HC Deb 20 February 1990 vol 167 cc768-9
6. Mr. John P. Smith

To ask the Secretary of State for Health if he will make a statement on the effects of the introduction of charging for dental inspections.

8. Mr. Rees

To ask the Secretary of State for Health if he will make a statement on the effects of the introduction of charging for dental inspections.

Mr. Freeman

The number of dental examinations in the September quarter of 1989, the latest available statistics, at approximately 7.4 million, represented a reduction from the year previously, at approximately 7.9 million. With a few more quarters' statistics, the underlying trend will become clearer. The annual number of dental examinations has gone up gradually in recent years, and we expect this long-term trend to continue.

Mr. Smith

In the light of that answer, can the Minister explain how, as a result of a survey among all dentists carried out in my constituency, the Vale of Glamorgan, it was shown that dental inspections have decreased by up to 20 per cent? The time lag between inspections has now gone beyond the recommended level and it is particularly worrying that 18-year-olds are not having inspections, but merely waiting until they need treatment. When asked to comment, dentists said that the dental health of the nation is suffering and that it will get worse. Will the hon. Gentleman comment on that?

Mr. Freeman

It is important to appreciate that the charge for examinations under the National Health Service is £3.45, which represents 75 per cent. of the cost. No one disputes that examinations appear to have decreased immediately after the introduction of charges, but we believe strongly that the long-term trend of an increase in examinations will shortly reassert itself.

Mr. Rees

It is no use for the Minister to hope for the long-term trend to reassert itself. This is an important element of preventive medicine, and in all areas the number of inspections is falling. It is a serious matter. What will the Government do about it?

Mr. Freeman

Some 50 per cent. of all patients who have National Health Service examinations are exempt from the charges. We believe that the long-term trend will reassert itself. The right hon. Gentleman may say that that is a hope and an expectation, but we firmly believe that the upward trend will continue.

Miss Emma Nicholson

Does my hon. Friend agree that people over 18 have a good cognisance of the value of preventive medicine, having received free medical care until school-leaving age, and that asking them to make a modest contribution to the cost of dental inspection in no way undermines our ability to keep their health high on our list of priorities?

Mr. Freeman

I am grateful to my hon. Friend. The money raised through charges goes back into the Health Service and, indeed, helps to improve the quality of dental care.

Mr. John Greenway

Does my hon. Friend agree that the best way to benefit dental patients is to make further progress on the new dental practitioners' contract, which will improve the relationship between patients and their dentists? Many members of the dental profession support it, but others have grave doubts. It would greatly assist those charged with the responsibility of persuading their colleagues to accept the new contract if my hon. Friend could tell the House—not now, but very soon—that the Government have no plans to increase dental charges.

Mr. Freeman

I cannot give my hon. Friend that commitment—he would not expect me to be so specific—but I can say that we have received some very positive encouragement from the profession. We shall not know the final outcome for another six months, but we are very encouraged by the response so far.

Mr. Kennedy

Will the Minister provide evidence to back up his assertion that, to use his own words, the long-term trend will reassert itself in the form of an increase in the number and proportion of people undertaking dental examinations? Does not the current plain evidence suggest that the present charging structures need to be reversed, and that the current trend is making nonsense of the emphasis on preventive medicine?

Mr. Freeman

I have cited the statistics as fairly as I can. There was a reduction of 6 or 7 per cent. in two comparable quarters. It is not surprising that some deferment of examinations and some reduction in the number of patients going for treatment should follow the introduction of charges, but we hope that the long-term trend will indeed reassert itself when the 50 per cent. of people who have to pay charges appreciate that the treatment is good value for money.