HC Deb 08 March 1922 vol 151 cc1433-48
Mr. SEDDON

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 want to say, in passing, that I joined the hon. Member for Wood Green (Mr. G. Locker-Lampson) in protesting against a five-guinea charge. It is an imposition and not a registration fee. I have reliable authority for doubting whether the medical or any other profession ask for such an imposition as five guineas for all time as far as these applicants are concerned. Therefore, while I entirely agree with and am prepared to support the hon. Member for Wood Green, I want to raise another issue which, I think, is of vital importance to very many men. The numbers I cannot give, but many hundreds of ex-service men who belong to this particular profession answered the call of their country, and their absence from the country during the years of war has, under this. Act and the Regulations that have been drawn up, given rise to a very serious grievance so far as their position is concerned. But I am not going to make any charge against the rival organisations that are in existence for the unregistered men. There are two societies that have been catering for this class of practitioner. One of them, by the consent of this House, was permitted to avoid certain conditions which were imposed upon other people who did not happen to belong to it. The Act provided that members of this particular Society, by virtue of 12 months' membership, should go on to the register, providing their character was of proper standing. Without making any attack on the society, I want to say that its charter made it impossible for it to take in more than 2,000 members. It is estimated there were some 10,000 unregistered dentists in the country who would make application for registration, and therefore if the society could only take in 2,000, there were 8,000 who were precluded from joining it. Where it hits the ex-service man is in this way. A man might belong to the society and go on to the register by virtue of his 12 months' membership. But the larger number who did not belong to it were asked to undertake an examination, and had inflicted upon them certain disabilities. Therefore there was created a certain privileged section of unregistered men as against another section of unregistered ex-service men who did not belong to the society. During the War it was made easy for medical practitioners and dentists to get on the register. There was a skeleton examination.

Lieut.-Colonel RAW

No.

Captain ELLIOT

That is a grave accusation to make.

Mr. SEDDON

I withdraw the statement. I want to point out there was not a supply of dentists sufficient for the requirements of the Army. In Egypt, for instance, one registered dentist was in charge of 4,000 troops. It was physically impossible for that dentist to carry out his duties for the men under his charge. What happened? He discovered that amongst the men serving there were dentists who were not registered, and he called them to his assistance, made them sergeants and corporals, and they gave efficient service under the superintendence of that registered man. According to this new Dental Board, that service cannot count at all; it is supposed to be unofficial service. I speak as a member of the Committee that dealt with this Bill, and that Committee, as the hon. and gallant Member who took exception to my remark just now, and who was on the Committee, will agree was unanimous that, so far as the ex-service man was concerned, there should be a consideration, even latitude, and a little elasticity on the question of registration. The position now is that, unless a man belongs to this particular society, the Board have laid down certain stringent regulations. They say that he must give proof of considerable practice before he entered the Army. In fact they go so far as to say that his pre-War service and his post-War service must be of the same duration, namely, five years, as in the case of the unregistered man who is making application to be put on the register. The man who belongs to the particular society I have mentioned, by mere virtue of his membership of that society, goes on to the register ipso facto, whereas the other men who do not belong to that society must give the same evidence of five years' dental practice before the War and since the War as the other people who will come under this Act. The greater number of ex-service men do not belong to this society. If these men, who were permitted to serve the troops, which they did, although it was done unofficially—if these men who went to serve their country are to be so treated, while other men who stayed at home are going to be put on by virtue of lapse of time, then these Regulations will inflict a grievous hardship on the men who did their duty to their country, and will give preferential treatment to the men who stayed at home.

I may be told that the action of the Dental Board is for the purpose of safeguarding the public. I am all in favour of the public being safeguarded against men who are, I will not say untrained, but who lack experience; but I have here a document which shows that a man who was not in practice before 1919, and who belongs to a particular society, is going, because of that membership, to be placed upon the register ipso facto, whereas others who do not belong to that society are to have an examination imposed upon them. I think that is grossly unfair. We have got short memories. We said men who went to the war should get every consideration. With these new Regulations the vast majority of ex-service men, who cannot give proofs—and it is not always easy to do it—are going to be put in a position which is not only detrimental to themselves, but is a breach of faith so far as the country is concerned with the men who went to serve the country in its hour of trial. All I ask the Minister of Health to do is to withdraw these Regulations and see to it that not merely membership of an organisation is going to be the talisman to go upon the register. We ask for equality of treatment for ex-service men irrespective of the organisations they belong to, and if that is done, I am convinced that a grave injustice to hundreds of ex-service men will be removed and the Government will be relieved from the responsibility which has been put upon their shoulders by the new Dental Board which has been set up. My only concern is that we should fulfil our pledges, with due regard to the protection of the public. If a man has been in practice, irrespective of the society he belongs to, since 1919, surely it is some indication that he had practised before he served in the Army. Do not let us penalise men, simply because of membership of a society, who did their duty in our hour of need.

Captain LOSEBY

I beg to second the Motion.

It is well known that the most influential ex-service men's organisation feel very strongly upon this point, and they think, rightly or wrongly, that they have been differentiated against, and to a certain degree, at any rate, penalised through their service, and they sincerely hope this prayer will be met in order that they may make their representation in due course. I believe the country hardly realises the extent to which professional and semi-professional men who served during the years 1914–19 have been penalised through that service as opposed to men who did not undergo those sacrifices, and I am quite convinced that when the right hon. Gentleman realises that it is after all only a small point that is asked of him, that these Regulations should be withdrawn in order that these representations, which I believe he will find are very weighty representations, may be made, he will accede to it.

Mr. RAFFAN

I should not have intervened in regard to the main point which my hon. Friend is bringing before the House had he not been diverted from his main argument to make something like an attack on the manner in which the Dental Board has dealt with members of the Incorporated Dental Society. As to his main thesis, that in considering what Regulations should have been submitted to the Dental Board he should have special regard to the position of ex-service men. I am in entire agreement with him and as a matter of fact not only was it the opinion of the Committee of this House which considered the Bill that that should have been done but there is express provision in the Bill that it should be done. I have no doubt the Chairman of the Board will be able to explain in what way the Board has given consideration to that provision in the Act. I shall be quite content to wait for that explanation. So far I am in entire agreement with my hon. Friend that it is a proper point for him to raise, but when he says that men have been differentiated against because they are not members of the Incorporated Dental Society I do think that he should have regard to what has happened in regard to the whole history of this matter. The Departmental Committee which inquired into the question, and whose recommendations were carried into effect, came to the conclusion that members of the Incorporated Dental Society, in accordance with the rules of that Society, were all people who conformed to the rule as to five years' practice which the Act called upon other people to prove. Therefore they made a recommendation that it would be a saving of time if instead of investigating whether each member of that Society had had the necessary five years' practice to qualify, they assumed that members of the Society had had the five years' practice, which they were bound to have under the rules of the Society. That recommendation was given effect when the Act was formed.

It is true that in Committee upstairs my hon. Friend endeavoured to secure, not that the members of the society should cease to occupy that position, but that other organisations should be placed in the same position. His resolution, if adopted, would have left out of consideration a large number of ex-service men who are members of no organisation. The Committee upstairs after carefully considering the matter decided by a majority of 26 votes to six that the Departmental Committee had been perfectly right in the recommendation which they had made that members of the Incorporated Dental Society should be in a different position from the members of other organisations. The Chairman of the Dental Board, who has been Chairman of the Departmental Committee, said: This is one of the most difficult questions we have to face. It was not without much consideration that the Departmental Committee came to the unanimous conclusion that the Incorporated Dental Society do stand on a very different basis of claim from that occupied by any other Society. He also pointed out that the Incorporated Dental Society was the only society that years before this Bill was thought of really tried to afford the unregistered dentists assistance by means of lectures, demonstrations and laboratories to render them proficient in their profession. In view of these considerations it was decided that members of that society should be in a better position than others, and it was felt that evidence had been submitted which showed that those members already conformed to the conditions laid down. For that reason I think my hon. Friend has introduced matter which is extraneous.

Mr. SEDDON

I studiously avoided any attack, but I have here a letter, and this is the gravamen of my charge. This is the case of a young man who started a surgery in 1919. I have his history before that. He is a member of the Incorporated Society, and I maintain that according to the Act as it stands, this young man, as a member of the Incorporated Society, will come on the register ipso facto.

Mr. RAFFAN

If my hon. Friend and those associated with him had evidence of that kind, the proper place to bring it forward was before the Departmental Commitee.

Mr. SEDDON

I had not got it then.

Mr. RAFFAN

Apparently it is a solitary case. [HON. MEMBERS: "No."] This matter was fully considered by the Departmental Committee. If my hon. Friend or those associated with him had any evidence of this kind, they had full opportunity of bringing it forward. There was further opportunity of bringing any cases of this kind before the Committee upstairs, but no charge of this kind was brought. We hear of this thing for the first time when it is impossible to test it in any way whatever. But the whole point is that my hon. Friend is not now making an attack on the Regulations but on the Act of Parliament, and he is endeavouring by moving an Address as to Orders in Council to secure a verdict which he failed to get upstairs when the Bill was passing through Committee. I submit that that is something which he is not entitled to do. I regret it all the more because it docs not appear to me to be relevant to his main ease. I should regret if it were found necessary to hold up these Regulations because that is bound to cause delay. The Regulations when considered have again to come here and lie upon the Table of this House for 21 days. This will lead to a considerable amount of delay. Therefore if the point which my hon. Friend raises can be met in any way without a revision of the Regulations I should very much prefer it as I have no doubt he would. With regard to that I await the statement which my right hon. Friend the Member for Lamborne (Mr. Acland), the Chairman of the Board, will make. I have intervened not in the main ease of my hon. Friend but to clear up one view which has been put forward.

Mr. ACLAND

In reference to the instance referred to by my hon. Friend the Member for Hanley (Mr. Seddon), I can assure him that this gentleman will not get on the register if the particulars given in this letter be true, because in that letter it is stated that the person concerned is under the age required by the Act. Therefore, whether he is a member of the Incorporated Dental Society or not he will fail on the matter of age, and there is no grievance at all. With regard to the main point, if there is one, having disposed of that particular question, I think that I, as chairman of the Dental Board, ought to say something so that the House may know exactly what the Board has done in reference to these ex-service men. I think that my hon. Friend is incompletely informed on the matter. There has been bad staff work somewhere. He is no doubt in quite an honourable position as Parliamentary agent of the rival society, the National Dental Association, and is no doubt in touch with the secretary of that society. The secretary of that society knows what we have done with regard to ex-service men, and knows certainly that the Board has not decided at present to refuse to register one single ex-service man who has the qualifications. On the contrary, the guiding principle on which we have made up our minds is this.

The Act says that persons admitted to the register ought to have practised for five out of the last seven years. It asks the Board to take special thought and care with regard to ex-service men, provided hey are satisfied these men can safely practise on the public. The Act clearly contemplated that there should be some continuity of practice, but that where, owing to War service, that continuity has been broken, allowances should be made. Therefore the first Resolution we came to was that if a man had practised for five years in all, even though that period might have been interrupted by his War service, and he might not, therefore, be so up to date in his practice as he other wise would be—if he had practised for five years, partly before and partly after War service, even if it were not in the last seven years, he should be admitted automatically. Where he has not completed a period of five years, partly before and partly after War service, and there is no proof that he has done any genuine dental work, during the War—

Mr. SEDDON

I have a letter from the Registrar, stating that practice during the War is unofficial and should not be taken into acount.

Mr. ACLAND

I am coming to that. Where an ex-service man has not completed five years' practice, we must have regard to the question of whether or not he is qualified to practise on the public. After all, we are giving him a life inclusion in the register, and must be certain he is fit to practise. Unless the question of his having practised dentistry during the War arises, we think it right that he should submit himself to one of the examinations which we are bound to hold with regard to other classes of persons, and which will be held in different centres in England, Ireland, and Scotland. To that examination we ask him to submit without the payment of any fee. The arrangements for examinations in dentistry are very expensive, but we only ask these men who have not completed the five years' period to let us have the reports of the examiners upon them, and they are free to enter the examination with no fee at all. That seems to be our duty, having regard to the instructions given to the Board under the Act, that they are to have regard to the fitness of these men to practise.

With regard to the actual practice of the profession during the War, the difficulties are very great. I, as chairman of the Board, was faced with 40 or 50 cases of men who claimed to have practised during the War. Most of them simply said that they treated men of their squadron for toothache in cases of need, or something of that sort. It merely meant that they were carrying their forceps with them and making a half-crown when anybody wanted a tooth taken out. That is not the practice of the profession of dentistry in any high sense Having to decide between all the varying cases, from the case of the man who just carried his forceps to the case of the man who was, in some way or other, officially approved as a dentist, we came to the conclusion that unless there was some genuine evidence that a man had some official engagement as a dentist during the War, we could not account the period of War service as being an equivalent—not an equivalent, but as a ground for excusing him from what we regard as the normal course with "under five-year" men, namely, that we should have the report of some competent person upon their technical ability before they are admitted to the register and practically endowed in the profession. We realise that one of the most difficult things we have to do is to decide what is evidence of such practice during the War as can be regarded as equivalent to practice outside the War. Up to the present, not one single applicant of any kind has been refused, and there are, in fact, several dozens of cases to be decided at the next meeting of the Registration Committee on that matter. I must put) this point to the House—that the I annulling of these Regulations would have no effect on that matter at all. In the Regulations there is nothing with which ex-service men have to comply, and, therefore, to annul the Regulations would annul nothing concerning the ex-service men.

Mr. SEDDON

The memorandum.

Mr. ACLAND

There is the last Minute of the Board laying down the preliminary conditions. The Regulations contain nothing as to what line the Board shall take with regard to these ex-service men, because every case has got to be dealt with on its merits, and the furthest we have gone yet is to lay down certain preliminary conditions, which are not at all ungenerous to the ex-service men, but which shall guide the Board. Apart from that, we have not turned down a single case of an ex-service man. That being so, I think the House ought to believe that the Board is going to carry out its duty with every possible consideration for those ex-service men who can in any way be brought within the general policy of safety to the public, and leave these matters of detail to the Board itself. So far as we have drawn Regulations for our own guidance, they have all been in favour of the ex-service men, and I do not think it a hardship to the ex-service men that they should have to submit themselves to a practical test. It will be a very simple examination. I have conferred with our examination committee and they, say they will have every disposition, if there be anything like a decent standard of ability shown, to let these men in. All admit that the country owes them a debt, and ought to help them in their profession in every possible way.

My hon. Friend came, first of all, with a particular case, which was not a case of a man who would be let on the Register at all under our Regulations; and, secondly, he made a statement that there was a differentiation between the Incorporated Dental Society and other persons, and that other persons would have to submit to an examination, which, as he knows, is entirely outside the facts. The main bulk of other persons do not have to submit to examination at all, but come on as persons who have been in practice for five years. He tried to make out that there was an examination for those who were not members of the Incorporated Society. I think he, as a definite Parliamentary agent of a society, ought to have informed himself better as to the facts before making an attack on a rival society in this matter. With regard to the ex-service men, I hope I have convinced the House that no hardship upon them has been intended or inflicted from one part of the United Kingdom to the other.

Mr. N. MACLEAN

The right hon. Gentleman who has just sat down has confined his remarks to the ex-service men's position under the Act. May I ask him if he has anything to say with regard to the recurring annual charge?

Mr. ACLAND

I regarded this as a fresh Debate. As I was saying the other night, we have asked for that money for the purpose for which the Act says we are to use it, namely, education and research, and the training of people so as to help them in their profession in the future. We knew it was rather a heavy fee, but not so much as solicitors have to pay annually, and for which they get no advantage. I agree that doctors pay nothing, but the State has managed to set aside an amount for education and medical research. The State at present gives no money for dental research. We are in the Act practically instructed to provide that money, but we admit frankly that we have started with rather high fees. These are fees lower than solicitors and barristers pay. If hon. Members say -that dentistry is not a learned profession, then I agree with their argument, but we have, to get money for dental education and research, and are practically instructed to do so under the Act. We knew quite well, and admit, that the fee is high, but we think that if we find after a few years that we have enough money to give sufficient help to education and scholarships, it may well be possible to reduce the fee from £5 to £3, or even to £2. We are instructed under the Act, however, to accumulate a sum capable of use for education and scholarship.

There has not been a single protest from a dentist. Not one has come to the Board, to the Privy Council Office, or to the Ministry of Health, and I think it extraordinarily ungracious if any dentist has made a complaint—which I do not believe to be the case, considering the amazing benefits this is conferring on them in putting them on the Register, although they have not gone through the training the men on the Register have—of having to put aside a little money in future years to help other people against whom the doors are shut, and who can only be put on the Register by being given the training provided for here.

The MINISTER of HEALTH (Sir Alfred Mond)

When this Act was established a Dental Board was appointed by the House. That Board represented all sections of the profession, and was appointed for the very object of preventing the time of the House being occupied with detailed discussions such as we have heard to-night, upon which discussions Members are quite incapable of forming an opinion without a great deal of work and research. These squabbles we had in the Committee upstairs when the Bill was going through, of the character that the hon. Member for Hanley (Mr. Seddon) brought out tonight, are not subjects which ought to take up the time of the House, particularly at this hour of the night. The whole object of the Dental Board was that it should have reserved to it the dealing with Regulations which had been carefully considered by my Department and by the Privy Council. [HON. MEMBERS: "Then why lay them on the Table?"] We lay them on the Table in order that they may be considered. The Regulations had nothing to do with the hon. Gentleman's speech. I have no complaint from any organisation or dentist about the Regulations. The hon. Member himself never gave me any notice that he was going to raise this question. I have had no representations from any ex-service men's organisation at all.

Mr. SEDDON

I have.

Sir A. MOND

I say I have not. I contend that some notice should be given to responsible Ministers that a matter of this sort is going to be raised so that they may have the opportunity to inquire into it.

Mr. SEDDON

It is on the Paper.

Sir A. MOND

All that is on the Paper is a Motion to the effect that the Act and the Dental Board are futile and useless. I have had no notice of the point the hon. Gentleman was going to raise, and I have had no complaint from any organisation of ex-service men on the point he has raised. I only wish to add a few words regarding the fee. The fee is fixed at present at £5 a year. I cannot understand why £5 is looked upon as a colossal demand to make on a dentist. A dentist's practice is a fairly lucrative business, so far as I understand it, and £5 is not in itself an abnormal sum. But I will say this. An organisation that is just started has got to provide itself with certain office accommodation, and the Board were authorised by the, Act to raise funds for the purpose of dental education. The question of dental education is of particular interest to hon. Members who represent the Labour party. It is particularly to their interest that there should be a possibility of providing funds in order to enable the educational facilities which are required to replenish our dental service, so that members of all classes can enter this profession, and entry to the profession shall not become exclusively the privilege of better class people who can afford to pay for the education to enable them to become dentists. This fund is to be raised to enable the Board to give educational facilities to the very people whom, I should have thought, my hon. Friend wanted to enter the dental profession. [An HON. MEMBER: "What is the income?"] Between £35,000 and £40,000. It is to provide funds for dental research, dental education, scholarships and examinations. Naturally and rightly this organisation wants to have some office. I do not say it will be necessary or advisable to continue this amount for a number of years, and I should say that a couple of years would be a reasonable time to have it brought under review. In a couple of years I think the matter should be reconsidered, and it will very probably then be found that a lower fee will foe required. I hope the Dental Board will not hesitate to use its income for the purpose for which it is meant. I trust, with this explanation, the House will agree to these Rules going through, so that the very important work of the Dental Board and the registration of dentists may proceed.

12.0 M.

Mr. ACLAND: May I just say that if I am still Chairman, and I think I can also say, on behalf of the Board, that we will most cordially take up that suggestion of the Minister of Health, and bring the matter up for consideration after two years to see whether there are sufficient funds to enable the fees to be reduced.

Mr. SEDDON

I am sorry that the right hon. Gentleman has complained that I did not go to him and that he had no representation made to him. I may tell him that the British Legion are very, very keen on this question and feel very strongly, and if no representation has been made it is not their fault—it is my fault; I apologise to the right hon. Gentleman for not going to him. After his statement and the Chairman, that these ex-service men will be given that elasticity and consideration that their service warrants, I do not wish to Divide the House.

Motion, by leave, withdrawn.

The remaining Orders were read, and postponed.

It being after half-past Eleven of the Clock upon Wednesday evening, Mr. SPEAKER adjourned the House, without Question put, pursuant to the Standing Order.

Adjourned at One Minute after Twelve o'Clock.