Date: 2023-04-27
Simon Fell: I thank the hon. Member for Bradford South (Judith Cummins) and my hon. Friend the Member for Waveney (Peter Aldous) for securing this timely debate. Hopefully, as my hon. Friend the Member for Milton Keynes North (Ben Everitt) said, this is the end of the trilogy. I am glad to see the Minister in his place; I asked him about the issue only a few days ago at Health and Social Care questions. To set this in context, in Barrow and Furness we are not well served by our dental provision. We have excellent dentists, but we do not have enough of them. We also have a problem with practices closing. Bupa in Barrow has announced its closure, as has mydentist in Dalton. One dental practice in Millom, just outside my constituency but serving my constituents, has closed, and Avondale in Grange-over-Sands has handed back its NHS list. So I now have constituents who have not seen a dentist in years and who are in a very poor situation. There are pregnant mothers who are unable to make their appointments, constituents who are self-medicating every night because they cannot find care, seven-year-olds who have never seen a dentist and constituents performing their own dental care with packs they buy from Boots the Chemist. That simply is not good enough. Before the first of the practices in Furness closed, because of the volume of constituents who came to see me to discuss their frustrations at being placed on waiting lists for waiting lists, or not being able to be seen at all, I hosted a couple of roundtables with local dentists. They were candid with me about their concerns--candidly frustrated, to be honest. I also met the senior management at Bupa and mydentist and spoke to local healthcare leaders, before our ICB came into force. In those discussions, two issues came up repeatedly. They have been well rehearsed in the debate already, so I will not labour the points. First, there was the inability to recruit the dentists we need to deliver NHS care. Bupa told me that half of its 85 practices currently have vacancies that have been open for over 6 months. It needs over 150 dentists nationwide to provide the kind of NHS care that it would like to provide. In rural, isolated areas such as mine, recruitment is compounded by the additional challenge of trying to draw people into those areas. Dentists also raised the issue of recruitment from abroad. I fully recognise that we would like to be sustainable and grow our own. I have heard a few pitches for dental colleges in the debate, although I am not asking for one. When demand is outstripping supply, we have to be realistic. I am told that the overseas registration examination does not meet demand, while the process for registering performer numbers is long-winded and overly complex, which puts off some dentists who might be attracted to the UK. We have to look at reforming that. The second issue raised is that dentists are often put off from practising NHS care in more deprived areas, where the work is more complex and more expensive to deliver. I know we have all seen this. It leads to ever-decreasing circles of care: poor dental health leads to worse provision, which leads to a lack of appointments, which leads to even worse dental care and dental health.  I could go on and on, but I am sure Members get the picture. There was hope that the reforms to the UDA system would address this, but practices are telling me that they do not go far enough, certainly in rural and isolated areas such as mine, to address the disparity in the system. The fact is that since the announcement of these changes, I have seen a further two practices close, which I think is testament to the challenges that these issues are throwing up. Following the most recent announcement of closure, I wrote to the Minister, who kindly responded very quickly, saying: "We are aware that we need to go further in improving the NHS dental system. We are planning further reforms...and discussions are underway with dental stakeholder groups, including the BDA and patients, to improve NHS dental services further." I would welcome an update from the Minister on those plans and details as to how my remaining dentists can feed into that process, because they certainly have things to say. Before I draw to a close, I must say that it is not all doom and gloom. I am incredibly grateful to the current Minister and his predecessors for engaging so openly and actively seeking to find solutions. The movements on UDA pricing are welcome--although they can go further, as can contract reform--and the aspiration to make visa schemes more workable is music to my ears. I am keen to hear what the Minister has to say on that. However, as I said at the start, what was a bad situation is now a dire one for my constituents in Barrow. We need to act quickly, improving UDAs, streamlining the visa process and working on recruitment as priorities. It is not an unreasonable expectation to hope for dental care to be available closer to where we live. We often chance our arm in here and ask for big projects to come to our constituencies. This is a minor but crucial ask, and it is one that I very much hope we will soon be able to deliver.