HC Deb 10 February 1964 vol 689 cc25-7
27. Mr. F. Taylor

asked the Minister of Health, in view of the fact that the present system of remuneration for dentists involves a reduction in their remuneration if as a community they work harder or more efficiently, what steps he is taking to avoid a lowering of general standards and the quality of workmanship.

The Joint Parliamentary Secretary to the Ministry of Health (Mr. Bernard Braine)

There would only be a reduction if dentists were receiving more than the recommended net income. It is the responsibility of the dentists themselves to maintain proper professional standards, and sample examinations by my right hon. Friend's regional dental officers do not suggest any general failure to do so.

Mr. Taylor

What my hon. Friend says is; correct so far as it goes, but is it not clear that the present system is designed to give a predetermined income to a dentist irrespective of his degree of efficiency and irrespective of the number of hours he puts into the job, the consequence being that, if dentists put in longer hours, then, in the long run, they will not get a higher gross income since expenses are increasing at a greater rate than was expected and their net incomes are undoubtedly being reduced?

Mr. Braine

The present system was recommended by a Royal Commission. It is true that the immediate effect was a reduction in remuneration because dentists as a whole have been earning so much more than the target income recommended by the Royal Commission. Since then, however, there has been an upward adjustment in the scale of fees. My hon. Friend may be glad to know that the Review Body in its last report said that it intended to give further thought to possible alternatives to the present system of remuneration. I understand that it is considering the matter now.

Mr. K. Robinson

The Minister must be aware that there is considerable dissatisfaction throughout the dental profession with the present method of payment. Is it not time that his right hon. Friend had some discussions with the profession on the basis of remuneration similar to those he is having with the doctors on the pool system?

Mr. Braine

The hon. Gentleman could not have been listening. I said that the Review Body is now considering the matter. But I take note of what he has just said.

28. Mr. F. Taylor

asked the Minister of Health, in view of the fact that the present system, by which the statistical average remuneration of a dentist is calculated by dividing the combined income by the number of qualified employers only, excluding qualified assistants, has proved misleading, if he will, in future, include the total qualified dentists in the calculations irrespective of whether they are employers or employees.

Mr. Braine

No, Sir. The Review Body specifically recommended that the target income should relate to the average of all principals working in the general dental service, and my right hon. Friend does not agree that this is misleading

Mr. Taylor

Is my hon. Friend aware that, if a dentist employs twenty qualified assistants and in such circumstances his gross income amounts to, say, £100,000, he is regarded as just one unit in the average figures expected? Does not this produce a most unfair and quite incorrect view of the average earnings of the majority of dentists who work as, so to speak, one-man firms with no qualified assistants or only one or two?

Mr. Braine

The average net income recommended by the Review Body includes any profit made by principals from employing qualified assistants. A lower aver age income would, presumably, have been recommended if it had been intended to relate it to all dentists, both employers and assistants.

As regards the future, I can only tell my hon. Friend what I have already told the hon. Member for St. Pancras, North (Mr. K. Robinson), that the Review Body said in its last report that it intended to give further thought to the basis of remuneration of general dental practitioners and to possible alternatives to the present system. If a more satisfactory system can be found, it may be recommended at a subsequent review.