§ Dr. VaughanI beg to move amendment No. 29, in page 27, line 16, at end insert—
'(1A) Schedule 12 to the Act of 1977 and Schedule 11 to the Scottish Act of 1978 (Additional provisions as to regulations for the making and recovery of charges) shall be amended as provided in Parts I and II respectively of Schedule (Amendments of the Act of 1977 and the Scottish Act of 1978 relating to exemptions from charges for certain services and appliances) to this Act.'
§ Dr. VaughanI hope that hon. Members on both sides of the House will welcome this group of amendments, because they change some of the arrangements for exceptions from charges for dental services, optical appliances and appliances supplied to hospital outpatients.
On dental treatment, we are impletmenting in a modified form our plans which were outlined in the latest expenditure White Paper for the removal of school leavers under 21 from the existing system of dental charges. Originally, we proposed to charge all those over 16 who were no longer at school. However, the British Dental Association put forward strong arguments that this would be particularly damaging to the dental health of 16 and 17-year-olds.
We have therefore accepted that all young people should be exempt from dental charges until they reach the age of 18. I hope that hon. Members on both ides of the House will welcome that. The new schedule therefore provides for the exemption from dental treatment charges for all young people under 18 254 and also those under 19 in full-time education.
3.15 am
There is also the question of charges for appliances supplied to hospital outpatients and for dental and optical appliances. For some time there has been an anomaly in the way in which the schedule defines children as being those who are following a course of full-time education in a school. It is the phrase "in a school" that creates the anomaly. As hon. Members will be aware, many young people do A-level and similar courses not in schools but in colleges of further education. Unfortunately, to date, those courses have not come within the statutory definition of the term "school". As a result, students at those colleges and institutions have been denied the exemption that they would have had had they stayed on at school. We propose therefore that the definition of "children" should include all those under 19 years of age who are pursuing a course of full-time education. I feel sure that hon. Members on both sides of the House will welcome correction of what is an unfair anomaly.
I hope, therefore, that the House will accept this group of amendments.
§ Mr. MoyleI am sorry to disappoint the Minister, but we oppose the main thrust of the amendments. These amendments are not entirely what the Minister says they are. They impose charges on young people who have hitherto been exempt.
I do not mind admitting that I feel that our Government did not do particularly well in this area, but we now have the advice of the Royal Commission, and I hope that we shall make a new start. The Royal Commission said that, by any standards, the dental health of this nation is poor. It also said that high charges for dental treatment was one reason. About 24 per cent. of those 255 with no natural teeth and 6 per cent. of those with only some natural teeth said that the cost of National Health Service treatment was the main reason for not visiting the dentist. There was a recommendation from the Royal Commission that there was a firm case for the gradual but complete extinction of charges. I hope that we can use that as a basis for a new start.
The whole language of the amendment and the words used by the hon. Gentleman are an example of "newspeak" as in George Orwell's "1984". The amendment talks of exemptions, but it is about imposing charges on young people. Apart from dishonesty of language, there is a fundamental dishonesty. The clause goes against a specific election pledge by the Prime Minister, when garnering votes in the general election last year, that the Conservatives had no plans to impose fresh charges during the current Parliament.
This is a new charge. We have never before imposed charges on young people under the age of 21 for dental treatment. That was founded on sound common sense, as the comments of the Royal Commission show. Our dental services are, in any case, based too much on treatment and not enough on prevention. Encouraging young people to go to the dentist is the best preventative measure possible. Under this amendment, 19 and 20-year-olds will have an extra burden to discourage them from visiting the dentist.
For all those reasons, we oppose these amendments. What I have said about dental services applies also to optical services.
§ Mr. RaceIf we are to have exemption for young people in full-time education at school, college or university up to the age of 19, it is likely that the vast majority of school students will be exempt, as will some, though not all, students at technical colleges and polytechnics, but a substantial proportion of students at university will not be exempt.
It is extraordinary that the Government should have chosen a cut-off point at the age of 19 rather than 21. Why has that been done? Is it simply a cost-
§ cutting exercise, as we suspect? There seems to be no reason in logic for that cut-off point. I hope that the Minister will reconsider it.
§ Mr. PavittI congratulate Mr. Allen and his team from the British Dental Association on getting some improvement on the original proposal, but, as my right hon. Friend the Member for Lewisham, East (Mr. Moyle) said, the Royal Commission's evidence shows that the imposition of charges is a barrier to the prevention of dental caries and oral diseases by periodontology.
Within 20 years we could eliminate dental and oral diseases. The charges are a direct barrier to the progressive action that needs to be taken and to which the Royal Commission has so clearly pointed the way.
§ Mr. William HamiltonI wish to add my protest about the way that the amendments will affect Scotland. I received this morning 50 or 60 letters, mainly from youngsters in Fife, protesting at the proposed charges. The Minister knows that there is a large volume of literature about bad dental health in Scotland, particularly among youngsters. It is deplorable. Even below the age of 10 they are having dental treatment and extractions and they need false teeth at an early age.
The amendment will do nothing to encourage preservative treatment. It is a false economy. In the long run it will lead to worse ill health and grossly extravagant further expenditure on the provision of dental services. It is an ill-conceived economy. I believe that the Government will live to regret it, and I hope that the next Labour Government will take early steps to retrieve the situation.
§ Dr. VaughanWe do not accept the Opposition's criticisms. The hon. Member for Wood Green (Mr. Race) asked about the age limit. That was the advice that we were given by the BDA. I hope that the House will accept the amendments.
§ Question put, That the amendment be made :—
§ The House divided : Ayes 124, Noes 67.
257| Division No. 348] | AYES | [3.25 am |
| Alexander, Richard | Benyon, Thomas (Abingdon) | Blackburn, John |
| Ancram, Michael | Berry, Hon Anthony | Body, Richard |
| Aspinwall, Jack | Biggs-Davison, John | Braine, Sir Bernard |
| Bright, Graham | Hunt, John (Ravensbourne) | Pollock, Alexander |
| Brinton, Tim | Jenkin, Rt Hon Patrick | Price, David (Eastleigh) |
| Brooke, Hon Paler | Jopling, Rt Hon Michael | Proctor, K. Harvey |
| Brown, Michael (Brigg & Sc'thorpa) | Kellett-Bowman, Mrs Elaine | Rathbone, Tim |
| Bulmer, Esmond | Kershaw, Anthony | Rees-Davies, W. R. |
| Cadbury, Jocelyn | Kitson, Sir Timothy | Renton, Tim |
| Carlisle, John (Luton West) | Knight, Mrs Jill | Rhodes James, Robert |
| Carlisle, Kenneth (Lincoln) | Lang, Ian | Rhys Williams, Sir Brandon |
| Chapman, Sydney | Lawrence, Ivan | Roberts, Michael (Cardiff NW) |
| Churchill, W. S. | Le Marchant, Spencer | Sainsbury, Hon Timothy |
| Clark, Hon Alan (Plymouth, Sutton) | Lennox-Boyd, Hon Mark | Silvester, Fred |
| Clarke, Kenneth (Rushcliffe) | Lloyd, Peter (Fareham) | Sims, Roger |
| Colvin, Michael | Lyell, Nicholas | Speller, Tony |
| Cope, John | MacGregor, John | Spicer, Michael (S Worcestershire) |
| Costain, A. p. | McNair-Wilson, Michael (Newbury) | Squire, Robin |
| Cranborne, Viscount | McQuarrle, Albert | Stanbrook, Ivor |
| Dean, Paul (North Somerset) | Major, John | Stanley, John |
| Dorrell, Stephen | Marlow, Tony | Stevens, Martin |
| Dover, Denshore | Maude, Rt Hon Angus | Stewart, John (East Renfrewshire) |
| Dunn, Robert (Dartford) | Maxwell-Hyslop, Robin | Stradling Thomas, J. |
| Fairgrieve, Russell | Meyer, Sir Anthony | Taylor, Teddy (Southend East) |
| Faith, Mrs Sheila | Mills, lain (Meriden) | Temple-Morris, Peter |
| Fenner, Mrs Peggy | Mitchell, David (Basingstoke) | Thompson, Donald |
| Fisher, Sir Nigel | Montgomery, Fergus | Townend, John (Bridlington) |
| Fletcher-Cooke, Charles | Morrison, Hon Charles (Devizes) | Vaughan, Dr Gerard |
| Fookes, Miss Janet | Morrison, Hon Peter (City of Chester) | Viggers, Peter |
| Garel-Jones, Tristan | Myles, David | Waddington, David |
| Grieve, Percy | Neale, Gerrard | Wakeham, John |
| Griffiths, Peter (Portsmouth N) | Needham, Richard | Walker, Bill (Perth & E Perthshire) |
| Gummer, John Selwyn | Nelson, Anthony | Waller, Gary |
| Hannam, John | Neubert, Michael | Ward, John |
| Haselhurst, Alan | Newton, Tony | Wells, Bowen (Hert'rd a Sfev'nage) |
| Hawkins, Paul | Normanton, Tom | Wheeler, John |
| Hawksley, Warren | Onslow, Cranley | Wickenden, Keith |
| Heddle, John | Page, John (Harrow, West) | Young, Sir George (Acton) |
| Henderson, Barry | Page, Rt Hon Sir R. Graham | |
| Hogg, Hon Douglas (Grantham) | Page, Richard (SW Hertfordshire) | TELLERS FOR THE AYES: |
| Hooson, Tom | Parris, Matthew | Mr. Carol Mather and |
| Howell, Ralph (North Norfolk) | Patten, Christopher (Bath) | Mr. Robert Boscawen. |
| Hunt, David (Wirral) | Patten, John (Oxford) | |
| NOES | ||
| Alton, David | Flannery, Martin | Roberts, Ernest (Hackney North) |
| Atkinson, Norman (H'gey, Tott'ham) | Foster, Derek | Robertson, George |
| Beith, A. J | George, Bruce | Rooker, J. W. |
| Benn, Rt Hon Anthony Wedgwood | Graham, Ted | Ross, Ernest (Dundee West) |
| Bennett, Andrew (Stockport N) | Hamilton, James (Bothwell) | Rowlands, Ted |
| Booth, Rt Hon Albert | Hamilton, W. W. (Central Fife) | Sever, John |
| Bray, Dr Jeremy | Harrison, Rt Hon Walter | Silkin, Rt Hon S. C. (Dulwlch) |
| Callaghan, Jim (Middleton & P) | Haynes, Frank | Skinner, Dennis |
| Campbell-Savours, Dale | Hooley, Frank | Soley, Clive |
| Clark, Dr David (South Shields) | Howells, Geraint | Spearing, Nigel |
| Cocks, Rt Hon Michael (Bristol S) | Hughes, Robert (Aberdeen North) | Spriggs, Leslie |
| Cohen, Stanley | Lamond, James | Thomas, Dr Roger (Carmarthen) |
| Coleman, Donald | McKay, Alten (Penlstone) | Tinn, James |
| Crowther, J. S. | McKelvey, William | Walker, Rt Hon Harold (Doncaster) |
| Cryer, Bob | Maynard, Miss Joan | Welsh, Michael |
| Dalyell, Tam | Millan, Rt Hon Bruce | Winnick, David |
| Davis, Terry (B'rm'ham, Stechford) | Moyle, Rt Hon Roland | Woodall, Alec |
| Dixon, Donald | Orme, Rt Hon Stanley | Wrigglesworth, Ian |
| Dobson, Frank | Palmer, Arthur | Young, David (Bolton East) |
| Dormand, Jack | Pavitt, Laurie | |
| Douglas, Dick | Powell, Raymond (Ogmore) | TELLERS FOR THE NOES: |
| Dubs, Alfred | Prescott, John | Mr. George Morton and |
| Eastham, Ken | Race, Reg | Mr. Hugh McCartney. |
| Evans, John (Newton) | Richardson, Jo |
§ Question accordingly agreed to.