Dr Caroline Johnson

I congratulate the hon. Members for Yeovil (Adam Dance), Sunderland Central (Lewis Atkinson) and Waveney Valley (Adrian Ramsay), and my hon. Friend the Member for Farnham and Bordon (Gregory Stafford), on securing this important debate. Madam Deputy Speaker, I once read that nothing you wear is more important than your smile, because it is your smile, and the laughter that comes with it, that brings joy and happiness to the world. In that spirit, I start by acknowledging some progress that this Government have made. The previous Conservative Government began establishing dental schools in Norwich and Portsmouth, to bring the next generation of dentists, hygienists and dental therapists to local people. We started fixing the roots of dental education, and I am pleased that this Government have continued that, allocating 25 training places to each of those schools. That is of course good news. As the Minister will know, it has been a long-standing campaign of mine to get a dental school in Lincoln. Excellent progress has been made so far, with the hub-and-spoke model to help rural areas, as my hon. Friend the Member for Bridgwater (Sir Ashley Fox) described. The team at the University of Lincoln are just waiting for the final sign off from the General Dental Council and the Privy Council. I am hoping that there will soon be places for Lincolnshire in the plans for dental education. To help bolster NHS dentistry, in 2024 the Conservative Government consulted on proposals to require dental graduates to work in the NHS for three years after qualifying. This Government’s 10-year plan committed to that policy, but I think we are waiting for a consultation to set out the proposals in greater detail. Can the Minister tell us whether it is still the Government’s intention to introduce tie-ins to NHS dentistry for dental graduates and when the proposals will be in place? As the Liberal Democrat spokeswoman, the hon. Member for Epsom and Ewell (Helen Maguire), said, the previous Conservative Government committed to expanding dentistry training places by 40% over 15 years, and, despite population growth, there are still more dentists per 100,000 people than there were in 2009. This Government’s workforce plan should lay out how many dentists, hygienists and therapists we need to recruit, and how the Government are going to do it. Unfortunately, that workforce plan was due last year, before being delayed until spring ’26. It is now summer ’26. In response to a recent question, the Minister said that it was due imminently, which I am sure is quicker than “soon” and much quicker than “in due course”. If the Minister has time to define “imminently”, I would be most grateful. It is not all about numbers. As the Minister himself has said, the issue is not the number of dentists, but the paucity of dentists who are doing NHS work. There is a case for making the NHS more attractive to dentists in the first place, as we know that dentists are disincentivised from working in the NHS. The main problem with that, as many have identified, is the contract created under the previous Labour Government in 2006. This has been a problem for some time; when I moved to Lincolnshire in the early 2000s, I remember travelling back to Redcar to see my wonderful NHS dentist, Mr Dixon, until he retired. There are several issues with the units of dental activity model in the contract. First, the units fluctuate bizarrely between practices, creating inequities in payment. Secondly, the UDA does not really equate with the real-time cost of delivering complex care. Thirdly, the UDA does not always cover the costs of care, meaning that dentists may be asked to provide some NHS care at a loss. The Conservatives started to change those issues by raising the minimum UDA payment and giving care commissioners the tools they needed to address UDA rates locally to better support delivery of care for patients. The former Secretary of State said that he would sort it by meeting the BDA on day one, and I believe that he did in fact meet the BDA straightaway, but there seems to have been little progress since. In April, the Minister promised that a consultation on fundamental contract reform would launch before the summer, but we are now in June—can the Minister say when that will be ready? Does he expect to reform the dental contract in this Parliament, as he promised? The Government are focusing a lot of resources on abolishing NHS England and have cut ICB budgets by 50%. Are they so focused on restructuring that promises to patients are not getting delivered? Speaking of delivery, the Government promised 700,000 urgent dental appointments and commissioned 1 million. In March, however, they admitted that just 100,000 additional urgent appointments had been taken up. I am aware of some dentists who are staffing appointments on call, on an in-case basis, so how many unattended appointments did the Government pay for? The Minister has now broadened his definition of urgent, but is he confident that we will have the urgent need met, and that it will not be crowded out by his broader definition? We have heard much about children’s teeth. In 2015, 42,209 children were admitted to hospital to have dental extractions due to decayed teeth; by 2024, that had fallen to 30,567—a drop, but still far too many. In 2025, however, that number rose to nearly 34,000. The previous Government introduced a Big Brush Club in south-west England, and I note that was the only region to have a reduced number of admissions in the year 2024-25 for decay extraction. What has the Minister made of that programme? How does the Government’s programme differ from the Big Brush programme? Children need their teeth brushing during the holidays, at weekends and in the evenings—how is the Minister working on ensuring that parents deliver on their responsibilities then? It is indeed their responsibility to ensure that their children brush their teeth twice a day. The Government’s 10-year plan rightly focuses on prevention, and one important preventive measure is the fluoridation of the water supply. The Government’s “Water fluoridation: health monitoring” report in 2026 found that children living in areas with a fluoridation scheme had a 20% lower incidence of tooth extractions. Will the Minister say what he is doing to explore expanding water fluoridation to help eliminate tooth decay? Dentistry is important, because good oral health is not just about our teeth, mouth and gums. Research published in The Lancet reports a growing body of evidence suggesting that oral health is closely associated with conditions such as cardiovascular disease, diabetes and Alzheimer’s. One’s dentist may also identify symptoms of Peutz-Jeghers syndrome, Sjögren’s syndrome, nutritional deficits, Crohn’s disease and oral cancers. Delivering on NHS dentistry is important for our wider health too, but so far it feels as though the Government have been all smiles but little action when it comes to making NHS dentistry work for everyone. I hope that the Minister and his new Secretary of State will not seek to blame others, but instead recognise that they now have the levers in their hands—indeed, they have had them in their hands for nearly two years now—and use them to address these concerns, and quickly.