Diolch yn fawr, Dirprwy Lywydd. The oral health response to 'A Healthier Wales' set out how oral health and dental services in Wales would continue to develop in line with the changing needs of the population. Our vision for dentistry builds on the philosophy of prudent healthcare and fully recognises that system change is required. Dentistry has been one of the more difficult services to recover following the COVID-19 pandemic and this explains, in part, why people experience difficulty accessing NHS dental care. But dental reform is progressing at pace, and I’d like to take the opportunity today to set out how this Government is increasing access to NHS dental care for those that most need it.

I turn first to access for people who have not been able to get a place at an NHS dental practice. I have heard statements recently saying that NHS dentistry is now a two- or three-tiered system. The fact is that there has always been a private dental system, available to those who choose to use it and can afford it. Private healthcare is an established alternative, and whilst we might aspire to provide NHS dental care for everyone, in reality some will prefer to go private, creating a divided market.

Access for people who have not regularly attended the dentist has always been a problem since registration was removed with the inception of the UDA contract in 2006. We have recognised that this is a problem, and have implemented a contract variation for this year, which has been adopted by 80 per cent of Welsh dental practices, with a requirement to give access to new patients. Around 140,000 new patients have now been seen since April 2022, significantly more than we had anticipated. So, we are not presiding over the creation of a tiered system. Instead, we are actively increasing access for the people that were excluded under the previous UDA contract model. We recognise there is more to do, and we will continue with this approach in the next financial year.

There are claims that this change has meant that people who have visited the dentist regularly are being disadvantaged as they can no longer get their twice-yearly check-ups. Members will be interested to know that the NICE guidelines published in 2004—18 years ago—recommended that people with healthy mouths could safely go as long as 24 months between check-ups. The unit of dental activity contract does nothing to enforce these guidelines, and effectively rewards dental practices for seeing patients more often than they need to. Again, this is being addressed through the variation offer, where practices are now remunerated for seeing patients based on a patient's individual risk and needs basis.

Fundamentally, we need to reimagine NHS dental services along that risk and needs-based approach, using our much-strained financial resource to provide care and treatment for those that need it most. And that's why we're doing a reform of the dental contract. It's a fundamental change for both patients and the dental profession, where we can, and will, do more to ensure that the change is acceptable and understood by all.

Another narrative circulating is that many, many dentists are handing back their contracts and turning to private dentistry only. There are some examples of this, but the reality is that there were 413 contracts in operation on 1 April 2022, and during this year, fewer than 20 have been handed back, for reasons such as retirement, practice sale or to go private. In monetary terms, this equates to around 3 per cent of annual expenditure on GDS. It’s important to remember that this funding is not lost but remains with the health board for it to consider how best to replace the services lost. I realise it can be disconcerting for patients when a practice closes or turns to private only, but I can assure them that those services will be replaced. But there will inevitably be a gap in provision during reprocurement. It's encouraging that the vast majority of contract handbacks, particularly the larger ones, are being successfully recommissioned, so this shows that there's an appetite for dentists to take on new NHS dental contracts.