HC Deb 16 April 1985 vol 77 cc119-21
1. Mr. Evans

asked the Secretary of State for Social Services what representations he has received about the new scale of charges for National Health Service dental treatment.

The Minister for Health (Mr. Kenneth Clarke)

We have received representations from a number of hon. Members, the British Dental Association and members of the public relating to the recent increase in charges and the changes in the system of charges.

Mr. Evans

Will the Minister confirm that the British Dental Association is extremely concerned about the confused, complex and extremely expensive structure of dental charges that he has imposed on its members? Will he also confirm that a young employed person with a diseased tooth will have to choose between paying £3.30 to have it out or £26 to have it filled? Will that contribute to good dental care?

Mr. Clarke

There will be no administrative problems in the new arrangements, and what we have introduced is fair as between patients. I recently met representatives from the British Dental Association, who said that they would put proposals before me for improving the structure of charges still further, and I said that I would look at them carefully. It has always been cheaper to have a tooth out than to have treatment, but I am glad to say that the number of teeth being extracted is steadily falling as people steadily make more use of the better parts of the service.

Mr. Galley

Will my right hon. and learned Friend confirm that increased charges over the years have led to more people having more dental treatment and to improved dental health? Secondly, will he confirm that he will take rigorous action to pursue the exercise already undertaken by family practitioner committees to root out abuses of the system, whereby a minority of dentists boost their income by unnecessary treatment?

Mr. Clarke

My hon. Friend is right. All the increases in charges have not deterred patients from using the service, and the number of courses of dental treatment in England and Wales has risen from 28.5 million in 1979 to 32.6 million last year. I agree with my hon. Friend that his last point is important. The British Dental Association also would like to see steps taken against that minority of dentists. It is encouraging FPCs to do as he asks, and is to set up a committee to inquire into unnecessary treatment.

Mr. Donald Stewart

Has consideration been given to areas such as mine where dentists have not been available on some islands for a number of years, and therefore dental hygiene is far behind what it should be? Is he aware that people there will be faced with charges of up to £115 for remedial work as against having all their teeth extracted? How can that help such people?

Mr. Clarke

I am sure that my right hon. Friend the Secretary of State for Scotland is doing all that he can to improve the distribution of dentists, just as we are trying to do constantly in England. The structure of charges has been changed only to make it fairer to patients. The practice of raising charges as a contribution towards the cost of the service has been the policy of successive Governments for many years. I do not believe that any Government will change it.

Mr. Nicholas Winterton

Is my right hon. and learned Friend aware that his assurance that he will be prepared to review the structure of charges if there is evidence that it will be necessary is widely welcomed? Will he also give an assurance that if there is evidence that the heavy cost is deterring people from seeking treatment he will review the system to ensure that there is no deterioration in the nation's dental health?

Mr. Clarke

I have previously invited the BDA to put to me its ideas on the structure of charges and I am glad that it has agreed to do so. We will consider its suggestions carefully because we certainly need a fairer system.

I assure my hon. Friend that we should be very concerned if there were evidence that charging was affecting standards of dental health, but, despite what has been claimed, all the experience of the past few years shows that charging has not had that effect.

Mr. Meacher

Is the Minister aware that the latest round of increases——

Mr. Robert Atkins

Tell us about mortgages.

Mr. Speaker

Order. This has nothing to do with mortgages.

Mr. Meacher

Is the Minister aware that the latest round of dental charge increases is so large that millions of people will be forced for the first time to pay the full commercial cost, even for relatively routine treatment? Many people who previously paid only £14.50 for such treatment will now have to pay £40. Is he aware that he must be exceedingly gullible if he thinks that that will not be a deterrent to many people, especially as many practitioners in the BDA have already made clear their view that increases of this size will set dental health back a generation?

Mr. Clarke

I will not make my usual remark about the hon. Gentleman going over the top and talking nonsense, but he seems to overlook the fact that 60 per cent. of all visits to dentists are free and that we are talking only about charges for those who can afford to pay them. On average, even those who pay, pay only about 60 per cent. of the cost of treatment. Therefore, it is nonsense to say that people are paying the full commercial cost. It is not true to say that we have altered the system in that respect. I wish that I understood clearly where the hon. Gentleman stands. I shall read his policy document with care. No doubt he plans to abolish dental charges, among other things, because of the revenue that he expects to raise from abolishing tax relief on mortgages.