HC Deb 16 June 1992 vol 209 cc764-6
5. Mr. Hain

To ask the Secretary of State for Health what steps she is taking to ensure that patients in all parts of the country have access to NHS dental services.

12. Mrs. Mahon

To ask the Secretary of State for Health what steps she is taking to assess the adequacy of the provision of the NHS dental services in all parts of the country.

Mrs. Virginia Bottomley

We are committed to an NHS dental service for the whole country. The Government have built up NHS dentistry; there are 27 per cent. more dentists than in 1979, and more than 7 million more courses of adult dental treatment are carried out every year. In most parts of the country, NHS dental treatment is readily available. Where there are difficulties, family health services authorities may make use of long-standing arrangements to employ salaried dentists. As part of our determination to safeguard access to NHS dentistry, my Department wrote yesterday to all FHSAs reminding them of this option.

Mr. Hain

Surely the Secretary of State must accept that by increasing charges to patients and cutting fees to dentists, she is effectively privatising dental care, especially as many people cannot find an NHS dentist in their area. Instead of playing Mary Poppins, she has become the Cruella de Vil of the national health service.

Mrs. Bottomley

The hon. Gentleman should look again at the facts. Our proposals would result in a reduction in the charges to patients. I hope that the hon. Gentleman is aware that dentists on average should earn £35,800. It is proposed that they should keep a further £5,000 on top of that. More than £40,000 is a good salary from any professional standpoint. In addition, it is proposed that there should be an 11.6 per cent. increase in expenses. That is a good salary which should certainly safeguard NHS dental services.

Mrs. Mahon

Are not the Government increasingly pushing dentistry into the private sector through their policies? Is the right hon. Lady aware that one third of children have not been registered with a National Health Service dentist during the first six months of the new contract? What is she going to do about it? Is she not failing British children?

Mrs. Bottomley

On the contrary, there are 27 per cent. more dentists than in 1979; almost 30 million people have signed up for continuing care; and, there are about 7 million more adult courses of treatment than in 1979. The NHS dental service is effective. I hope that we can get over the present fee situation and work with dentists for a fundamental review of the way in which they are remunerated.

Mr. Nicholas Winterton

I recognise dentists' vital role within our national health service, but will my right hon. Friend tell the House that, were dentists allowed to keep the total remuneration that they receive, it would set a sad and dangerous precedent for other vital groups of NHS workers, not least doctors, nurses and paramedics? In an endeavour to bring the unfortunate dispute to an end, is she prepared to discuss with representatives of the dental profession their right to pick and choose their patients?

Mrs. Bottomley

I am grateful to my hon. Friend for making a number of important points. Certainly, the increase in dentists' income recommended by the review body, at 8.5 per cent., was much higher than that recommended for nurses or doctors. I have to consider not only the interests of dentists, but those of patients and other NHS workers. I hope that the dentists will find their way through the present difficulties. Given present figures, a 23 per cent. fee reduction would be required to deliver that income of £38,500. We are proposing a 7 per cent. fee reduction only, which is sensible and fair. My hon. Friend made other points about the way in which dentists work, which are rightly and properly matters for the fundamental review. The Minister and I shall certainly be happy to see all interests concerned with the dentists on that review.

Mr. Sweeney

Does my right hon. Friend agree—

Several Hon. Members


Madam Speaker

Order. Let us have a little tolerance in relation to new Members.

Mr. Sweeney

Does my right hon. Friend agree that the British Dental Association's withdrawal from the dental rates study group is an act of folly? Whatever the disagreements between the Government and the profession about fees, surely it is better for dentists to be fully represented in all negotiations over fees. If they disagree about the figures, is not the DRSG the correct way to discuss it—[Interruption.]

Madam Speaker

Order. The hon. Gentleman would do well with his question if he would sit down now and allow the Minister to answer.

Mrs. Bottomley

I agree with my hon. Friend, to the extent that the public will be confused if dentists fail to attend the dental rates study group with the independent chairman, because that is the setting in which detailed figures should be discussed and examined. For example, I have heard dentists refer to their expenses, but on each of the last three occasions that that issue was debated it turned out that they had been over rather than underestimated. This year an 11.6 per cent. increase in expenses is proposed. The profession should get back to the dental rates study group to discuss the details.

Mr. Robin Cook

Will the Secretary of State admit that the current dispute stems from the contract imposed by the Government only two years ago against the wishes of most dentists? If Ministers got their sums wrong then, why should dentists and their patients have to pay the price now? May I warn the Secretary of State that if, as a result of this dispute, more of our constituents are told by their dentists that they will have to go private, we shall not just hold her responsible for privatising the dental service but will suspect that the Government want such a privatised dental service?

Mrs. Bottomley

I do not agree with the hon. Gentleman that the dispute results from the new contract. It is the result of the long-standing method by which we have remunerated dentists, which dates back nearly 40 years. It is time that we reviewed that system of remuneration, which is what the chairman of the review body suggested. We want to make progress on that review as soon as the dispute is settled. Of course, I am concerned about the needs of national health service patients. That is why I have reminded family health services authorities of their power to take on salaried dentists to safeguard the national health dental service. I hope that dentists will think long and hard before turning their backs on an average income, with expenses, of £88,000.