Part of the debate – in the Senedd at 4:45 pm on 14 March 2023.
I thank the Minister for her statement today. Quite early on in your statement, Minister, you talked about the fact that you've heard some people saying that there is now a two or three-tiered system. Well, I'm one of those people who have made that comment, and we've made that comment in our report from the Health and Social Care Committee. I'm just wondering whether you've perhaps misunderstood, or what is behind that statement. And you also say that, in reality, some people will prefer to go private, creating a market divide. I would suggest—and I want to check if you think this is fair—that it's not so much that people prefer to go private, it's that people have to go private, because there's no other alternative for them because they can't access an NHS dentist.
So, perhaps just to gauge your assessment on that, but perhaps to explain the three-tiered system from my perspective. Some people can access an NHS dentist; some people will go private, but there'll be some people who can't afford an NHS dentist and they cannot also access an NHS dentist either. Therefore, there is a potential three-tiered system. So, I just want to ask: do you recognise what is meant by a potential three-tiered system?
I think, today, if you don't answer all my questions, answer this one: from a patient's perspective, when will we get to a position where every person in Wales, every resident in Wales, will be able to access an NHS dentist without having to make up to a three-hour round trip? Because that's what we once had; when I first got elected, that's what we had. But when will we get to that position? Give us a date when that will be achieved by, so I can answer constituents who raise these issues with me.
Now, the British Dental Association have warned that the very concept of NHS dentistry could cease to exist, and they have warned that dentists have described being on the brink of handing back NHS contracts due to stress and concerns about patients' aftercare. That's not me saying that—that's the British Dental Association. And they said in their—. The chair of the British Dental Association wrote to me shortly before the statement was originally scheduled, and what he said, quite frankly, startled me. What he said then was, or what they said, was that the messages have been deeply buried whenever Government answers are given to questions in the Senedd Plenary debates, and that the tone of the Government's replies have been growing noticeably colder towards dentists over the last year. So, I think my question is: why do you think, Minister, that you have alienated a key stakeholder and representative group like this? You no doubt disagree with what they say—perhaps you can tell us that—but tell me why you think that there's been such a divide with the BDA. How many times have you met with the BDA, it'd be interesting to know, since you've come into post? And, how do you respond to their claims, backed up by testimony as well—testimony that I've also heard myself—that the reforms make NHS dentistry a financial risk for professionals?
Now, it is, of course, totally understandable from my perspective, Minister, that you want to orientate policy towards widening access to patients—that's what we all want; I agree with that, of course. And, after all, we are in a position in Wales where we have the least accessible dentistry in the UK. But the BDA's recent survey of high-street dentists tells us that more than a third would reduce their NHS contracts this year, while 13 per cent said that they would hand back their contracts entirely. Now, to finish, I've heard what you've said, Minister; you've talked about it being a very different picture, and about relatively few contracts being handed back. And you’ve talked about there being an appetite for dentists to obtain new NHS contracts, but that doesn’t feel like reality to me, because in my own health board area—not only in my own constituency, but in the entirety of Powys—not one dentist offers entry for a new NHS patient. My colleague Sam Rowlands has done similar research in north Wales. So, what you’re saying in your statement today doesn’t match reality, and I want to try and understand why that is.
Finally, perhaps you could give us an initial assessment of some of the recommendations and the work and report from the Health and Social Care Committee as well. I’m hoping to extract some initial views on the work of our committee.