1. Will the First Minister provide an update on access to dental services in South Wales West? OQ58287

Llywydd, 99 per cent of NHS dental contract value in Swansea Bay University Health Board and 88 per cent in Cwm Taf Morgannwg University Health Board will now be undertaken by practices that have opted in to dental contract reform. Working under reform principles creates capacity for new patients to access NHS dental care.

I'm grateful to the First Minister for his answer, but I can't exactly say I share his optimism about the dental industry here in Wales. The most obvious example that we're facing a crisis in dentistry is the sheer number of questions that you and the health Minister have faced from Members in recent months on the subject. My colleague Sam Rowlands asked you about the situation in north Wales last week, and, unfortunately, it's an issue prevalent in my region too. Broadlands Dental Surgery in Bridgend has now terminated its contract with the NHS via the health board, citing problems with the way the NHS dental contracts are structured. The health board have said they'll try and find patients a new NHS dentist, but, in reality, given the current the situation, we know it means they'll be added to a waiting list, which is often years long. And instead, patients are being encouraged to take up often expensive private dental cover just to keep the level of service they enjoyed before. So, with dental waiting lists getting longer, fewer and fewer dentists offering places for NHS patients, and a third fewer dental treatments taking place compared to a decade ago, First Minister, one thing is quite clear: you're privatising dentistry in Wales by the back door. First Minister, when will your Government get a grip on the crisis in dentistry in Wales, and what action are you taking to fix it right now?

Llywydd, part of the premise of that question is nonsensical, and the Member knew it when he said it, as well. The contract reform, as we have explained many, many times on the floor of the Senedd, was an optional matter. It was for practices to decide whether or not to opt into it. The vast majority of practices have done so; a small minority have decided to make other arrangements. That was always available to them, as I have had to explain several times now to Conservative Members of the Senedd. 

The truth of the matter is, Llywydd, that, up until the time of the pandemic, the number of dentists carrying out NHS activity in Wales rose every year—rose every year—from 2014-15 to 2018-19, and our ambition is to make sure that there is NHS dentistry available to everybody who wishes to take it up. However, as the Member will know, dentists are contracting professionals. They choose whether or not to take up work on behalf of the NHS. When they choose not to, in that small minority of cases who have made that decision, the money is not lost to NHS dentistry; the money remains in the system. The money remains so that other practices, or new entrants into dentistry, are able to carry out work on behalf of the NHS.

Our estimates for contract reform in the area covered by the Member are that it will create 16,000 extra NHS places, as a minimum, in the Cwm Taf Morgannwg University Health Board area, and 17,000 extra, as a minimum, NHS patient places in Swansea bay. That's why dental reform and contract reform has been such a priority for this Government. 

First Minister, there has been a lot of goodwill in NHS dentistry for a really long time. Having talked to dentists in Bridgend, and the British Dental Association, unfortunately, it is the case that, with the new contracts, NHS practices are seeing lots of new patients and need to reach high targets of patients. Practices have to cover the cost of treatment due to the level of care needed and time taken to facilitate. This has meant that, essentially, dentists can be working for free. With the cost-of-living crisis, how many of us can afford to do that on a long-term basis? So, staff are leaving practices, and the knock-on effect is that practices cannot reach their targets of seeing new patients, and therefore, sometimes, they are being financially penalised. You have dentists working incredibly hard through the backlog of COVID patients, with costs going up, and there is a lack of goodwill flexibility available with the contracts, I've been told. I know this is being investigated by the Senedd health committee, and I very much welcome their work on this. First Minister, what action is the Welsh Government taking to support dental services with the impact of coronavirus and the backlog of care that is impacting their workload? Also, is there a way of prioritising dental care for children?

Llywydd, let me give the Member an assurance that no dentist in Wales is working for free. Dentists, on average, earn somewhere between £70,000 and £100,000 a year, depending on the nature of their contract. And while I agree very much with what Sarah Murphy said about the commitment that dentists in Wales have shown during the coronavirus period, they are remunerated, and fairly remunerated, for the work that they do.

The point that the Member raised about the impact of coronavirus, Llywydd, is an important one. On 1 June, the Chief Dental Officer was able to write to dental practices across Wales, de-escalating some of the infection prevention and control measures that dentists have had to implement because of coronavirus. Unfortunately, because of the current rapid rise in the number of people falling ill from the virus, and the even greater transmissibility of the latest variants of omicron, that is a position we will have to keep very carefully under review. Coronavirus has not gone away, Llywydd. Thousands of people in Wales are falling ill with the virus. We have 1,500 people who work in the health service not in work today because they have fallen ill with COVID-19, and we have another 600 people beyond that who are self-isolating because they are in contact with someone who's had the virus. That's over 2 per cent of the entire workforce of the NHS who are unable to be doing all the other things we ask them to do simply because of the continuing impact of coronavirus here in Wales. And aerosol-generating procedures, which is what dentistry relies on so much, are amongst the most challenging procedures for the transmission of the virus. So, I very much welcome all the actions that dental practices have taken, the extra help they've had through the Welsh Government to improve ventilation in those practices, but there's no doubt at all, and no Member in this Chamber should be in any doubt at all, that the operating environment in dentistry, and right across the Welsh NHS, remains very challenging because of the impact that coronavirus is having.