Access to Dental Services: West Sussex

I beg to move, That this House has considered access to dental services in West Sussex. It is a pleasure to serve under your chairmanship, Sir Desmond, to have secured this debate—on Sussex Day, no less; I am confident that the Minister will have some excellent responses on behalf of all constituents in Sussex—and to have the opportunity to lay out the impact of the historic failings within the dental contract before the Minister. The state of access to NHS dental services across the country is utterly disgraceful. In Sussex, 63% of adults had not seen a dentist in the two years prior to June 2025. Similarly, four in 10 children had not seen a dentist during that time. Fourteen million people were unable to access NHS dental care in early 2025 across the UK. The result of people locked out of NHS dental services has been a rise in cases of DIY dentistry, with a survey earlier this year suggesting that 7% of UK adults had attempted some form of DIY dentistry. All that contributes to an alarming increase in hospital admissions for tooth-related issues. Tooth decay is now the most common reason for hospital admission among children aged between six and 10, with more than 100,000 children admitted to hospital with rotting teeth between 2018 and 2024. Those figures outline a dire situation that is only getting worse. Improvements in oral health are being wiped out, and tooth decay rates are at levels not seen since the 1990s.

I commend the hon. Lady on bringing this forward. She is absolutely right that there is a dental crisis not just in West Sussex, but across the whole United Kingdom. Some 14 million people cannot get an NHS dentist. Whenever I look back—and I am old enough to look back, at my age—I think that perhaps we should move back to the situation I can well remember in the past, when there were full-time NHS dental surgeries in community hospitals. They never let us down. Those positions must pay enough for dentists to be comfortable. Is that perhaps where we are going?

I thank the hon. Gentleman for his passionate advocacy for NHS dentistry in West Sussex. I am grateful to him for caring about access to NHS dentistry across the whole country. He is a fierce advocate for Strangford and makes the important point that the situation we are in is a damning indictment of the failure of the previous Government—a failure that the Prime Minister himself referred to regularly in the run-up to the general election. It was a stick that he used to beat the Conservative Government with in every televised debate, when he spoke about rotting teeth falling out of children’s mouths. We are still going backwards, dealing with problems on a scale not seen for generations, all at a time when the British Dental Association has warned that NHS dentistry is facing an existential threat. Parliament often hears the term “postcode lottery”, but I cannot think of a more applicable example than NHS dental services for residents in Chichester and West Sussex. Last week I had the opportunity to conduct a little bit of research with a staff member who has recently moved to London and needs to register with an NHS dentist. Within two miles of his new postcode in London, 10 surgeries were accepting NHS patients. Entering the postcode of my constituency office in Chichester into the NHS search tool produced a very different result: zero surgeries accepting new adult NHS patients within a 12-mile radius. There were none within the city itself, and only one surgery was accepting new patients under the age of 17. That means that residents not registered locally have to travel to other towns and cities. At the time of looking, the closest surgery was in Littlehampton in the constituency of the hon. Member for Bognor Regis and Littlehampton (Alison Griffiths). That is not close to the city of Chichester. I ask the Minister what his solution would be for people attempting to register locally, people living in the area already and people moving to it after years of increased mandated development in my constituency. I would like to share with the Minister a few examples of what this means for my constituents in Chichester, who very kindly got in touch with me to share their stories. Kathryn moved with her family to the area four years ago. She still travels to Three Bridges for dental care. Christine still returns to the Isle of Wight for treatment. Marina and Denise moved to Bracklesham in 2011—15 years ago—and have never been able to register for an NHS dentist locally. Jim contacted me to say that he undertakes a 140-mile round trip just to receive routine dental care.

I commend my hon. Friend on an excellent speech. Some of my residents still travel to their NHS dentist clinic in Nottinghamshire, which is a more than 500-mile round trip from Cornwall. Does my hon. Friend agree that Cornwall integrated care board needs to sort out its underspend? This year, there was a £1.2 million underspend that could have been invested in vital NHS dental services. I understand that West Sussex is a good example: it has managed to reinvest any underspend money on the services that my hon. Friend is talking about, which are so desperately needed in West Sussex and in Cornwall.

My hon. Friend makes an excellent point about his local ICB. The underspend issue has plagued the dentistry contract over many years. The ICB for Sussex did manage to commission more urgent dental care using its underspend, meaning that it had very little to give back to the Treasury. That was absolutely the right thing to do; I commend my hon. Friend for recognising that that is an opportunity that Cornwall ICB could take. However, the Sussex ICB invested in urgent dental care while not addressing the problem that we have in routine dental care. Residents in Chichester cannot access routine dental care in their own city and are forced to travel considerable distances. That takes time out of people’s lives, costs money, and creates additional risks. Imagine someone making that 140-mile round trip for a routine appointment, only to discover that they require an emergency procedure. They would be miles away from their home and family, and might not be capable of driving themselves home afterwards. That is completely unacceptable in today’s society. To make matters worse, a number of individuals told me that they had been removed from their surgery’s patient list, particularly during the pandemic when they did not want to be in close contact with others. They had no notification that that was happening. Others were informed out of the blue that their surgery was switching to private care and that, unless they paid, they would need to seek treatment elsewhere. Given the costs involved, as reflected in the national figures, many simply choose to go without care altogether. On top of that, individuals who have been lucky enough to secure an NHS place often face enormous waiting times for treatment. Jade shared her experience of being placed on a waiting list for routine root canal treatment and then being ignored for months. At 28-weeks pregnant, she suddenly found herself in excruciating pain and required emergency surgery. As we know, that costs the taxpayer a lot more than if the issue is addressed before it becomes an emergency. Another mother contacted me to say that three years ago her son developed an abscess over Christmas. They were unable to secure emergency treatment so they joined a waiting list at three separate practices. They still have not secured an appointment. Those examples all point to a broken system in Chichester and across the country—one that is failing my constituents and worsening health outcomes. In the long run, it is also making the country poorer: the failure to invest in preventive care means that individuals require more serious and expensive treatment further down the line. This has to end. That view is shared by the dentists I spoke to ahead of today’s debate. A key issue raised by them and many across the profession is the state of the NHS dental contract. The British Dental Association identified it as a major factor driving NHS dentists into the private sector. The current settlement has been widely criticised since its inception back in 2006. The Health and Social Care Committee published a report in 2023 calling for an urgent overhaul of the system, and the Labour party promised to renegotiate the contract in its manifesto. One former dental nurse who contacted me described the contracts as being like “tying dentists’ hands behind their backs.” That is hardly practical if they are trying to perform a root canal procedure. The contracts are failing patients because the number of patients a dentist can see on the NHS is limited according to the units of dental activity that they have been commissioned to deliver. The nurse I spoke to suggested patients are being referred to hospitals for routine procedures because contractual arrangements prevent practices from carrying them out themselves and being renumerated. The Government promised to reform the contracts, but they have been slow to address problems that are widely recognised across the sector. The consultation that the Government announced in April must lead to a contract that is genuinely patient-focused, with greater flexibility in commissioning. When it was announced, the Government committed to bringing out the consultation before the summer, but the official line has changed slightly to “in due course”. I share the concern raised by campaigners that any further delay will mean that a new system will not be implemented before the end of this Parliament. Will the Minister commit to bringing out the consultation before the summer and to a firm deadline for when formal contract renegotiations will begin? Frankly, we cannot afford any further delays. Another issue is costs. Lab costs went up 9% last year, but NHS contract holders got just a 3.55% uplift—add to that the hikes in national insurance contributions, which have exacerbated an already dismal situation. The British Dental Association believes that an average NHS dentist is losing £25 per routine dental check. Without support and changes to the contracts, many practices will continue to be pushed into the private sector, as we have already seen happen to many. In West Sussex, the number of dentists with NHS activity has dropped by 13% since 2019. I imagine that that figure is actually an underestimation, because a practice can offer just one NHS appointment a year and still feature on the list of NHS providers. Local dentists are also concerned that the merger of the Surrey and Sussex ICBs, alongside a 50% reduction in ICB running costs, could undermine the local commissioning expertise and local relationships with providers. Can the Minister today provide any reassurance that, at a time of significant change within our ICBs, they will be given the resource to maintain and improve relationships with contract providers? The Government talk a good game on dentistry, but they are tinkering around the edges and leaving major issues such as the contracts so far unresolved. They quietly dropped their manifesto pledge of delivering 700,000 more dental appointments, under the guise of broadening the definition of urgent dental appointments for clinical reasons. That is a sticking plaster that addresses the requirement for more urgent dental appointments, but does not address those who cannot get routine care, which in many cases would prevent them from needing the emergency care. The Liberal Democrats have long called for reforms that will address the root of the crisis. Our £750 million plan would begin to undo years of underfunding, guarantee urgent and emergency dental care for everyone who needed it, and hopefully bring an end to DIY dentistry. That would be needed to address the backlogs in emergency care. I have heard of wait times of up to 18 months at St Richard’s in Chichester for complex dental treatment such as difficult extractions. It is clear that the system is broken. Nobody is naive enough to believe that it can be addressed overnight, but the Government have had two years. All the while, residents in Chichester continue to have a lack of access to basic dental services. Dentists want to help patients, but it is not currently financially viable for many to stay in the NHS. That has to change, and I urge the Government to listen carefully to contributions from all Members in today’s debate, and take the steps that they promised in their manifesto.

It is a pleasure to serve under your chairmanship, Sir Desmond. I thank my hon. Friend the Member for Chichester (Jess Brown-Fuller) for shining a light on this important subject, which causes such distress for residents of West Sussex. The Department for Health, like many Government Departments, has promised a consultation, as well as extensive reform of the dental contract. I appreciate that the Minister wants to get this right. He has said that the dental system is complex. He has also made it clear in the past that these changes will not be rushed. Speaking to dentists across my constituency and beyond, very few people would say that taking two years just to start a consultation could be called rushing. The Government need to be clear with both dentists and patients. Dentists were told that the consultation would come last year; then they were told that it would come before the start of summer—but summer is more or less upon us, and we are still waiting. At this rate, the Government risk making no meaningful reforms to dentistry within this Parliament. This sense of political inertia is, of course, not confined to one Department, and we do not have to look far to imagine the reason for that. Alongside those delays sits an equally serious issue: funding. The Government have been clear that no new funding is available for dental reform; I imagine that the Minister himself finds that deeply frustrating. Only about 40% of adults are effectively provided for within the current NHS dental budget, and even that is propped up by an estimated £1 billion cross-subsidy from private provision. The Public Accounts Committee was clear in its assessment: without frontloaded investment, meaningful reform has no chance of success.