of the NHS providing better access to services and an improved patient experience.

We have already made considerable progress on implementation. We have consulted widely with representatives of the profession on the framework proposed for the new primary dental services. A recurrent theme from the consultation is that time is too short for our planned implementation date of 1 April 2005. The British Dental Association asked for phased implementation. I have therefore concluded that we should give more time to the NHS and to dentists to prepare for these significant changes and am also announcing today that the new arrangements will be introduced from 1 October 2005, rather than 1 April 2005. In recognition of the additional work and training dentists and their practice staff will need to prepare for these changes we will make available an extra £9 million to help dental practices prepare for October 2005.

The new arrangements are modelled on five years' successful experience of personal dental services (PDS) pilots. The PDS continues to provide an opportunity for those dentists and their PCTs who wish to move further and faster towards local commissioning to do so. There are already more than 1,500 dentists in more than 750 practices working under PDS arrangements, out of a total of around 9,000 practices. With this in mind, I am asking PCTs to encourage dental practices to notify PCTs of their intention to move early to local commissioning under existing piloting arrangements.

We will shortly publish additional guidance for dentists and PCTs to streamline this conversion process—with a 12-week turnaround time from application to approval.

We are also using the skills of the whole dental team more appropriately so that hygienists and therapists provide more routine and preventative care. I have already invested an additional £5 million to increase the number of training places for dental therapists from just 50 to 200. Some of those new training places are already on stream, and the first of the additional therapists will be joining the workforce in autumn 2006.

We are also looking into simplifying the system of patient charges. The NHS dentistry patient charges working group, which involved experts from national patient, consumer and dentist organisations, has made recommendations to Ministers which we are currently considering.

I can also confirm our aim to publish for consultation the new regulations for local commissioning of primary dental services and dental charging (but not the actual level of charges) in spring 2005.

This package of measures represents an unprecedented level of government commitment and investment in NHS dentistry.