HC Deb 02 March 1922 vol 151 cc715-22

I beg to move, That an humble Address be presented to His Majesty praying that the Order in Council under the Dentists Act, 1921, dated the 16th day of January, 1922, approving Regulations of the Dental Board of the United Kingdom, presented on the 7th day of February, may be annulled. I should like to explain that the Dental Board of the United Kingdom is asking us to-night to pass Regulations which I believe will be very unjust and harsh upon all those dentists who come on the register in the future. The Dentists Act, 1921, permitted certain unregistered dentists to secure registration without having passed an examination, and the same Act set up a Board of 13 persons to take charge of the registration and generally look after the business of the registration. My complaint is that the Board under these Regulations is charging absurdly high fees. Under the old Act of 1878, which is still in force, the registration fee was £5, and the dentist paid that fee once and for all, and was not called upon to pay further fees in any year after that first year. But by the last Act, the Board has been given power to charge an annual fee for retention on the register, and under the Regulations which the Board have now laid on the Table they are going to charge dentists who come on the register in future, not only the £5 registration fee, but an annual retention fee of £5 in subsequent years. To my mind that is far too high. I should like to know what really is the reason for this differentiation, which is going to affect a large number of dentists all over the country. It is probably going to affect about 10,000 dentists during the next few months. At the present moment there are about 5,000 dentists on the register, and I believe that over 5,000 have joined since the Act was passed last year. They are coming on every day and every week, and therefore, at the figure of £5, you have already got 10,000 on the register, and the Board will receive an enormous sum within the next few months. Year after year that sum of money is going to increase, because as the dentists who came on the register under the old system die out, their places will be taken by new men, who will have to pay this retention fee of £5 annually. Very likely, in a few years' time, as others die off, there will be 20,000 dentists on the register, each of them paying this annual retention fee. That is to say, the Board will be getting from this item alone £100,000 a year. They will get about £50,000 in a very short time.

What I want to know is what really is the Board going to do with all this money? It works out at about £1,000 a week. Is their office going to cost this large sum of money? I should think, putting it at a high figure, that £10,000 a year is plenty in these days for an office of this kind. I should have thought another £10,000 would have been sufficient—say, £20,000 in all, which only works out at £2 per dentist. The Board is asking for a £5 fee every year.

That is not the only revenue that the Dental Board will get. First of all, they are making a pretty handsome profit on the sale of their regulations. I suppose to print a thing of this sort cost about 6d.; they charge 2s. 6d. for it. They have the copyright of it and every single dentist who comes on the register has to have a copy. That is not all. They have a fee of £1 for registering every degree obtained after examination. They have another fee of £1 if a man wants to be entered as a dental mechanic. There is still a whole list of fees, ranging from 2s. 6d. to £5. As a result of all these fees they will get a great deal more than the sum I have mentioned. If one of these dentists is one single day late in paying his retention fee of £5, he is immediately struck off the register, and if he wants to come in again he has to pay a fine of £5 and also pay his retention fee. I maintain that this provision will be a great hardship on the dental profession. This is all the more to be lamented because the Dental Board is really voting to itself a very handsome allowance, in addition to the fees. Each member of the Dental Board gets £5 5s. a day; he also gets extras if he is not residing in London. Every Scottish member of the Dental Board gets £16 16s., plus travelling expenses. I should have thought that very excessive. After all, many members of many professions are only too glad to help their profession gratuitously. It is not as though the hours are very long during which these gentlemen work. I find that the meetings of the Board only commence at 2 o'clock in the afternoon and end at 6 compulsorily under their regulations.

I find that the Board was only formed at the end of November. It met for the first time on 7th December. I have the minutes here of the meeting on 14th February. I find that in about three weeks' time the allowances paid to members of the Board reached £349 16s. 6d. They have also now taken the lease of a vacant piece of land north of the office of the General Medical Council and I suppose they propose to erect a very handsome office upon it. Is that necessary? I very much doubt it. At the present time the Board are sitting at Hallam Street, the headquarters of the General Medical Council. The same registrar works for both, so I should have thought it would have been the most convenient system to have them under the same roof. All this expense comes out of the fees which are going to be paid by these wretched dentists.

There is no argument whatever, for a huge fee like this. You do not have these big fees in the medical profession. When a doctor gets on to the Medical Register, he pays £5 1s. and that is all. He pays nothing in the way of retention fees, and all he has to do is to notify any change of address. If that is the case with doctors, I do not see why we should put dentists on an entirely different footing. I hope the right hon. Gentleman the Minister of Health will withdraw these Regulations, modify them on this point and bring them in again. In the Act we passed last year a special section was put in that these Regulations should be upon the Table for 21 days and that was to give the House an opportunity of reviewing the whole question. Therefore we are merely carrying out the intention of Parliament. I have done my beet to show why I think these Regulations should be withdrawn and modified. If the right hon. Gentleman does withdraw them, it does not invalidate any step taken up to this moment. If he withdraws them and brings them in again, everything the Board has done up to the moment remains absolutely good. I therefore ask the right hon. Gentleman to concede this point.


I beg to Second the Motion.


The right hon. Gentleman the Member for Camborne (Mr. Acland), the hon. Member for Leigh (Mr. Raffan), and myself and others have striven for five years to get this Dentists Act through, and we are anxious that at this moment its work shall not be suddenly stopped by the overlapping of these Regulations. I believe, as the matter stands, the law is that one Regulation alone cannot be objected to, but that all the Regulations must go if exception is taken to one by this House. That being so, I hope hon. Members will carefully consider whether in these circumstances it would be worth while to reject all these Regulations and leave the dental profession in a state of chaos for some time to come.


That is not proposed.


It takes time to do this, and it is well to see whether some via media cannot be achieved which may be satisfactory to all parties. Nobody likes less than myself a law of the Medes and Persians which cannot be altered, and if the regulation is unalterably fixed that a £5 fee is to be paid there may be a very large number of dentists some day, resulting in an enormous unnecessary income.

I see litle force in that because I think the idea is that the Dental Board should not accumulate a large capital sum, but should pay its expenses as it goes along out of the annual fees. Therefore it might not be necessary in the future to raise such a large sum as £5 per head from the dentists. Trouble then arises, however, in the matter of jurisdiction. If the Minister of Health had the power of bringing about a revision we should be safe in leaving it in his hands, or if the Privy Council could intervene then the matter would be extremely simple. Either the Minister or the Privy Council could say, "We find you have raised so much money; we think you have enough for your expenses and it is time you revised the fees and lowered them." I understand that the Minister of Health has little or no jurisdiction in the matter and that even the Privy Council itself cannot move after this Motion has once gone through the House. Then what are we to do? I had experience on a previous Bill, not very long ago, in which a similar state of affairs arose, and we got an honourable understanding between this scientific body and the Minister under whose jurisdiction it was generally—an understanding that he should be able to intervene at times and call upon them to revise their Regulations. If some sort of understanding of that kind could be achieved between my right hon. Friend the Member for Camborne, who is President of the Dental Board, and the Minister of Health, that whenever they had accumulated a certain sum of money, say, at the end of two or three years, he would promise to put down a Regulation again for the consideration of this House, then we should be perfectly satisfied, and the Regulations would go through to-night. To decide to-night that £5 is too much, without going into the facts, would be a wrong thing for the House to do. I leave the details as to how much money is required, and why the £5 has been put in, for the right hon. Gentleman the Member for Camborne to deal with.


I hope the House will let me, as Chairman of the Dental Board, intervene at this stage, and that it will excuse me if I have to go away without hearing the end of the Debate, as I must catch a train. I understand this Motion to be so worded that, if carried, the whole work of the Board would have to come to an end. It is not a Motion objecting to our scale of fees, but praying for the annulment of the Regulations, and it would not be possible for us to go on at all without the Regulations. That, I think, is the practical effect if the Motion is carried, and I am certain that there is not one dentist in a thousand who wants the work of the Board, which, under the Act of last year, has been very widely welcomed by the profession, to come to an end at all.

On the matter of fees, I am very glad to be able to give what I hope will be a clear explanation of the object of the Dental Board in fixing the fees at their present scale. We have undoubtedly fixed the maximum fee for the original entry on the register and for the annual practising fee that the Statute allows us to fix. The reason for that was not because we thought we should need the money for our own administration or for our own housing, or remuneration, or comfort. We must have premises, and if my hon. Friend who moved the Motion would do me the honour to visit 44, Hallam Street, where we are now housed, he would find such hopeless congestion in the offices of the General Medical Council that he would be the first to say, before he had gone five yards inside the door, that it was impossible to carry on without having fresh premises. We cannot indefinitely go on planking ourselves down in the offices of the General Medical Council, and everyone must agree, I am sure, that we must have offices for the Dental Board. As I say, it is not as if that sort of fee were needed at all, or ever would be needed for any matter connected with our administration. The core of the matter is that the Act itself, in a provision which my hon. Friend did not quote, says that the amount collected in these fees which is not needed for administration is to be allocated to purposes connected with dental education or research or any public purposes connected with the profession of dentistry.

It was purely because we had in mind the overwhelming necessity for getting funds for the encouragement of dental research and dental training that we have thought it right for the present to fix as high fees as those named. If hon. Members will realise even for a moment the fact, in the first place, that there are no funds whatever for dental education, research, and scholarships from which it is likely that any assistance will be got, and if, secondly, they will realise the very great necessity, from the point of view of public health, of being able to devote funds to dental training, scholarship, and research, they will, I think, realise what was in the mind of the Board in determining, as undoubtedly we did determine, to try to collect a reasonable amount of money for these educational purposes for the first few years, at any rate, until we saw where we were. There is no doubt what ever, as was pointed out by the Committee over which I had the honour to preside, that at the present time there are not enough dentists. There is no doubt that in future we shall not be able to get enough dentists unless we help their education and training, and provide scholarships for those to come to classes who cannot afford to pay the £300 or more which is now required to complete the course of dental training, if it is to be very thorough and very scientific. From the point of view of the improvement of public health in this nation, dental research and education of the highest class—

Notice taken that 40 Members were not present; House counted, and 40 Members not being present

The House was adjourned at Twenty-seven minutes after Eleven of the Clock till To-morrow (Friday).