My Lords, I commend my noble friend Lord Hunt for such a thorough analysis and for bringing this debate before your Lordships’ House this evening. As ever, he brings his expertise, knowledge and incisive approach to this important subject: the provision, or lack of provision, of dentistry.
As we have heard, we have seen a quarter of the budget cut since 2010 and with dentistry, a complete failure to provide a proper service to the population of this country. We know that dentists suffer burnout and that there is difficulty in retaining and recruiting the dentists that we need, while insufficient numbers are in training. This is a toxic mix. We also know that even under the existing budget, even if it was utilised fully, funding is available to provide NHS dental services for only around half the population. We find ourselves in considerable difficulty.
Let us remind ourselves about this statutory instrument. It was drawn to the special attention of the House by the Joint Committee on Statutory Instruments in its report because the regulations are
“defectively drafted in two related respects.”
To look at the specifics of those, as the noble Lord, Lord Allan, also raised, I ask the Minister why it was not felt necessary in respect of primary dental service agreement changes to give a timeframe for dental practice profiles to be provided for the NHS website. Does this not, as the Joint Committee on Statutory Instruments criticised, insert a somewhat unacceptable level of uncertainty into the statute book? I look forward to the Minister’s comments on that point. Furthermore, in respect of the criticisms of this statutory instrument, can the Minister say why NHS England has received no steer within this as to what a “reasonable timeframe” is to take action against non-compliant contractors, which the JCSI concludes
“leaves this law unacceptably uncertain”?
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To pick up a point of process which I have raised several times before, I can only say to the Minister that it is a great shame that we are once again taking part in a debate on a DHSC regret Motion. The SI scrutiny committees of both Houses have certainly had their work cut out with the department, having been presented repeatedly with regulations that have required comments of the type that I am sure the Minister would rather not be seeing.
In the last exchange we had in your Lordships’ House regarding a regret Motion laid in the name of my noble friend Lord Davies of Brixton, I asked the Minister to investigate what action could be taken within his department to stem the flow of regret Motions, but just this week we find that we have two, one night after another. Perhaps the Minister can say whether he has been able to take me up on that suggestion and what progress has been made.
The Government’s Explanatory Memorandum references the consultation that they did with the British Dental Association and others. It says that respondents agreed that changes were not positive. Could the Minister unpick what that means? Does it mean that there was a mixed response? Does it mean, if I may use a double negative, that there were no negative responses? In any case, perhaps the Minister can share the responses with your Lordships’ House.
As my noble friend Lord Hunt said earlier, we are debating one element of a package that was announced by the Chief Dental Officer and which was designed to improve access. I hope that the Minister will address the questions posed by my noble friend Lord Hunt, because three parts of the announcement require further comment.
The first point is around the adherence to existing NICE guidance on the recall interval between check-ups. As my noble friend said, this is something that we might be used to but it is not evidence-based, and we should be reviewing recall intervals to establish whether there is a way of freeing up services. Secondly, we need to look at giving DCPs the ability to open up courses of NHS treatment. That is a significant change and should be acknowledged positively but, as my noble friend said, there are considerable obstacles to address. I hope that the Minister will do so today. The third point is the introduction of new bands. This will be welcomed by dentists but the impact on access, and who gets that access, is entirely unclear and unpredictable. It may result in more treatment being provided, but to whom will that treatment go and how accessible will it be? Perhaps the Minister can indicate what assessment has been made of what improvement, or otherwise, that will make to accessibility.
Lastly, I want to say a word on workforce. There is a lack of data about the dental workforce to inform any clear plan, which we continue to be promised. For example, the registers of the General Dental Council list only dental practitioners and not whether they are practising. There must be meaningful data available to provide a starting point for the workforce strategy that the NHS dental service so desperately needs. Can the Minister advise your Lordships’ House on how that proper data will be made available?
I am sure that the Minister will refer to the increase in funding that was committed some months ago to help NHS dentistry fund appointments over and above existing hours. The difficulty here is that, because of issues with the system—including practices struggling to meet contracted hours, the intervention coming at the end of the NHS financial year, and omicron—only 28% of that funding has been deployed, according to the British Dental Association. Can the Minister comment on that and on how the funding may be properly deployed to make a difference?
I hope that the Minister can address all these points, because I am afraid that NHS dentistry in this country is going in the wrong direction. We need to see it provided so that people can be assured of their health in all ways.