CHILDREN'S TEETH

HC Deb 26 March 1962 vol 656 cc965-84

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Whitelaw.]

9.19 p.m.

Mr. John Howard (Southampton, Test)

At a time when the link between smoking and lung cancer is under scrutiny, it is perhaps appropriate that the House should consider the only other condition which is steadily winning the battle against modern science. I refer to the question of decay in children's teeth, and decay also in the teeth of adults. Caries, to give the technical name to decay of teeth, is widespread, and becomes more serious each year.

Undoubtedly, a large proportion of the population suffers from dental caries, and a very much larger proportion indeed than at any other time in our history. Unfortunately, and this is the subject of tonight's debate, a very large proportion of these people are children. This is an entirely preventable disease, and it is making Britons, including the children of Britain, the wearers of false teeth.

I will set out quite briefly the background to this debate, which I shall tell the House originated in Southampton. I was asked to meet local members of the dental profession, and these dentists were so concerned about the position and so convinced of the need to publicise the strong views they held on the scourge which they contend threatens to overwhelm the dental profession that not only did they give me an extremely good dinner, but also put on for my benefit a display of the most horrific slides. These slides were in colour, and they showed the distressing condition of children, many of them under the age of ten, who not only lost their first teeth from the ravages of caries, but whose second teeth were also irreparably damaged. The slides demonstrated that many children at the ages of 12 and 13 were condemned to wear dentures simply because at that tender age there was no treatment possible other than the extraction of a mouthful of decaying teeth.

In the opinion of the dentists of Southampton and district, the extent of dental caries is so great that the problem can only be tackled, with even a remote chance of success, if attention is concentrated on the teeth of children of school age and of children under that age. The information which I shall put before the House is not only confined to the opinions expressed to me in Southampton, for I have taken advantage of an opportunity provided for me to check the conclusions of this group of dentists, and the suggestions which they made for dealing with the problem, against certain other authoritative sources.

In the time at my disposal, I propose to say just a little about these subjects. First, I will refer briefly to caries and exactly what it is; secondly, I will assess the present problem and the position of the dental service; and, thirdly, I should like to suggest some possible lines on which my hon. Friend the Parliamentary Secretary could take action. Dealing with caries first, it is decay which is caused by eating carbo-hydrates—sweets and sugar. Sucking sweets is the principal cause of caries, particularly among children. The Guardian of 14th March drew attention to this problem in relation to smoking and, under the subheading "Sweets next?", analysed this problem, and I propose to quote from one paragraph: Sales of chocolate and sugar sweets climbed in 1961 to a record of £272 million, or just over £5 for every man, woman and child in the country, every one of whom, on average, ate half-a-pound a week. This only bears out the continual complaints of doctors and members of the school dental service about children who eat sweets so regularly that their teeth start rotting even before they start going to school. Munching sweets so that bits of sugar stick to the teeth with the best chance of causing decay is one thing in which Britain leads the world. Why?

Tonight I propose to say a little more about the problem so neatly summarised in that paragraph in the Guardian. Certain interesting conclusions can be reached from experiments, the maintenance of records in certain areas, and from reports of the school dental service. For example, sweets which are taken at meal times are not so harmful in causing decay as sweets which are taken in between meals, and toffees and caramels are associated with more decay than any other type of sweets. It is also clear that there is an increasing lack of oral hygiene. Although I realise that it is not competent to raise that matter on the Adjournment, it is odd that there should be Purchase Tax on toothpaste.

Children go to school eating sweets first thing in the morning and, no doubt, return sucking sweets in the afternoon if their pocket money holds out that long. The ubiquitous "lolly" must add millions of pounds a year to the nation's health bill. The present position is that the low standard of dental health education, coupled with the increased consumption of sweets, has resulted in the appalling state of children's mouths.

Children beginning school at five years of age have an average of five decayed teeth. As there are approximately one million children beginning school each year in England and Wales this means that 5 million fillings are required. A dentist certainly cannot fill anything like 4,000 teeth a year. Therefore, well over 1,000 dentists, roughly the whole complement of the school dental service, would be required to deal with the decayed teeth of the new school intake each year alone. This, of course, is quite apart from other duties and the care of the remaining children from the age of five to school-leaving age, which is also the responsibility of the school service.

The severe shortage of dentists in the school dental service has to be measured against what it is estimated a dental officer can do. I believe that my hon. Friend the Parliamentary Secretary to the Ministry of Education and his Ministry take the view that a dental officer can look after about 3,000 children successfully. This assumes that a number of the children do not report for treatment and that others are dealt with by the dental practitioners in the National Health Service, otherwise the figure which the dental profession prefers, of 1,000 to 2,000 children as a maximum, would be nearer the mark. In any event, if dental decay increases at the same rate the ratio of dentists to children obviously must be increased if we are to contain the ravages of caries.

The possibility of dealing with the problem through the school dental service can best be measured against examples which I have taken from official reports. The first example brings to light the appalling piece of information that in the last fifty years the average number of rotten teeth in five-year-olds in Birmingham has increased from 2.8 teeth per child to 4.6. In Manchester about 65 per cent. of the schoolchildren were suffering from dental caries when the last available report was published.

The lack of co-operation from parents is evidenced in another survey of 12-year-old schoolboys in Northamptonshire. This showed that 11 per cent. cleaned their teeth more than once a day, 39 per cent. brushed them once daily, 47 per cent. brushed them only occasionally, and 3 per cent. were honest enough to confess that they did not brush their teeth at all and never had done so. In Bedfordshire, the annual report of the school dental service revealed that one out of four children under five would need false teeth before they reached the age of twenty.

What is being done to remedy this state of affairs? I know that efforts are being made to increase the number of dentists, but inevitably progress is slow, and it does not necessarily benefit children if the number of dentists is increased because, if previous experience is any guide, the bulk of the extra dentists may go into general practice rather than into the school dental ser-vise. Another possibility is the fluoridation of water supplies. This is a particularly promising development, and I hope that it will be accelerated. Its wide extension would be a valuable addition to the public health services.

In addition, the wider use of auxiliaries might help. Dental auxiliaries are being trained now under the new scheme at New Cross. There are dental hygienists and dental surgery assistants available, and these are two very useful additions to the dental force in this country. But this is experimental. The results of the first course at New Cross have yet to be known and it may be necessary to revise the syllabus. We must, therefore, treat this experiment with reserve.

These efforts barely touch the problem which, as I have shown by the examples I have given, is immense. As a result of my conversations and inquiries, I think that there are certain possible solutions to the problem. One solution would be based on early and continuous treatment of children's teeth, the purpose being to enable a comprehensive school dental service to be maintained by lifting some of the load from it through, first, rearranging the scale of fees to induce dental practitioners to treat children and adolescents, and, secondly, by requiring dental students on qualifying to serve for a time in the school dental service. My hon. Friend may not like this suggestion, but I am one of those—I believe that there are many—who hold the view that when training fees have been paid by the public the young men and women concerned ought to make some contribution in return, not only in dental surgery but in other fields as well.

An experiment on this line could be applied to one area of the country, a test area, where we could see the outcome of a fully functioning school dental service. Such a service would involve, first, continuous dental health education, a campaign to make the facts well known; second, an adequately staffed school dental service with complete autonomy; third, fluoridation, and support from general dental practitioners.

Unless something on these lines is introduced, the only alternative will be to abandon the school dental service as a treatment agency. In its place, if it were abandoned, the family dentist, using, preferably, every form of ancillary help, could take care of all children from birth to adulthood. If such a policy decision could be made, a public health dental staff would have to be created at local authority level whose task would be similar to that of the local medical officers of health with whom they would work in parallel, not in the department of the medical officer of health as at present.

Treatment would become the responsibility of the dental practitioner and all aspects of dental health such as fluoridation dental health campaigns and such other measures as may be evolved would be the concern of the public dental health officer. It would also be his task to maintain a close liaison with the schools by using the dentists on his staff who would examine the children and refer them for treatment to one of the general dental practitioners in the area. Such a scheme, backed toy an extension of the dental health programme at teacher-training colleges and the interest, perhaps, of the parent-teacher associations, would make for closer liaison between dental health officers, the schools and parents.

I hope that my right hon. Friends the Ministers of Education and Health will give this suggestion consideration. If it were followed, it could result in this major assault on our teeth, health and pockets being first contained and finally defeated. We should have then made a major contribution to the health of the coming generations.

9.36 p.m.

The Parliamentary Secretary to the Ministry of Education (Mr. Kenneth Thompson)

I am sure that the House is grateful to my hon. Friend the Member for Southampton, Test (Mr. J. Howard) for drawing attention to this matter of very great seriousness and public importance. I am grateful to him for presenting the facts of the case in moderate terms. I do not dissent in any way from the words he used in describing the condition of the teeth of many of the children in this country. Nor do I dissent from his description of the causes which have led to that condition. It is undeniable that in recent years the condition of school children's teeth has deteriorated considerably. Dental caries among school children has spread at an alarming rate. It is probably true, and I think accepted by those who have studied the problem, that the condition arises mainly as one of the concomitants of the affluent society, in that children today have more money to spend and a wider choice of things on which to spend it. They regale themselves with large and unregulated quantities of sweets and succulents of one kind or another, including the ubiquitous "lolly".

I do not know whether it is seriously contended that it is possible to approach this problem by the sort of education in self-denial which would meet my hon. Friend's description of the cause of the trouble. Certainly—and I shall return to this in a few moments—dental health education has a very important part to play in bringing this scourge under control. However, we should be foolish to imagine that children will not continue to be children.

My right hon. Friend the Minister of Education is responsible for the school dental service. But we in the Department work in very close collaboration with the Minister of Health. The Parliamentary Secretary to the Ministry of Health is present, which signifies the responsibility which we share. The responsibility is also shared by the parents and children themselves, and I hope to show before I resume my seat how they fit into the pattern.

My right hon. Friend's responsibilities and powers are defined for him in the Education Act, 1944, and in the Education (Miscellaneous Provisions) Act, 1953. I want to assure the House that he has made and continues to make the greatest possible efforts to ensure that his duties are performed under the powers vested in him by those Acts. His duties devolve from him to the local education authority, and Regulation No. 3 of the School Health Service Regulations, 1959, requires local education authorities to provide comprehensive dental treatment for the children who are in their schools. This comprehensive dental treatment can be provided either by dentists employed directly by the local education authority or under arrangements made by agreement with the regional hospital board. The purpose of this requirement was to ensure that it would be impossible for authorities to meet their statutory obligations simply by referring all children requiring treatment to the general dental service.

In discharge of this duty, local education authorities are required to appoint a principal school dental officer and such other officers and staff as may be required to enable them to carry out this duty. In addition to these dental officers, they also employ dental surgical assistants, oral hygienists, dental technicians and anæsthetists. The principal school dental officer is responsible under the system to the principal school medical officer for organising, supervising and advising in the carrying out of the duties devolved to him. Dental officers are either employed as full-time officers of the authority or they work on a sessional basis as required and as they are willing to serve.

Having defined the duties which fall upon local authorities and having said what obligations they must discharge, I must point out that local education authorities come up against the first stark fact in their lives—that there is an overall shortage of dentists both in the school dental service and in the general dental service. Here I refer to my hon. Friend's proposal that the responsibilities might be shifted from one point to another. I remind him—as I am sure he recognises—that no amount of shifting of these duties will produce more dental officers and, therefore, more of what I understand is called chair-side time. I apologise if I am interrupting the conversation between the hon. Member for Loughborough (Mr. Cronin) and the hon. Member for Orpington (Mr. Lubbock).

Mr. John Cronin (Loughborough)

I hope that I did not give the hon. Member the impression of discourtesy. I was just saying to the hon. Member for Orpington (Mr. Lubbock) what an excellent speech the Parliamentary Secretary was making.

Mr. Thompson

I am prepared to forgive almost anything in those circumstances.

As I was saying, the service is faced with the stark fact that there is an overall shortage of dentists. This shortage affects not only this country but is a characteristic, I am advised, of all highly developed countries at present and is a worldwide condition.

My hon. Friend asked what steps we are taking to meet this admitted serious deficiency. The training and supply of dentists is a matter for my right hon. Friend the Minister of Health, and, as would be expected, he has been active in trying to effect an improvement. Steps are being taken and plans are in operation to increase the number of places in the dental training schools. From 1963, when the buildings have been completed and the courses organised, it is expected that the dental schools will be able to accommodate an additional 300 students, which represents an increase of about 50 per cent. on the present position. In addition, as my hon. Friend reminded the House, there is a scheme for dental auxiliaries to be trained under a two-year training scheme and for them to be employed either in local authority health services or in the hospitals. It is believed that this experiment may result in better use of the dentist's time on the more serious dental surgery; and then dental auxiliaries will be able to carry out much of the simpler dental care.

The position in the school dental service itself, although difficult and in many ways still serious, is not deteriorating. The number of children is our schools has increased very considerably in recent times. There are now in the maintained schools well over 7 million children compared with 5 million at the end of the war. During this period two significant changes have occurred to affect the school dental service. At the end of the war, the school dental service, like so many other local authority services, was in a state of considerable disruption. It began to settle down between 1945 and 1948. In 1948 the National Health Service Act, with its universal dental provision, came into operation. A large number of dentists at that time employed in the school dental service and in other local authority dental services decided that there were more attractions in the general dental service, and they left, with the result that the number of full- time dental officers in the service of the schools suffered a severe setback.

In 1952, the year when the first effects of the 1948 Act had begun to be seen in the school dental service, there were available altogether in that service 713 dental officers or full-time equivalents of dental officers. This compared with 921 in 1948, prior to the Act. That figure has now risen fairly steadily, apart from one or two minor setbacks, until at present there are 1,069 full-time equivalent dental officers in the school dental service. This represents a considerable improvement, a little more than enough to keep pace with the very rapid rise in the number of children in our schools.

These dental officers are required to examine and recommend for treatment and, where possible, treat the children in their areas. I do not want to enter into a dispute with my hon. Friend, or, through him, with the profession, about the appropriate number of children that a school dental officer ought to take care of. The position at the moment is that a little more than half the total number of children in our schools have their teeth examined annually and a little more of half of those who are examined and recommended for treatment receive it through the school dental service.

I freely admit that these are very unsatisfactory figures. But that is not the end of the story. The parents have their responsibility, and it is not right for us to minimise it. Rather is it our duty to help the parents to appreciate it and carry it out. The general dental service is available for the care of the teeth of these children, and I would hope that where children are not inspected in the schools because of the shortage of school dental staff or where, when needing treatment, they are unable to get treatment through the school dental service, their parents will make the necessary arrangements for them to have the service provided by the general dental service.

My hon. Friend suggested that it might be possible to rearrange the service so that all the treatment which was required for children's teeth was carried out by dentists in the general dental service or in some new local authority dental service. There are many complications attached to changes of this kind, although there might be some attractions. First, I am quite sure that it would not provide an attraction to set up a school dental service which consisted of nothing more than the examination of children's teeth. Dentists, who are professional men in an interesting and complex profession, would find little satisfaction if their entire professional life were to be spent doing nothing more than examining children's teeth and passing them to somebody else for treatment. I fear that that side of the service envisaged by my hon. Friend would quickly fall into decay—if that is the right word—if organised on that basis.

It might be thought desirable to set up some local authority clinics which did nothing but treat children's teeth, whether the children were sent by the means my hon. Friend has described or some other. I am sure that all dentists would find a profession unattractive which consisted of doing nothing but treating children's teeth. The variety and change and the additional and different complications that can arise in different tooth conditions form, I am sure, part of the attraction of the dental service. I think if it were organised on the basis my hon. Friend suggests, some of those attractions might disappear.

My hon. Friend suggested that it might be considered appropriate to award dentists on a different or better basis. I refuse to be drawn into a discussion of what is the right kind of reward for professional services of this or any other kind. I think my hon. Friend knows that there is a dental Whitley Council for local authority dentists which has the responsibility in this matter. He will know that the dentists were awarded, in January, 1961, a 12½ per cent. increase in their salaries, and I have no doubt that when the time arises for different awards to be considered, the Whitley Council will take the appropriate action and make the appropriate recommendations.

But I do not think that a comparison between the general dental service on the one hand, with its somewhat higher rewards, and the public dental service on the other hand, with its rather more limited rewards, is quite a straight com- parison in those terms. There are other attractions to public service that are perhaps more apparent in the dental service than in some others. Dentistry, I am advised, is an arduous occupation requiring not only high competence and professional skill but also considerable physical fitness and capacity to endure long hours of physically tiring work.

In the general dental service, a dentist requires to be physically fit for the greater part of his working life in order to win for himself the abundant prizes to which we hear reference made from time to time; and the facts of life are probably against his being able to do that until his working life comes to an end. He gets older, more tired and less capable of carrying out these arduous tasks during a whole working day.

Mr. J. Howard

Would not my hon. Friend agree that it is more tiring for a dentist to treat a child for a tooth condition than an adult?

Mr. Thompson

I think that is a professional value judgment which I am not competent to make, but my hon. Friend is probably right.

In the local authority dental service, however, the dentist works a set number of hours a day during a set number of periods in the week over a set number of weeks in the year—usually fewer weeks than for many of us engaged in different forms of public service. He is able to endure this degree of hardship and effort for a longer part of his working life. It is felt by many dentists that this is a compensatory consideration to be taken into account in evaluating the two professional courses open to him. There are longer holidays for school dental officers—providing that their terms of contract have taken that factor into account—than there would be for the dentist who is engaged in the more arduous conditions pertaining in the general dental service.

My hon. Friend referred to the proposed fluoridation of water supplies. That again is a matter beyond the competence of my Department to discuss, but he will know that certain studies are now being undertaken which remain to be evaluated. I have no doubt that when the work is done, the lessons learned from these studies will be made available to local authorities and the House.

My hon. Friend finally referred to the need for proper dental health education. I am sure that this is the most important and most immediately useful job that we can do. Given the shortage of dentists and given the time that it takes to increase the number of dentists available, here is where we ought to be moving. Again I must warn the House that the schools have already been engaged upon a great number of warning campaigns. We have at one time or another warned or are warning children not to pick up dangerous missiles; not to burn their nighties in front of open fires; not on any account to smoke; we do not like them to suck lollipops, and now we are to teach them how to clean their teeth.

A great deal is already done by many teachers who are devoted to their children and anxious and concerned to see that they should have the benefit of the best possible advice. In our teacher training colleges a great deal is done to help the teachers themselves to understand that the whole child is a much more teachable instrument than a child with toothache or some other physical disability. All this is part of the normal day-to-day exchange of a teacher's life.

My right hon. Friend the Minister of Health and his hon. Friend the Parliamentary Secretary do a great deal in their Department and in co-operation with mine to see that suitable literature posters, guidance and advice are available. Every other year my Department issues the "Health of the School Child", which is the Report of the Principal School Medical Officer and contains an important section dealing with the dental health of the children.

A great deal is being done along these fines, but it is a hard row to hoe. Children like sweets and parents like pampering children. I very much hope that the constant effort being made by propaganda, by information and advice will add up to a total of information which will be of value in saving the teeth of at any rate some children. I hope that the good examples that those children can set to their fellows and what the Government and the teachers themselves do will produce some slowing down of the present unfortunate situation and an improvement in the health of the teeth of our children generally.

9.58 p.m.

Mr. John Cronin (Loughborough)

I intervene in this interesting debate with a good deal of hesitation, but I feel obliged to do so for certain reasons. The Parliamentary Secretary made a stimulating and interesting speech and explained his Department's point of view with considerable lucidity. We all feel due sympathy with what he said, but I feel obliged to intervene for various reasons. One is that I have a particular respect for the views of the hon. Member for Southampton, Test (Mr. J. Howard), who has done a careful study of this subject and to whose views one must pay much attention. One must also bear in mind that the hon. Member for Orpington (Mr. Lubbock) is with us tonight. I understand that although he has not yet spoken in the House, he will do so tomorrow on the subject of conditions in the National Health Service. I believe he has a considerable interest in the subject of dental care.

I am reluctant to speak on matters of dental care, because for the last year I have spoken more frequently on matters concerning aviation. Nevertheless, as a Fellow of the Royal College of Surgeons I have some knowledge of dental matters—

It being Ten o'clock, the Motion for the Adjournment of the House lapsed, without Question put.

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Whitelaw.]

Mr. Cronin

—although the only people really to understand these things are the Fellows of Dental Surgery in the Royal College of Surgeons. The hon. Member made some stimulating remarks, which I should like to refer to. Perhaps, with the permission of the House, he will have the opportunity to catch the eye of the Chair again.

The hon. Member for Southampton, Test said that he thought that the care of children's teeth would be less interesting to members of the dental profession than the other forms of dental surgery—

Mr. J. Howard indicated dissent.

Mr. Cronin

I am sorry. I understood the hon. Member to say that. I am glad to see that he expresses dissent. I can assure him that many dental surgeons take an interest in children's teeth. The difficulty is that the school dental service is not made sufficiently attractive to members of the dental profession.

When alternative attractions exist, concerning salaries and conditions of service, it is necessary to offer some inducement to people to enter a certain service. This is what we need to obtain an increased flow into the school dental service. I did not have the opportunity of hearing the whole of the speech of the hon. Member for Southampton, Test, but I heard him say that the school dental service was inadequate in the strength of its personnel. A heavy responsibility rests upon the Government to make it clear that the school dental service is sufficiently attractive in order that we can obtain the right people in sufficient numbers.

Mr. J. Howard

The point I endeavoured to make was that the school dental service started with an enormous handicap. Every child starting school began his school life with an average of about five decayed teeth. An enormous number of fillings had to be done at the commencement of the school year.

Mr. Cronin

I am glad that the hon. Member has pointed out this difficulty. It increases my feeling of diffidence about not having heard all his speech. I am sorry that Parliamentary duties outside the House prevented me from doing so. The Government must concentrate on increasing recruitment to the school dental service.

I hope that the Minister will comment further upon the question of the fluoridation of water. It is generally accepted in scientific and medical circles that if the fluorine content of water is increased the incidence of dental caries is enormously reduced. It is not satisfactory for the Minister to say that this is a scientific matter which is outside his sphere. Hon. Members on both sides of the House have a great deal of confidence in the way in which the hon. Member conducts the affairs of his Department, and this seems to be something of a lapse on his part. He should carry things a little further in this respect.

It is known that the increase in the fluorine content of water decreases dental caries, and it is not satisfactory that a responsible Member of the Government should confess ignorance of this important scientific principle. We are all concerned with the care of children's teeth, and it is a little surprising to hear a Member of the Government say that this is beyond him. I would have expected him to brief himself very carefully. It may be that he should have talked to his hon. Friend the Parliamentary Secretary to the Ministry of Health, who is sitting beside him. She is probably an expert on these matters. It may be that she feels that she ought to make some contribution to the debate. I do not think that the matter should be left there. It is a scientific fact that the increase of fluorine content of water reduces dental caries, and therefore we might have expected something more valuable from the hon. Gentleman on the Treasury Bench than merely a suggestion that this is an abstruse point of scientific knowledge which is beyond his knowledge. I hope that we shall hear something more about this.

The next thing that occurs to me is that it is well known and well recognised that the consumption of sticky sweet foods is a great cause of dental decay. I am glad that the hon. Gentleman is paying attention to this, because it is an important point. This is well-recognised in all scientific circles, and I am sure that I carry the hon. Member for Orpington with me when I say that an excess of consumption of sweets, toffees, chocolate—

Mr. J. Howard

Lollies.

Mr. Cronin

I am glad that I carry the hon. Gentleman with me—causes a greatly increased tendency towards dental decay.

Some of us, on the rare occasions when we have time to spare from our Parliamentary duties, watch television. As a result, we hear and see continuous advertisements recommending small children to eat and chew large quantities of lollies, toffees and sweet substances which we know are deleterious to their teeth. It is very important that we should have some idea where the Government stand. Are the Government really concerned that television should be used as a medium to induce children to take specific action to cause a serious decay in the health of their teeth? I hope the hon. Gentleman will take this point very seriously. I am sure that the hon. Member for Southampton, Test will agree with me that this is a very substantial cause of ill-health in children's teeth. As we all know ill-health to teeth can cause numerous other kinds of ill-health. I think that the Parliamentary Secretary should give us some idea whether the Government are taking this seriously.

Fortunately, we heard last week from another place that the Government are taking seriously the question of the excessive smoking of cigarettes, which is a rather lethal habit. Dental decay, although not lethal, is something that causes real ill-health and inconvenience to children. It is important that we should know whether the Government are taking any serious action to combat the ceaseless propaganda to induce children to take action which will interfere with the health of their teeth.

The Parliamentary Secretary has given us a very helpful and very lucid speech and has shown that his Department has a real concern for the welfare of children and particularly their teeth. I hope that the hon. Lady will speak or that the Parliamentary Secretary will speak again. I do not think there will be any difficulty about the hon. Gentleman obtaining the leave of the House to do so. I cannot imagine that any hon. Member present would wish to deny him that permission. I hope that the Parliamentary Secretary will relieve the anxiety of all hon. Members on both sides of the House as to the future welfare of the teeth of our children.

10.8 p.m.

Mr. K. Thompson

With the permission of the House, I wish to reply briefly to the point made so courteously by the hon. Member for Loughborough (Mr. Cronin). May I first thank him for his generous comments on the speech which I have already delivered and may I also thank my hon. Friend the Member for Southampton, Test (Mr. J. Howard) on the initiative which he has shown in bringing forward this matter.

Even with the permission of the House, there is little that I can add to what I have already said regarding the two points to which the hon. Member for Loughborough referred. He knows the conventions, if not the rules, which bind Ministers to the affairs of their own Departments. It would be quite wrong for me to embark on a discussion about the scientific merits or social demerits—all of which are highly arguable—of the fluoridation of our water supplies.

Mr. Cronin

I sympathise with the hon. Gentleman's difficulties. But sitting on his left is the Parliamentary Secretary to the Ministry of Health who is well briefed in these matters and could make a substantial contribution to this important debate.

Mr. Thompson

I am quite sure that if I did not restrain her, nothing would give my hon. Friend more pleasure than to give the hon. Member for Loughborough all the technical advice which he needs about the fluoridation of our water supplies. I do not wish my hon. Friend any harm, but I think that that subject would be an admirable one for an Adjournment debate particularly on a night when, for example, we had been discussing the Committee stage of the Finance Bill, or something equally interesting.

The hon. Member for Loughborough claims this to be a matter which is established by scientific fact. But it is something about which there is considerable dispute among scientists. Even when they have finished their arguing there is a lot of disputation to be done between those who take account of the social considerations aroused by the proposal to add some of this substance, whatever it is, to our water supplies. But that is a matter to be discussed on another occasion. I am grateful to the hon. Member for Loughborough for letting us know of the importance which he attaches to the matter. We attach importance to it, too.

I can say no more than I have already said about the habit of children of eating sweets. I have no doubt that they will continue to eat large quantities of sweets, and, bless their little hearts, if they were not doing that no doubt they would be getting into some other kind of trouble. We must teach them how to eat sweets sensibly, and how to take the appropriate action afterwards. I hope that education in general health and hygiene will lead them to do that. As our society becomes more accustomed to the fruits of good living and of living with the benefit of a good liberal education and a balanced approach both to the problems of plenty as well as to the problems of a shortage, I am quite sure—

Mr. Cronin

I hope that when the hon. Gentleman refers to a "liberal" education he is talking in a general manner and not making a concession to the hon. Member for Orpington (Mr. Lubbock). I trust also that what he has said is not an indication of a wholesale conversion on the part of the Government.

Mr. Thompson

I was using the word in its least offensive sense.

Having said all that about the sweet-eating habits of our children, I hope that the hon. Gentleman will feel that we are well aware of how important it is to treat this matter in a balanced and sensible manner.

Question put and agreed to.

Adjourned accordingly at fourteen minutes past Ten o'clock.