Contribution
I thank the hon. Member for Yeovil (Adam Dance) and others for securing this important debate.
Cornwall is a dental desert. Healthwatch Cornwall’s 2024 report found that every single NHS practice was closed to new adult patients. In Cornwall, under 30% of adults have seen a dentist in the last two years; across England, that figure is 40.7%. That is a stark reflection of the regional inequality, and the lack of access to basic healthcare. At the same time, the number of dentists in Cornwall and the Isles of Scilly has fallen dramatically, from 285 in the year 2019-20 to just 221 in 2024-25. Since 2010, the proportion of the NHS budget spent on dentistry has more than halved. At best, NHS dentistry only ever covered about half the population.
Cornwall is rural and coastal, and like many such areas in the south-west, we face real challenges in attracting and keeping dental professionals. Two years ago, more dental nurses left the workforce than joined it in every NHS region. In the south-west, for every nurse who joined, two left. Every dental practice in Cornwall reports recruitment difficulties for all staff, and morale among NHS dentists is at a low, with more than six in 10 in England saying that they are thinking of leaving NHS dentistry. We need to make the NHS a place in which dental staff choose to build a career, and the golden hello scheme is a start. Cornwall and Isles of Scilly ICB has invested £188,000 in 11 posts across the area.
It is also crucial that we train more dentists. I recently visited the Peninsula dental school at Treliske in Truro, which is part of the University of Plymouth. Fourth-year dental students train in Truro and offer free dental care. They provide essential treatment and community outreach to more than 30 local groups. That is exactly the type of model that we need. The school wants to expand its intake from 58 students to 72 students per year to meet demand and bring the region in line with the national average. If we train more dentists in Cornwall, we stand a better chance of keeping them there. The Government are expanding dental school places, with 50 extra dentists, which is brilliant, but I ask them to include Peninsula in the next wave.
There is a recognition that the current contract is flawed. It is based on UDAs, which effectively cap how many patients a dentist can see. If dentists exceed the cap, they are not paid for it; if they under-deliver, money is clawed back. In Cornwall, only around two thirds of UDAs are delivered, which sometimes leads to millions of pounds being clawed back. That money could be used to treat patients. The money has historically been paid monthly in advance to practices, but unused money has not been repaid in some cases until the end of the year, which has made it hard to divert it to other uses.
Cornwall’s ICB has introduced an incentive scheme to encourage practices to hit a certain percentage of their target, so that less money needs to be returned. The Government have introduced reforms to the contract from April ’26. There will be a level of urgent care that is at an improved rate, and there will be a new care pathway for higher-needs patients and more clinically complex cases.
Let me talk about some of the schemes already in place to tackle the acute dental need in Cornwall. Since July last year, there has been a dental van, run with Smile Together, which delivers care for our veterans, the fishing community and patients who have been waiting for urgent treatment. The Government’s scheme for brushing in schools has already reached up to three quarters of the schools in Cornwall, and up to six new dental practices are due to open in Cornwall soon, through the clawed-back funding. This will not fix everything overnight, but there is positive reform. I will ensure that these changes are felt in Cornwall, because everyone deserves access to dentistry where it is needed.