Contribution
I am proud to speak in this debate. I declare that I co-chair the all-parliamentary group on dentistry and oral health.
I have been working on this issue for the best part of a decade, raising it with Ministers in the previous Government, and I have to say that the scale of the challenge that this Government inherited is nothing short of a national scandal. I welcome the steps that the Government have taken: the 700,000 additional urgent appointments; the broadening of that definition in February; and the 1.8 million extra treatments delivered in just seven months. These are real achievements, and I pay tribute to the Minister, whom I have always found to be accessible. He and I have had a number of discussions, and I know that he is not just sympathetic to the issue, but very keen to resolve it. However, as he knows, although these steps are welcome, they are just a sticking plaster on a wound that runs very deep.
Almost 14 million people in this country could not access NHS dental care in early 2025—that is more than one in four adults in England, and more than three times as many as before the pandemic. These are not statistics; they are people in pain, people who cannot eat properly and people who are even embarrassed to smile. The British Dental Association’s research tells us that 41% of adults now have tooth decay—levels that have not been seen since the 1990s, undoing decades of hard-won progress in oral health. Polling from Ipsos makes for truly shocking reading: people across this country who cannot get an NHS appointment have been forced to pull their own teeth out. In one of the wealthiest nations in the world, that is just not acceptable.
How did we get here? Since 2010, the proportion of the NHS budget spent on dentistry has more than halved, from 3.3% to just 1.5%. That is the direct result of 14 years of the previous Government—£1 billion gone, and patient charges hiked by over two thirds. In 2023, the Health and Social Care Committee branded the dental contract “not fit for purpose”; both the Public Accounts Committee and the Nuffield Trust have said the same. Yet the previous Government for 14 years did nothing about it.
After the Tory Government recovery plan was found by the National Audit Office to be off track, this Government have tried to change things. The new patient premium cost £88 million, but produced no measurable improvement in access. Just last week, we learned that despite the offer of a £20,000 golden hello, just two dentists in Greater Manchester signed up to do NHS work. That tells us how broken our system is.
I want to raise a specific injustice that was brought to my attention by the Epilepsy Society. Around 630,000 people in this country have epilepsy. A third have uncontrolled seizures and fall without warning, often face-first, breaking their teeth again and again. Harriet, who is 29 years old, has six missing teeth, including her front teeth—top and bottom. After she broke her NHS dentures three times in a single year, her dentist has refused to issue another set. She can barely speak clearly, she struggles to eat, and every time a seizure strikes she faces a new bill for the damage she could not possibly prevent. A broken arm caused by a seizure is treated free in hospital; a broken tooth caused by that same seizure incurs significant expenditure. There is no medical exemption for epilepsy-related dental damage, but there should be. I urge the Minister to look specifically at that in the short term before going on to the full dental contract.
What is the cost of fixing it, and why do we need it? The British Dental Association estimated that it would take about £1.5 billion a year to restore NHS dentistry to a universal service. When the Chancellor announced £29 billion for the NHS in her statement on the spending review, I asked her whether any of that money could be set aside for dentistry. Sadly, it has not been, and no additional money has been set out for dentistry.
Catching decay early is far cheaper than an emergency treatment, prevention in children costs a fraction of what we spend fixing the damage in adults and a workforce who stay in the NHS are definitely cheaper than one who walk away. We need a new contract that breaks decisively with units of dental activity, prioritises prevention and makes NHS dentistry a place where talented professionals want to build their careers. The Government have announced a public consultation for this summer, which is great news, but we need a timetable and a firm deadline for a new system in this Parliament. We cannot kick this into the long grass again—13 years of that was quite enough.
As I said, I have been raising these issues for years. I sat in rooms with Ministers and heard warm words but found nothing changed. I do believe that this Government are different and that the Minister is serious—I have had many discussions with him, and he has met the all-party parliamentary group on dentistry and oral health a number of times—but that seriousness must be matched with urgency, and that urgency must be matched with investment. The people of Bolton South and Walkden and people across the country deserve to see a dentist without waiting years and without pulling their own teeth. They deserve a Government who will finally fix NHS dentistry. I urge the Minister to please urge the Chancellor and the Secretary of State for Health and Social Care to give it the utmost priority. Let us resolve it once and for all.