4. Will the First Minister make a statement on the reduction in the number of practising dentists in the NHS in South Wales West? OQ57739

Llywydd, a reduction in the number of NHS dentists in South Wales West is primarily due to the effect of boundary changes on data reporting. Brexit and the COVID pandemic have also reduced the overall level of dental activity and that too is reflected in these figures.

Diolch. The health board with the highest percentage reduction in NHS dentists was Swansea Bay University Health Board, which serves residents in my region, with 22 per cent fewer dentists in 2021, compared to the previous year. The effect of the pandemic and boundary changes may partly be responsible for this situation, but the fall in NHS dentists is a long-standing trend, and the British Dental Association believes that unhappiness with NHS dental contracts is a key factor.

The health Minister has admitted in her reply to my letter on this matter that there will be delays for new patients seeking regular care, but constituents who are registered patients are telling me that they are being turned away if they don't need emergency treatment; hundreds of people who have been affected by this crisis have contacted me—hundreds of them—one mother in Gorseinon saying, 'I have a three-year-old who is yet to have his first-ever visit to a dentist. Every time I call, they say they're only able to see emergencies.' Other patients report of having better treatment in the private sector, some NHS patients even being told that they'll be seen if they pay.

Does the First Minister agree with me this is completely unacceptable, and with regular dental care being vital in preventing oral health problems from occurring in the first place, what is the Government doing to address this scandal that is seeing patients, including children, having to face significant delays, or, in many cases, being turned away entirely?

Well, Llywydd, let me begin by just correcting the record on one important thing that the Member said in the beginning, when she suggested that the reduction in the number of dentists in Wales was part of a long-term trend. In fact, the number of dentists providing NHS care in Wales rose every year between 2006-07 and 2018-19, and, in 2018-19, the number of dentists carrying out NHS work in Wales went above 1,500 for the first time. So, actually, the long-term trend is exactly the opposite to the one that the Member suggested.

The downturn in the numbers in the last couple of years is, particularly in the Swansea bay area, most explained—not partially explained—it is most explained by the changes in the boundaries, because the health board that saw the largest increase in the number of dentists is the health board that gained the Bridgend area of the previous health board. That's why the numbers went down in the way they did; there was a whole chunk of the health board that was no longer in the health board.

But the important points—the important points—are the ones the Member made in the second part of her contribution, because, of course, we want to see a recovery and growth in the ability of the dental profession in Wales to provide for more people than it is able to at the moment. The pandemic continues to have a bigger impact on dentistry than on any other part of the NHS, because those aerosol-generating procedures continue to mean that dentists are not able to see the volume of patients that they were able to in less challenging circumstances.

'How will we tackle that?' the Member asks, and it's a perfectly proper question. Well, here are three ways. First of all, as we emerge from the pandemic, we will be working with the profession so that they can safely see more patients within their premises. The Welsh Government has provided significant investment to dentists, for example, to improving ventilation in dental premises so they can see more patients safely.

Secondly, we will introduce contract reform, beginning, again, in earnest in April of this year. We will offer dentists a choice. Members of the British Dental Association will have a choice. They will be able to opt for the new contract, the better contract in my mind, because it will mean that dentists use their skills to the maximum extent and don't do as much routine and repetitive work as has been in the past in order to earn the incomes that they do, but those who prefer to continue to have their practices based on units of dental activity will be able to opt for that as well. I believe the contract reform will be in the long-term interests of the profession and of patients.

And then the third way, Llywydd, that we will address the need to increase the supply of NHS dentistry in Wales is to liberalise the profession. We need to make sure that there is a wider skill mix, that we don't have dentists who are very highly trained and very expensively trained doing work that does not require the level of skill that the dentist possesses. And the dental profession, if I'm being frank about it, has been the slowest of the primary care professions to move in that direction. There are ways in which we will be able to invest in the training of hygienists and therapists who perfectly clinically competently, under the supervision of a dentist, are able to do more work today than they do in most parts of Wales, and that will allow us to have a different sort of service here in Wales in the future.