Rosie says her farewells

The woman responsible for introducing the most far-reaching dental reforms in 50 years has left her job insisting that the new NHS contract ‘is working’.

Rosie Winterton ended her four-year period as Health Minister adamant that the controversial changes she helped put in place in April 2006 are making it easier for patients to get an appointment.

In her final Parliamentary appearance before being moved to the Department of Transport by new Prime Minister Gordon Brown, Ms Winterton said half a million extra patients would soon be able to see an NHS dentist.

But, echoing Tony Blair’s recent admission that he had failed to guarantee an NHS appointment to everyone who wanted one, she admitted access difficulties were ‘far from’ resolved. The minister said: ‘Since April last year, primary care trusts have commissioned a growing volume of new dental services. Once those services are fully up and running, approximately 500,000 patients will gain access to NHS dentistry.’

Opposition MPs remained unconvinced. Liberal Democrat MP Lorely Burt pointed out the number of adults seen by an NHS dentist had fallen by 63,000 in the past 12 months and called for an urgent review of the system.

She said: ‘The latest figures show that 45% of the population have not seen a dentist in the past 24 months – a figure that has remained stable over time. How can the Secretary of State claim that the new contract has increased access to NHS dentistry?’

Fellow Liberal Democrat MP Tom Brake said: ‘In the past couple of months, I have had 7,000 health survey responses returned to me, and 70% of respondents said that getting access to an NHS dentist was extremely difficult. Furthermore, according to an orthodontist I met yesterday, the situation will get worse when the contracts expire in 2009 and ring-fenced funding disappears.’

Ms Winterton responded: ‘We know that the number of units of dental activity commissioned has increased from 77 million last April to 78 million. Some of them are yet to be provided, but they have been commissioned. We know that NHS dentistry is expanding, and that the new contract is working.’

She continued: ‘I am not saying that the situation has been fully resolved – far from it. What I am saying is that the new dental contract is proving that we can increase access to NHS dentistry. If an NHS dentist leaves the NHS, we now have the money at local level to recommission NHS dentistry. That is the difference between the old contract and the new one – now, local people have power to recommission at local level.’

Ms Winterton, responding to claims that primary care trusts were failing to provide enough dentists, insisted the trusts were not allowed to divert money allocated to dentistry to other services. She said: ‘We work closely with the PCTs, through the strategic health authorities, to make sure that if an NHS dentist leaves the NHS, the PCT recommissions at the local level.’

Conservative MP Sir Paul Beresford challenged the government’s optimistic outlook and said: ‘People outside the House in NHS dentistry do not quite recognise the glorious oil painting that the minister just painted.’ Sir Paul asked whether any changes had been made to the contract due to work done by the implementation review group, or whether the group, made up of professional and patient representatives, was just ‘a sop to keep the dentists quiet’? Ms Winterton said the group was ‘a way of keeping an open dialogue about any difficulties that occur’.

Ms Winterton’s successor is yet to be officially confirmed, however Whitehall sources said Ann Keen was heavy favourite to take on the dentistry portfolio.

Ms Keen, Labour MP for Brentford and Isleworth, was one of five ministers appointed to the DoH under new Health Secretary Alan Johnson. Prior to her appointment, she served as Gordon Brown’s Parliamentary aide. Ms Keen has been appointed Parliamentary Under Secretary of State – a more junior position than that of her predecessor, with Ms Winterton being Minister of State.

Shortly after her appointment to the DoH, Ms Keen delivered a strong defence of the government’s reforms. Hailing the increased investment and expansion of training places, she told a Westminster debate: ‘There have been solid achievements in the first year of the new system. There is, of course, still much work to do, including building up trust in the contracts and in working relationships.

‘Nevertheless, investment is growing, the local NHS is commissioning a steadily increasing volume of dentistry, and the numbers of NHS dentists are back on an upward track. The government is committed to working with the NHS and the profession to build further on that progress.’

She added: ‘I agree that more progress needs to be made. There are still difficulties in obtaining access to services in some areas of the country… I will be talking to patient groups, dentists and the NHS to consider how we can achieve further progress.’


By Andy Tate, parliamentary correspondent

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