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Canvey Island (Southern Bypass)

10.18 pm

Bob Spink (Castle Point): The petition, signed by about 700 of my constituents, including Mr. Mark Dennis, who organised the petition and lives in Western esplanade, and by many illustrious fighters for the environment of Canvey Island, including Mrs. Eileen Gough and Edna Bowden, calls for the dropping of a proposal to build the Canvey Island southern bypass road. Many of the petitioners would agree that the resources that the road would require would be better applied to provide a third access road for Canvey Island.

In presenting the petition, it is my duty to inform the House that opinion on the matter on Canvey Island is mixed. The petition states:

To lie upon the Table.

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NHS Dentistry (South Somerset)

Motion made, and Question proposed, That this House do now adjourn.—[Dan Norris.]

10.19 pm

Mr. David Laws (Yeovil): I am very grateful to you, Mr. Speaker, for this opportunity to raise an issue of great importance in my constituency. It is one of the issues that has featured most in my postbag since the general election. Indeed, concerns about access to NHS dentistry in south Somerset were also raised consistently with my predecessor, Lord Ashdown.

Yeovil has a particular problem with access to NHS dentistry. At present, no dentists in the area are taking new adult NHS patients. That has been a problem not only in recent weeks and months, but since at least two years before the general election. It is shared by many other areas in the region and in the other part of south Somerset represented by my hon. Friend the Member for Somerton and Frome (Mr. Heath).

The issue can be encapsulated not only by the fact that no dentists in Yeovil are taking new adult NHS patients, but by the realisation that registrations of dental patients in Somerset have declined from about 69 per cent. of the adult population in 1993 to a low of just under 50 per cent. The level is now hovering around 50 per cent., which shows the great difficulty that many people in south Somerset are having in trying to get access to NHS dentistry.

That difficulty leads to a number of problems. First, the NHS dentists who are nearest to many of the towns in my constituency, such as Yeovil, Chard, Ilminster and Crewkerne, are based as much as 15 or 20 miles away. I am sure that the Under–Secretary of State for Health, the hon. Member for Salford (Ms Blears), will agree that that is a great distance to go to benefit from a basic health service such as dentistry. In a rural area, transport is a difficulty for many people, which creates greater pressures.

The second problem that is caused by the lack of access to NHS dentistry is that many people are forced to opt for private provision, which is obviously more expensive and is very difficult for many people in the area to afford. Some people have found that their NHS dentists have converted to private practice and insisted that any NHS patients who want to stay with them should go private, at great additional expense.

Thirdly, there are many people who fall out of access to dentistry altogether and therefore cannot get the attention and especially the preventive care that they would expect. Progress on that problem has been slow in the constituency, which is a matter of concern for me and my hon. Friends in the surrounding area. A couple of years ago, the Prime Minister made a welcome pledge to increase access to NHS dentistry so that everybody had it. However, the Government seem to have modified that pledge over the past couple of years, so that people have access to a telephone number and operator for information, but not a dentist in their area.

I think that people in the main towns of my constituency—Yeovil, Chard, Crewkerne and Ilminster—would have expected the Government's commitment to mean that they would be able to get access to an NHS dentist in their area. I raise that issue with the desire not

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to make a political point, but to emphasise to the Under-Secretary how great the problem is and to see whether we can find a way forward.

I have recently had the pleasure of formally opening the new NHS dental access centre in my constituency. Others have been opened in Chard and—I believe—in Taunton. That has to be a welcome development. It means that people who need emergency treatment can obtain it, which is obviously helpful for those particular individuals. The Under-Secretary will appreciate, however, that that does nothing to provide the on-going dental treatment that most people would want. I am sure that the Government wish to encourage such treatment, given their emphasis on preventive treatment not only in NHS dentistry but in all aspects of health care.

I hope that the Under-Secretary will agree that such treatment cannot be provided unless people see dentists regularly. Although I welcome the money that has been invested, it will not deal with the dental access problems in the constituency and the Government should not be encouraging it as the only solution. In some senses, it is a solution that treats failure but not the dental and other health problems that a proper system of NHS dentistry should tackle.

We appreciate that the problems are not new and that they go back to the reduction in fees for NHS dental treatment under a Conservative Administration. Access problems have therefore been prevalent for some time.

Anxiety also exists about the lack of trained dentists. More dentists going through our medical schools would help to tackle the shortage throughout the country. Local dentists and other health experts believe that the Government should deal with those two major problems if we are to make progress not only in south Somerset but throughout the country. We need more dentists and a revision of the fee structures that govern NHS treatments.

Much modernisation is required. Most dentists who have gone private in the past few years are resistant to transferring back to a national health service system in which their fees and ability to treat patients to a high level are significantly curtailed. It will be difficult to get many of them back into the NHS. We must therefore try to ensure that new dentists remain in it.

Such changes will take many years to effect, and people in Yeovil do not want to wait that long for action. They are not encouraged by the mere provision of access centres or Somerset health authority's commitment to stabilise registrations at the current level rather than increasing the proportion of people who are registered. I should like the same solutions that were applied in other parts of the country, such as north Devon, to be tried in Yeovil.

In north Devon, the health authority, the Government and private partners have worked together to attract dentists to the area and even used professional dentistry publications to draw attention to the gaps. However, we also need action to help dentists who want to establish practices in black hole areas where there is currently no provision.

There are major problems in identifying those areas and help for new dentists. Local newspapers such as the Yeovil Express and the Western Gazette have highlighted those issues, and many of those who recently wanted to set up practices in the area have been alerted to the problem only through that means. Dental practitioners whom my

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predecessor, Lord Ashdown, and I have tried to encourage to come to those areas in the past couple of years have looked to funding from Government schemes such as investing in dentistry and its successors to tackle the problems. The Minister knows how expensive it can be to set up a new practice. One has to secure appropriate property and much equipment as well as staff.

Information and financial support have been lacking. Perhaps the Minister recalls that, a couple of years ago, one of the investing in dentistry schemes had bids of approximately £1 million in the Somerset health authority area, but only around £80,000 was granted. There is a definite shortfall in assistance with the start-up costs.

I would not support endless subsidies on top of the ordinary payments that are made to NHS dentists, but it is important to give additional financial incentives to dentists who are moving to the black hole areas that we are considering. I hope that the Minister will say whether the Government propose to continue such schemes as investing in dentistry so that we can assist dentists to move to such areas.

My final point is not political. I accept that the Government are trying to tackle lack of access and to renew NHS dentistry after a period in which it has suffered. However, I am worried that the Government's ambitions, which the Prime Minister expressed, are not matched by the policy achievements and that some Government solutions, such as dental access centres, seem to provide only emergency and safety net treatment, which is better than nothing but not good enough for many of our constituents.

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