Contribution
I completely agree with the hon. Member on that point. We have seen that in my constituency and others in Somerset: one place will be on a higher rate, and another place will be on less. Ultimately, we need to get rid of that system if we want more NHS dentists, and look at alternatives, such as the weighted model suggested by the Health and Social Care Committee.
But that is not all. One of the frustrating things that I found when we were setting up a new NHS dentist in my area is that dentists cannot prioritise locals. The dental contract means that people do not register with a dentist as they do a GP; they can attend any dental practice that is taking NHS patients, even if the practice is based miles away. That is because, technically, people are only with a dentist for as long as a course of treatment, which means that if someone lives in Yeovil, Crewkerne or Chard—or in the rest of my constituency—they do not have the right to be permanently registered with their local NHS dental practice.
When we got the new practices open, there was no guarantee that locals who needed a dentist most would get one. That is madness. We had people travelling 200 or 300 miles to come to one of our new dental practices, and someone a mile down the road could not sign up. What is the point of opening a new dental practice in our area if it does not benefit all—or even half—of the people there? That part of the contract also means that to stay with their NHS dentist, someone needs to have six to 12-monthly appointments to keep their spot. That meant that a lot of people lost spots during covid. Local providers, the NHS and I are doing our best locally, but there is only so much we can do within those rules. I urge the Minister to make reintroducing permanent patient registration rights a priority in contract reforms.
Even then, without proper funding such changes will not work. Since 2010, the amount of the NHS budget spent on dentistry has more than halved. Integrated care boards, which oversee local NHS services, have also been making serious budget cuts, with 50% of their staff having to be made redundant. That has left us in a situation where we invest less of our health budget in dentistry than any of our European neighbours, according to data from the OECD. At the same time, dental practices in Yeovil tell me that the cost of materials, energy and labour have gone through the roof, while missed appointments or last-minute cancellations are costing practices a fortune. We need the Minister to set out how the Government plan to fund NHS dentistry properly. Will he also set out what steps he is taking to support dentists with day-to-day costs, particularly in relation to resourcing and cancellations?
There is one other big issue that we have to address: getting dentists to work and stay in rural areas such as Somerset. Mark, who is about to retire after 39 years as a dentist in Yeovil—thank you for your hard work, Mark—has been saying to policymakers and the press since the mid-1990s that we would end up in exactly this situation if we did not attract dentists to places like south Somerset, which lose out because NHS dentistry tends to be concentrated around dental training schools and urban centres. It is therefore a good start that the Government will require younger dentists to work in the NHS after graduation for around three years, but that is only a short-term fix, just like the golden hello bonus—another one-off fix. We need to write proper workforce planning for health and social care into law, including projections for dentists and dental staff.
Similarly, the Government’s recent announcement of 50 new dental school places from 2027 is great, but that is a rise of only 6%—a drop of water in the dental Sahara desert that is the south-west. I think it is fair to say that dentists trained in Portsmouth will probably stay around there and instead of coming to fill demand in Somerset, which is a real tragedy because as a community we have so much to offer. I invite the Minister to come to Somerset to talk with us about how we can get that across to dentists.
Ultimately, we need fundamental changes to the NHS contract, how we fund it and how we recruit. Of the local dentists I surveyed, 100% said that they were not satisfied with the Government’s progress on improving the NHS dental contract, while 82% of the public I surveyed rated the Government’s performance on NHS dentistry as poor or very poor. Two years into this Government, we are still waiting for proper changes to the NHS dental contract; if we factor in early discussions, consultations and then actually drafting and proposing the thing—we all know how long those things take—I am sure the Minister is aware that if this is kicked down the road any further, the Government will not be able to deliver on their promise to roll out a new NHS dental system by the next election.
I urge the Minister to provide a clear commitment to getting the consultation on fundamental reforms done this summer, no matter how distracting a new Secretary of State, a by-election and a change of Prime Minister may be—let us get on with it. I hope the Minister will also use this debate as an opportunity to go further and provide a clear timetable for when formal negotiations will start, as well as a firm deadline for rolling out the new system in this Parliament. I know that the Minister is committed to getting this right, and that he is working with a difficult brief, but there seems to be a disappointing trend emerging with this Government, whether in social care, defence, investment or dentistry: if it is hard, kick it down the road.
We were promised change, so please work with us to deliver that. I do not want to have to be back here in a year or two, reporting that things have got even worse in Yeovil.