4. What discussions has the Minister had with the Minister for Health and Social Services with regards to the future funding of dental services? OAQ54875

I have regular discussions with the Minister for Health and Social Services about a range of financial matters within his portfolio, including issues that impact on the provision of dental services.

Minister, in response to the Health, Social Care and Sport Committee's inquiry into dentistry in Wales, the Welsh Government failed to commit a single penny of new investment. The British Dental Association has stated that:

'The crisis facing NHS dentistry in Wales won't be solved with a few warm words'.

Their words, not mine. Therefore, what discussions are you having with the health Minister to ensure that the necessary contract reforms and additional recruitment in dentists are supported by sufficient and additional funding?

I've had a number of discussions with the health Minister with regard to the contract reform and with regard to the issues facing dentistry across Wales, because I know this is an issue that comes up frequently in the Assembly. We've acknowledged that the current contractual system does need reform, and that's something that we are absolutely getting on with, and significant changes are already being made and those changes are being welcomed by dental teams.

We've said we want to see the number of practices participating in the reform programme expanding further, and we do expect now to see over half of practices being part of the programme by October 2020. Currently, there are 132, so that's around 30 per cent of dental practices currently taking part.

Obviously, there are workforce and retention issues that we're seeking to address as well. Part of that is through the training programmes that we're putting in place. There are year-on-year increases now in the number of dentists providing NHS care in Wales, but we recognise recruitment and retention is a particular issue, and particularly so in some parts of Wales—north Wales, mid Wales and west Wales, particularly—and it is causing some difficulty in terms of filling vacancies.

But, I can confirm that Health Education and Improvement Wales are now looking at the commissioning of training numbers, training and education packages to develop the workforce, and considering whether there are more effective workforce models to deliver services that could improve dentists' workloads and help make practices more sustainable and the career more attractive.

That was interesting to hear, really, but these contract reforms have been going on in terms of pilots, or general progress, for about three or four years now. Bearing in mind that the change in the contract was about helping people become better at taking care of their own oral health, I would have thought that there might have been a reduced need for Welsh Government spending, not just due to fewer unnecessary appointments, but also fewer treatments for preventable damage.

In 2015-16, the old-style dental care and oral healthcare programmes cost Welsh Government £137 million plus the £33 million revenue from patient charges, which is 2.14 per cent of the NHS spending total. How does that compare now with the spend under this revised contract and what evidence did you get from the Minister to justify the changes?

This year, we're providing over £146 million to the Welsh NHS for the provision of primary care dental services. We are seeing increased use of dental services, which is a good thing. So, the latest published data shows that 1.7 million people were regularly accessing NHS primary care dentistry, and that's 42,000 more people than was the case five years before the latest figures. We now have over 1,500 dentists working in the NHS in Wales compared to 1,439 back in 2014, so we are gradually seeing an increase in the number of dentists, but also a corresponding increase in the number of patients accessing those services.

It is understandable that many care home residents have poor dental health when they first move into care, as they often move into care due to deteriorating health and lack of mobility. As dental access for children is at an all-time high, and, as you know, I speak very regularly about how good Designed to Smile is, does the Minister agree with me that it's fantastic news for older people that the A Lasting Smile programme budget will double next year, ensuring that the scheme reaches all care homes across Wales?

I thank Mike Hedges for raising that particular, important issue and for his constant support for Designed to Smile. I remember in the finance scrutiny session just recently, he was able to cite that as one of the excellent examples of really, truly preventative spend that we do have in Wales. I think it's only right that we seek to focus our efforts to improve the dental and oral health of older people who are living in care homes, so I'm delighted that the Minister for Health and Social Services announced an additional £0.25 million to extend that Gwên am Byth—A Lasting Smile oral health programme into the next year, and we're doubling the available funding for that now to ensure that it's rolled out to every single care home in Wales during 2020.