Poorly Briefed, New Minister Struggles with Dental Questions
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- Published: Friday, 08 December 2023 10:06
- Written by Peter Ingle
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Since she was appointed Secretary of State for Health and Social Care, Victoria Atkins, has not had much to say about dentistry.
In a recent interview with Sky News she said of the NHS that: “It is also unique because of the very fact that our care is free at the point of use. And that will continue for as long as I’m alive." Despite this bold claim, she survived to answer questions in the House of Commons a few days later, when Dental Services were amongst the topics debated.
Her performance suggested that after three weeks in her post, the Minister has yet to read the recent Health and Social Care Committee report on Dentistry, and seems woefully misinformed regarding the condition of the dental budget’s ring fence. She is continuing with her departments approach that when all else fails, the public should try calling NHS 111.
There were two questions for the minister.Kim Johnson (Liverpool, Riverside) (Lab) asked: “What steps she is taking to improve the commissioning of primary care dental services for vulnerable people.”
Victoria Atkins replied: “I want to reform our NHS and social care system to make it faster, simpler and fairer. Dentistry is a critical part of that.” She then proceeded to explain that it was up to ICB’s to identify local needs and priorities for investment. She referred to the NHS England guidance published in October to help them use “their commissioning flexibilities within the national dental contractual framework.”
Kim Johnson then asked her supplementary question, starting by saying that she was glad that the Minister had mentioned ICBs. Liverpool has a high percentage of children with dental decay, and extractions are the most common hospital procedure for five to nine-year-olds at the Alder Hey Children’s Hospital. Despite this, there had been a £10 million underspend for primary care dentistry. She said that rather than reallocating it to fund extra preventive care, NHS England had given permission to all ICBs, including her local one, to use the money to balance their budgets. Would the Minister agree, she asked, “here and now, to reinstate the ringfenced funding to commission extra capacity for the most vulnerable patients? The Minister replied that NHS England had provided guidance for ICBs which required dental funding to be ringfenced, and any unused resources redirected to improve NHS dental access in the first instance.
This would appear to be contradicted by recent reports, with the BDA saying that they believe that senior officials have given Integrated Care Boards (ICB) permission to use dental clawback money to help cover deficits in other parts of the NHS. GDPUK.com - Ring Fence Blown Over
Kim Johnson, no doubt aware of this, was not satisfied that the Minister had given a credible reply. She began to say, “But the underspend is not being used on dentistry—” and was promptly cut off by the Deputy Speaker, saying, “No, no—you do not get another supplementary question” and sparing the Minister an awkward explanation.
With the MP who had asked the other question absent, the Deputy Speaker then called the Chairman of the Health and Social Care Committee. Steve Brine (Winchester) (Con) moved proceedings to familiar territory with his statement; “The Government previously committed to publishing a dental recovery plan, which the former dental Minister, my hon. Friend the Member for Harborough (Neil O’Brien), said that the Government would publish shortly. He also told my Committee:
“We do want everyone who needs one to be able to access an NHS dentist”.
We were surprised, but he said it. We were told that the plan would be published during the summer or before the summer recess. When will the plan be published, if that is still the intention? Presumably it will come alongside the response to our “Dental Services” report, which was due on 14 September.”
In her reply Victoria Atkins referred to the, “very important dental report that his Committee published”. She would be ”looking through it that afternoon and would be publishing the response and sending it to the Committee imminently. In relation to the dental plan, both the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), and I are looking carefully into the needs of communities in rural and coastal areas, as well as in more urban areas, to understand not just the need but the answers that we can provide to help with urgent care and, importantly, preventive care, particularly for our children and vulnerable people in our society".
At this point Justin Madders (Ellesmere Port and Neston) (Lab) spoke, revealing that the previous week another dentist in his constituency had told patients that they were no longer able to provide NHS services. There was nowhere else to go nearby. He then returned to the underspend, saying that he had attended a meeting with the local ICB and been specifically told that the ringfence was being disapplied. “Does the Secretary of State agree that that money should be spent on dental services and that that instruction should be given by her today?” he concluded.
The Mnister’s response was brief, if not reassuring: “I agree, and that is why NHS England has provided guidance, as I set out earlier.”
Derek Thomas (St Ives) (Con) said that, while Cornwall ICB had committed to ringfencing money for dentistry next year, the truth was that, before it took on that commitment, £4.5 million for unmet units of dental activity had been returned to NHS England. “What can the Secretary of State do to ensure that Cornwall gets the money that was intended for Cornwall to deliver NHS dentistry?” he asked.
Victoria Atkins responded: “A theme is emerging of underspend in dental work, which is one of the things that the ministerial team and I are looking at. NHS England emphasised in its guidance to ICBs that the funding should be ringfenced. I very much understand the pressures that my hon. Friend and other south-west Members have been raising over many months on the care that their constituents are getting. To ease pressures in the south-west, NHS England has commissioned additional urgent dental care appointments that people can access through NHS 111.”
The Shadow Minister of State, Abena Oppong-Asare (Erith and Thamesmead) (Lab), spoke next,recalling that the Prime Minister had pledged to restore NHS dentistry, including a specific promise to protect its budget. Then last month, “we learned that he will break that promise and allow ICBs to raid dentistry budgets to fill the gaps.” She then outlined Labours plans to help NHS dentistry. She finished, saying that: “We have a plan, but the Government’s plan is four months overdue. Where is it?”.
Victoria Atkins reply was limited to saying that she looked forward “to discussing these matters with her over the despatch box.” She then went on to some political point scoring and finished by reminding her opposite number of Mrs Thatcher’s comment that, “The problem with socialism is that at some point you run out of other people’s money.” Somewhat ironic, since one of the problems for her departments dental delivery, demonstrated in the debate, is that it does not even appear to know what its own money being spent on.
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