HC Deb 02 February 1971 vol 810 cc1447-50
13. Mrs. Renee Short

asked the Secretary of State for Social Services what assessment he has made of the effect of recent Government announcements about increased dental charges on the dental health of the nation.

Sir K. Joseph

The new system of dental charges will give a financial incentive to patients to look after their teeth —[HON. MEMBERS: "Oh!"]—and should, therefore, have a beneficial effect on dental health.

Mrs. Short

One could call that reply standing logic on its head. Does the right hon. Gentleman know of the opposition put forward by the British Dental Association, particularly in view of its experience when dental charges were introduced in the 'fifties, of the reduction in the level of treatment demanded by patients? Is he further aware that in 1948, before the National Health Service was introduced, about 11 per cent. of people under 30 in this country had no teeth of their own, and that since the introduction of the National Health Service this proportion has been reduced to 4.6 per cent.? Is not that a complete case against his own argument and his reply to me? Will the right hon. Gentleman therefore—[HON. MEMBERS: "Too long!"]—in view of the genuine and serious concern expressed by experts in this matter, look at the issue again and withdraw the proposed charges?

Sir K. Joseph

The hon. Lady is right that there is serious concern. She is right that in the 'fifties the imposition of a charge did lead first to a surge in treatment, and then to a dip, but a dip that was only temporary.

The House will be aware that under the new arrangements two-thirds of treatments will remain either free or be at a lower cost than they were under the Labour Government. The number of people exempt altogether from charges will rise. Between me and the British Dental Association there will be a comprehensive campaign to explain to people the advantages, the immunities and the probable costs under the new system.

Sir G. Nabarro

Will my right hon. Friend bear in mind during his campaign that the most valuable contribution which he, personally, could make would be to step along to the Chancellor of the Exchequer and point out to him that the scale of charges and the excess treatment now required arise partially from the fact that, while toothbrushes are free of purchase tax, toothpaste and dentifice are purchase-taxed at 36⅔ per cent.?

Sir K. Joseph

I thought my hon. Friend was going to say that these taxes are higher than those on sweets, As a user of sweets, toothbrushes and dentifrice, I have to point out that I do not think that a change in purchase tax, even if my right hon. Friend agreed, would, bring about a reduction in dental caries.

Mr. William Hamilton

Will the right hon. Gentleman sack the civil servant who gave him the original answer? If the right hon. Gentleman himself believes this, why does he not do the job properly and double the charges, and then we shall all have first-class dental health?

Sir K. Joseph

I drafted my reply with loving care—[HON. MEMBERS: "Resign!"]—because I believe, and I believe that the House will come to realise, that a system by which a regular attender at a dentist will bear far less cost than those who do not attend regularly will improve dental health.

Earl of Dalkeith

Can my right hon. Friend say what proportion of children who qualify for free dental treatment take advantage of the facilities available to them, and what steps he will take to encourage greater use being made of free dental treatment?

Sir K. Joseph

All children are entitled and will remain entitled, to free dental treatment. I hope that one result of the system of charges proposed will be that dentists will reach out to provide even more treatment to children, which will remain free.

Mr. Shirley Williams

The right hon. Gentleman is sounding a little as though treatment is bound to be extraction, because his loving care has persuaded very few dentists. Does what he has said mean, first, that he is informing the House that he is going to reduce the age of exemption from 21 to 18, or keep it at 21, because his last reply implied that the situation would be the same?

Second, does the right hon. Gentleman deny that as a result of high demand there has been a consistent fall in the price of dental treatment, largely owing to the much more efficient use of dentists?

Third, can the right hon. Gentleman inform the House that a situation in which treatment for extractions is going to be very much cheaper than treatment of a conservative kind—I use the term technically—is one which will improve the dental health of this nation?

Sir K. Joseph

The Government propose to introduce legislation to reduce the age of exemption from 21 to 18, and there will be an opportunity to discuss the merits of that at the time. I am the first to pay tribute to the improvement in the dental health of the nation which the dental service, dentists and the skills of those who serve them have brought about.

Mrs. Renée Short

The National Health Service.

Sir K. Joseph

Yes. The answer to the third point is that I think it will always be important for dentists to explain to patients the advantages of one sort of treatment against another. A few will refuse what is sensible, but most will accept it.

Mrs. Short

In view of the unsatisfactory nature of that reply, I beg to give notice that I shall raise the matter on the Adjournment at the earliest opportunity.