Covid-19: Dental Services — House of Commons, 2021-01-14
Topic: Health
Alexander James Jorden Norris (Labour, Centre-left): I completely share that perspective, and I will cover that in my final points On prevention, I hope that the Minister will make a commitment that the Government want to move towards a preventative model. If she does that, the Opposition will work with her to deliver it Of course, there is a more immediate issue at hand. On 17 December, as colleagues have said, NHS England imposed new activity targets on NHS dental practices, which took effect at the beginning of this month. At the beginning of the pandemic the Government were right to step in and offer dentists their full contract for a much smaller proportion of their usual activity. We supported that then and we still do. It is also right to seek to increase capacity to help tackle the backlog, and avoid NHS patients being pushed into the private sector. However, what has followed is a mess, with negotiations between NHS England and the General Dental Practice Committee breaking down, and so targets being imposed on the sector, with practices needing to hit 45% of their pre-pandemic activity targets in the first quarter of this year Allowing negotiations to break down like that, rather than intervening to ensure that an agreement was found, is a failure of leadership by this Government. Where have they been on this issue? Whether we think that dentists are right or wrong in their perspective, and whether we think the figure should be 45%, 55% or 35%, surely we would agree that an imposed target is a failure of leadership It simply will not do that such a crucial part of our health service has working arrangements that discomfort it so greatly. NHS England would never pursue a work pattern that is dangerous, but there are reasonable questions about how practical it is. It is not just dentists raising that; we have had public pronouncements of concern from the faculty and the colleges. There should have been a negotiated deal that found common ground. I know the Minister is a consensus builder and I enjoy working with her. I hope she will say that she will step in to build consensus and fix this, and Labour will support her in that venture In the meantime, I hope the Minister can offer some reassurance on areas of concern relating to this: first, if practices do not hit that 45% of pre-covid activity, and instead land at between 36% and 45%, any reduction will be proportionate to the full payment; it will be downscaled in ratio. However, below 36%, a practice will drop off the cliff edge and not get its contract. That is concerning because in November that would have applied to 40% of practices. Those targets were put in prior to the third wave of the pandemic gripping, and we know that is having an impact. Eight in 10 practices have seen increased cancellations or missed appointments, and three quarters of practices have experienced staff absences this month alone Will the Minister therefore reassure the House that she will look again at that element to ensure that dentists have a fair chance of meeting targets and are not unfairly penalised if they do not, through no fault of their own? I know there will be a regional analysis of whether there are extraneous factors. I hope the Minister will endorse and double underscore that today Secondly, will the Minister offer reassurances that the use of units of dental activity will not incentivise just the treatments that fit in a little more easily—for example, check-ups that do not require fallow periods—while disincentivising more urgent complex care, and care that does not count towards the target? Thirdly, I am concerned about the wellbeing of dentists and their staff, because 45% of UK dental professionals feel that their mental wellbeing is worse compared with the start of the pandemic. What steps are in place to support our workforce? We have a duty of care towards them I will conclude with a point about dental laboratories. They make the crowns, bridges, dentures, and more, on which dentistry relies. While the Government acted quickly to protect the dental industry—as I said, we supported them on that—there has been nothing for dental labs, which have seen their orders collapse. Many have shuttered and will never reopen. People are leaving that skilled profession, but we are going to need them again, and in greater volumes as we catch up. Instead, we will now buy those products from the continent and beyond, all around the world, and we will have lost skilled work because we let it wither. I hope that the Minister will use this opportunity today to announce relief for that Dentistry is a vital part of our NHS. Dentists and their staff have fought valiantly to keep the industry going in unprecedented times. Now they are at a crossroads and need political help. The Government must step up and resolve the contracting issue, and work with dentists to build a new exciting future for dentistry, preventing ill health, rather than chasing it. If they meet the moment, we will support them, but if they do not we will call them out.