HC Deb 22 May 2003 vol 405 cc963-7W
Mr. Pike

To ask the Secretary of State for Health (1) if he will introduce provision within plans for the transition into new arrangements for NHS Dentistry contained within the Health and Social Care (Community Health and Standards) Bill to ensure that(a) patients and (b) dentists are kept informed of changes and to ensure that the livelihoods of dentists already providing NHS dentistry are safeguarded; and if he will make a statement; [113274]

(2) what proposals he has included within the Health and Social Care (Community Health and Standards) Bill to attract (a) dentists, (b) dental nurses, (c) dental hygienists and (d) dental therapists into NHS dentistry; and if he will make a statement; [113273]

(3) what provisions there are in the Health and Social Care (Community Health and Standards) Bill which will increase the proportion of the NHS budget allocated to NHS dentistry. [113272]

Mr. Lammy

It is the intention of the Health and Social Care (Community Health and Standards) Bill to better match the provision of primary dental services with local oral health needs through local commissioning of the service. This would enable local flexibility to be built into the system.

It is also the intention of the Bill that providing oral health services to national health service patients becomes a more attractive option to general dental practitioners by making it possible to pay them differently. The current item-of-service remuneration system is widely recognised as the main reason for dentists' disaffection with NHS work as they are paid only for treatments rather than oral health care. Under this proposed approach, the whole dental team would be better able to advise patients on improving their oral health allowing further improvement of the quality and patient focus of their care. In addition, NHS dentists and other members of the dental team will increasingly become part of the NHS family, participating in local dental public health programmes and benefiting from primary care trust (PCT) support networks and in due course, to NHS occupational health services. By contracting with a PCT, dental practices will receive a more secure and predictable income in return for a longer term commitment to the NHS.

All stakeholders are being kept abreast of the proposed changes. The patients forum has met officials and is broadly supportive. A working group, led by the Department's Director for Patient Experience and Public Involvement and including patient representatives, will undertake a review of the charging regime. To improve patient experience of NHS dentistry, each PCT will be required to publish information about the primary dental services in its area.

A series of events for dentists was held by the NHS Modernisation Agency earlier this year. The events were designed to explain the proposals in "NHS dentistry—Options for Change" and to encourage their involvement. Workshops for PCTs are being run by the national primary and care trust development programme and the Department of Health. In addition, learning events are being provided for local dental committee representatives by the British Dental Association, together with the NHS Modernisation Agency.

The legislation before Parliament proposes transitional arrangements under which a dentist already providing general dental services must be offered a new GDS contract, the terms of which would include remuneration.

Subject to Parliament, funding will be allocated to PCTs, which will then hold a predictable financial resource to secure primary dental services. Funding for primary care dentistry, hitherto held centrally and administered by the Dental Practice Board, will then be part of PCT general allocation, which has in recent years seen a higher rate of growth than that in the general dental service. Over time, PCTs will be better able to target these resources and to increase their spend on dentistry in the light of local circumstances.

Funding is being made available for a support team for NHS dentistry to support local health economies during this period of substantial change to develop their capacity for local commissioning of primary care dentistry and to assist them in addressing immediate or potential access issues.

Mr. Dhanda

To ask the Secretary of State for Health (1) what action he is taking to encourage dentists to continue to offer dental treatment on the NHS; [113742]

(2) what action he is taking to protect patients who are having dental treatment on the NHS withdrawn by their dental practice; [113741]

(3) if he will make a statement on dental practices which are withdrawing NHS treatment for existing patients while offering to continue treatment through private dental plans. [113740]

Mr. Lammy

I refer my hon. Friend to the response I gave my hon. Friend the Member for Burnley (Mr. Pike) today.

General dental practitioners are independent contractors and, as such, are free to choose whether they wish to provide national health service or private dentistry or a combination of the two. However, very few practices are exclusively private, with only about 5 per cent. offering no NHS treatment. Under their NHS terms of service, dentists who stop offering NHS services are required to complete any outstanding treatment on the NHS or notify the appropriate primary care trust if this is not possible.

A number of initiatives have been introduced in recent years to encourage dentists to continue to offer dental treatment on the NHS: The commitment payments scheme was introduced in 2000 to encourage dentists' commitment to the NHS. Dentists who have offered NHS treatment to patients for five years or more and who have a certain level of NHS commitment receive extra payments. Dentists in England earned an extra £23 million under the scheme in 2002–03. £10 million was made available between 1997–99 under the Investing in Dentistry scheme to allow dentists to increase their NHS commitment or start new practices in areas of poor access. A Dental Care Development Fund of £4 million was made available in 2000–01 along with £6 million Dental Action Plan money in 2001–02 to allow practices to grow and treat more patients. A Modernisation Fund of £35 million was made available in 2001–02 for practices to expand or improve their premises.

Where dentists withdraw from providing NHS dentistry, PCTs can apply to the Secretary of State for agreement to fund salaried general dental practitioners under Section 56 of the 1977 NHS Act. Any such applications recently received have been given a positive response.

In addition, a number of dental access centres (DAC) have been set up primarily in areas where access to NHS dentistry is difficult. Patients do not have to be registered to receive treatment in a DAC.

A range of dental treatments is available under the NHS to unregistered patients through the occasional treatment arrangements. This ensures that those patients who require urgent treatment can receive it without registering with a dentist.

Mr. Burstow

To ask the Secretary of State for Health pursuant to his Answer of 12th May, Official Report, column 107W, on NHS dentists, what the gross increase in the number of dentists treating NHS patients was. [114632]

Mr. Lammy

[holding answer 20 May 2003]: 4,922 dentists joined the general dental service (CDS) between September 1997 and September 2002. Due to dentists leaving the CDS on retirement and for other reasons in the same period, the overall increase of dentists was 1,672.

Mr. Paul Marsden

To ask the Secretary of State for Health how many dental practices in(a) Shrewsbury and Atcham and (b) Shropshire accept new patients for treatment on the NHS that are (i) elderly, (ii) children, (iii) unemployed and (iv) disabled. [114760]

Mr. Lammy

Shropshire and Staffordshire Strategic Health Authority has provided the following information.

In Shrewsbury and Atcham, one practice is currently accepting children up to age 18. One practice is currently accepting adults eligible for free National Health Service dental care. This includes patients who are pregnant, or claiming benefits.

In Shropshire, there are thirteen practices currently accepting children. Seven practices are currently accepting adults eligible for free NHS dental care. This includes patients who are pregnant, or are claiming benefits.

In addition, there are dental access centres (DACs) in Shrewsbury, Oswestry, Whitchurch, Market Drayton, Bridgnorth, Ludlow, Craven Arms and Telford. Patients do not need to be registered to receive treatment in a DAC.

No separate figures for elderly patients, unemployed patients, or patients with disabilities are available.

Mr. Hancock

To ask the Secretary of State for Health if he will make a statement on NHS dentistry, with particular reference to(a) Portsmouth and (b) the rest of Hampshire. [114863]

Mr. Lammy

I refer the hon. Member to the response I gave my hon. Friend, the Member for Burnley (Peter Pike) today, at columns 964–66W.

I recognise that the access to routine national health service dental in Southern Hampshire and the Isle of Wight remains difficult. Access is particularly difficult in Fareham and Gosport, East Hampshire and Southampton City primary care trusts.

Five dental practices in Portsmouth City PCT are currently accepting new NHS patients for registration, although all have waiting lists.

Arrangements are in place across Hampshire to ensure that patients with an urgent need for treatment can be seen within 24 hours. The PCT helpline staff can make an appointment the same day, or within 24 hours, for such patients in either a dental access centre, or with one of a number of general dental practitioners who have contracted with the PCT to provide a number of urgent appointments.

Three out-of-hours emergency dental service facilities operate in Hampshire.

It is anticipated that with the local commissioning of primary dental services proposed in the Bill currently before Parliament, PCTs would be better placed to address local access issues as they arise.

Mr. Hoban

To ask the Secretary of State for Health what plans he has to provide additional resources to primary care trusts for commissioning dental care under the proposals set out in the Health and Social Care (Community Health and Standards) Bill. [114522]

Mr. Lammy

Subject to Parliament, funding will be allocated to primary care trusts as part of each PCT's general allocation.

The exact allocations are yet to be determined.

Mr. Gordon Prentice

To ask the Secretary of State for Health how many dentists have been recruited from(a) within the EU and (b) other countries to work in NHS dentistry since 2000. [113548]

Mr. Lammy

Information on the number of dentists who joined the general dental service, by country of qualification, in the years 2000–02 in England and Wales, is shown in the table.

Year ending 31 December 2000 2001
EU (not including UK) 230 197
UK 670 693
Other Countries 198 172


Excludes dentists whose status is currently shown as Statutory Exam or Awaiting Entry