4. What assessment has the Minister made of the provision of dentists in mid Wales? OQ58168

Well, a follow-up from the last question. Certainly, the health boards are responsible for the planning and assessment of dental provision to meet the local population needs. The Welsh Government is working on reforming the dental contract to focus on prevention and needs-based treatment in order to create more access for new NHS patients.

Thank you for your answer, Minister. I've been raising in this Chamber for years and years and years the issue of my constituents not being able to access a local NHS dentist. Now, this was well before the pandemic started, okay—well before the pandemic started. What my constituents tell me now is that, if they contact an NHS dentist, they get put on a waiting list, which they get told could be up to three years, or they get offered a dentist and it could be a two-hour round trip to the nearest dentist because we don't have the transport provision available to accommodate that. Can I say, Minister—and I heard your answer to Laura Anne Jones in terms of more dentists now being available—that this is the information I've got: there are 83 fewer dentists now than there were at the beginning of the pandemic? You've talked about the new contract, but, when I speak to dentists, they tell me something very different: they tell me that new contract is actually not helpful because it takes the focus away from regular check-ups, it makes dentists choose between old and new patients, it pays dentists based on out-of-date performance data, and is also funded by a falling amount—in fact, 15 per cent less than it was six years ago. So, can I ask you, do you agree with me that there is a genuine capacity issue in people being able to access or register with an NHS dentist? And what more are you going to do and are the Welsh Government going to do, to ensure that, in two years' time, I'm not standing here again asking when my constituents can get an NHS local dentist?

Thanks, Russell. I would accept that there is currently a capacity issue, and that's why I'm spending quite a lot of my time now trying to address this very issue. We are making steady progress with the recovery of dental services. And whilst I accept that it wasn't fantastic before the pandemic, the pandemic has certainly made things considerably worse, and we're still a long way from being 100 per cent of what we were doing pre pandemic. So, those are restrictions that are beyond a politician's control. And we've got to understand that we have to ensure that people are safe when they are having that treatment.

Now, 89 per cent of the contract value will be operating under that new dental reform principle, and what will happen as a result of that, for example in Powys, is that we will see access for around 5,000 new people to be able to come onto the NHS to be able to see an NHS dentist. I think one of the differences is that if you look at what the National Institute for Health and Care Excellence proposes in this space—and what we've all been conditioned to believe over the years is that you've got to go for a check-up every six months, but NICE is no longer saying that; it's not me—NICE is saying that, actually, it depends on how healthy your teeth are. So, you shouldn't necessarily need to go for a check-up every six months. Now, it's not me, as I say; this is clinical experts saying that, actually, we've spent a lot of money and a lot of time on sending people for a check-up who didn't necessarily need it, and people who did need to get a check-up who couldn't get a check-up at all because they couldn't get access are left out completely. And that's one of the reasons why we've gone for the reform of the contract as we have.

Minister, it is teeth again. Like many in this Siambr, you'll know that I have repeatedly raised the issue of access to dentistry in mid and west Wales over the last year. I am grateful to you for the funding to support an additional dentist in Llandrindod Wells, although, sadly, there have been no expressions of interest in the role since February.

I understand, Minister, that part of the solution may be increasing the availability of dental therapists and nurses. I understand that dental therapists, for example, can complete fillings in children and single fillings in adults. So, I wondered, Minister, what steps you may be taking to increase the training of more dental therapists and nurses to help us in mid and west Wales. And do you have any targets or thresholds that would signal a point of improvement for patients? Diolch yn fawr iawn.

Thanks, Jane, and thanks for your continued focus on this issue. It's certainly keeping my feet to the fire. I'm pleased to say that this new contract will, as I say, hopefully see 5,000 additional people who currently can't get access to NHS dentists in Powys getting access, and 13,000 people in the Hywel Dda area.

So, we have put money on the table, but, as you note, money is not going to fix this alone. We put £2 million on the table last year and there's recurrent funding of £2 million, but, actually, what we're seeing is that dentists just don't want to pick it up, they don't want to play. And so, you're absolutely right that what we need to do is to think around new ways of doing things, and that's why we are very focused on using dental therapists in the way that you suggest. This is certainly something that I've raised with all of the health boards in my annual appraisals with them—something that I raised just this week with the chair of the Powys health board. Certainly, one of the things that we are seeing, for example, is an increase of 74 places in the foundation training of dental places. So, things are improving, but what I'm trying to do is to see if we can push a lot further on those people who are able to do a lot of the work that dentists have been doing in the past.