MPs Turn Spotlight On East Of England – But Does It Shine Any Light?
- Details
- Published: Wednesday, 31 May 2023 07:30
- Written by Guy Tuggle
- Hits: 1659
In the first of a two-part report, GDPUK’s Guy Tuggle listens in to MPs discussing dentistry in eastern England.
“One of the unifying features of the speeches today is that we have heard them all before” Jerome Mayhew MP.
“It is easier for an MP to secure a debate on NHS dentistry in this place, than it is for one of our constituents to actually see an NHS dentist.” Peter Aldous MP
Dentistry returned to Westminster Hall last week where MPs debated "That this House has considered dental services in the East of England".
Parliament has spent so much time ‘considering’ the state of NHS dentistry it’s a wonder that our elected representatives aren’t requesting to be paid in ’Units of Parliamentary Activity’ or "UPAs" such is their commitment to the cause.
Or is it the volume of complaints from constituents unable to access NHS dental services as Parliament commences its slow descent towards a general election next year with non-existent NHS dentistry an increasing a preoccupation for our MPs? Untreated cavities and root canals have votes it seems.
In his opening speech, Richard Bacon MP (CON, S Norfolk) quoted Allison Pearson writing on 10 August 2022 in The Daily Telegraph
“I can’t think of a better example of a two-tier NHS than the one that currently exists in dentistry.”
Bacon continued “I understand that the providers of dental plans—for example, Practice Plan, which styles itself “the UK’s leading provider of practice-branded dental membership plans to help you leave NHS dentistry or switch providers”— are so busy that they are rushed off their feet.”
The British Dental Association’s briefing ahead of the debate referenced the 2002 BBC / BDA investigation which revealed that no dental practice in Norfolk, Suffolk or Cambridge was taking on new adult NHS patients, and that this was also true of nearly all dental practices in Hertfordshire, Bedfordshire and Essex.
NHS dentistry is small change in the overall NHS budget.
Mr Bacon said “Let me say a word about money. The thing that struck me most in preparing for this debate was how little money the NHS spends on dentistry—indeed, how little is spent on dentistry at all compared with what it spends on other things.
The figure is currently about £3.2 billion a year—that fluctuates a bit—and about 20% to 32% of that is actually paid through patient charges, paid by the patients themselves.
A recent National Audit Office study showed NHS spending rising from £123.7 billion in the financial year that ended in 2020 up to £151.8 billion—more or less £152 billion—at the end of the financial year that just finished.
Further big rises are expected and planned—going up to £162.6 billion—by the end of the financial year 2025. Those are huge sums. In comparison, the annual cost of dentistry is tiny.
I tend to compare anything under £3 billion with the NHS national programme for IT in the health service under the last government. The Health Committee and the Public Accounts Committee studied that extensively at the time, and showed that the electronic patient record element, which cost £2.7 billion, had achieved basically nothing.
Compared with the £124 billion or £152 billion or £160-something billion that we are talking about, £2 billion or £3 billion here or there is of very little account” said Mr Bacon.
‘Lock NHS Dentists In With Accommodation Deals’
Dr Dan Poulter (CON Central Suffolk and North Ipswich) asked Mr Bacon “What does he think about finding a way to lock in dentists to the NHS for maybe five years, post-graduation, to ensure that they pay back some of the training that cost the taxpayer many hundreds of thousands of pounds?
Mr Bacon replied that affordable accommodation was a challenge for young dentists and Drs adding that the government has “hundreds of thousands of acres of public land, including Ministry of Defence land, NHS land, railway land and church land, which has a quasi-public flavour to it.
Norfolk County Council alone owns 16,000 acres of land. I would say to these people, “Come and work for the NHS for a few years full time. Commit yourselves completely to this, and we will help you design, build and rent from us at a decent rent. And then, depending on the calibrated loyalty package, which I am sure we can easily work out, you will get the chance in future to buy the house that you have designed for yourself.”
Andrew Selous MP (CON, SW Bedfordshire) also advocated incentivising young dentists to commit to the NHS. “Students leave with quite a lot of student debt, but there is something we could and should do there.
If someone is training to be a doctor or a dentist, they receive a large amount of taxpayers’ money, and taxpayers can reasonably ask what they are getting back in public service.
Whether we could do something on the amount of debt they have, or vary or pause the interest rate, if they gave those five years to the NHS, that would be worth looking at, and having a greater supply of dentists would make a significant difference.
Where Dentists Train Is Where Dentists Work
“Getting people to stay in a particular area has proved difficult, not least because we do not have a dental training college (in the east of England). However, this is also about people understanding that the area they are going to work in is particularly attractive.
That is true of much of the east of England, except people do not realise it because not enough of them, certainly in dentistry, are educated there. There is a huge opportunity for the Government to get this right.”
The east of England is the most arid region in the country Mr Aldous claimed with the failings of NHS dentistry becoming “the No. 1 item in many of our inboxes over the past two years.”
More Funding Required – And No Clawback
In an optimistic sign that the profession’s concerns are at last being heard and understood by MPs, Mr Aldous acknowledged that NHS dentistry requires fair funding.
“The British Dental Association has estimated that we would need £1.5 billion a year to restore budgets to their 2010 level. I recognise that that will not be achieved overnight, but there does need to be a meaningful start”.
Aldous said the annual budget for NHS dentistry is of the order of £3 billion; just over 10% of that is due to be clawed back because it has not been spent.
“I do not know whether the Minister has given an assurance elsewhere, but that money must remain ringfenced for NHS dentistry. The fact that there is money not being spent shows that the whole system is broken.
We saw that at the beginning of January 2022, when the Government announced £50 billion of funding for what was described as a dentistry treatment blitz; only 30% of that was spent. There is a lot of work to do on the funding side” said Mr Aldous.
Specific to the east of England, Aldous quoted BDA work before the pandemic that showed that spending on NHS dentistry in England lagged way behind that in Scotland, Wales and Northern Ireland.
Calling the east of England the ‘tail-end Charlie’, Aldous insisted “there are a great many steps that we need to be taking to address that particular inequality.”
Jerome Mayhew MP (CON Broadland) pricked a bubble when he observed “One of the unifying features of the speeches today is that we have heard them all before”.
Mr Mayhew added “Not only have we all heard it before, but we have all said it before”.
The MP then cited Broadland, a local government district in Norfolk with a population of 124,646 (2011 census) where the lack of dentists of any description is profound.
“I was lucky enough to persuade the Department to advertise a new contract for NHS dentistry in Fakenham last year. The money was available and the contract was advertised; not a single organisation applied for the contract, and it is still vacant”.
Sheringham v London
Next Mr Mayhew turned to Sheringham, a delightful town on the Norfolk coast.
Mr Mayhew quoted there being “a dental practice (in the town) that is owned by an organisation that has an equivalent practice in London.
The organisation has been advertising consistently for a new private dentist in Sheringham for 10 years, and it has yet to fill the role, whereas during the same time multiple positions in its London practice have been advertised and filled. It is therefore not just a regional issue; geography really matters.”
In an illuminating moment Mr Mayhew spoke of the consequences of the access crisis for people. After all, behind all the figures, all the statistics are real people, many in pain, desperate for help.
“I am sorry to say that just last week the latest in long and ignoble line of announcements came when Brundall Dental Practice (in Norwich), which is an NHS practice, contacted patients to say that it would no longer be accepting adult NHS patients from 1 September this year.
People are being asked to move on to monthly subscriptions for dental care, which are between £150 and £400 a year.
I struggle to know what to say to the many constituents who have contacted me, because not a single NHS practice in the county of Norfolk is currently accepting new patients under an NHS contract. The £11 a month is only for check-ups and hygienists; it is not for dental care, which is an extra charge.
People might say that many can afford to pay for dentistry if they have to, but we have to also consider those who are excluded from paying dental charges because of their financial circumstances.
What are we asking of those constituents? Where are they to go when not a single provider in the county of Norfolk is accepting NHS dentistry? “
In Part Two, Guy Tuggle will report further on the deliberations of these MPs and evaluate their contribution to the ‘great debate’.
You need to be logged in to leave comments.
Report