Dental Services (Hansard, 6 December 1994)

§ 1. Ms Janet Anderson
To ask the Secretary of State for Health how many national health service patients have been deregistered by dentists in the last year.

§ The Minister for Health (Mr. Gerald Malone)
Some 177,752 adult and 1,154 child patients were deregistered by dentists in the year ending 18 November 1994, but 1 million more patients were registered at 30 September 1994 than at 30 June 1992.

§ Ms Anderson
What advice would the Minister offer to my constituents in Haslingden, who have been told by their dentist, Gillian Burn, that, as a direct result of the Government's Green Paper, she is no longer able to treat them under the NHS?

§ Mr. Malone
Where dental services cannot be found from a local dentist, they are available through family health services authorities. Haslingden, which has a population of 14,000, is served by three dental practices, but NHS dental services are available in neighbouring villages. Service are available and we are monitoring the position closely.

§ Mr. Shersby
What proposals do the Government have for strengthening the provision of NHS dentistry, for improving the quality of the service and for providing fairer remuneration for dentists?

§ Mr. Malone
My hon. Friend will be well aware that we published the Bloomfield report and the Green Paper that followed thereafter and that there have been consultations with the dental profession. Dentists have provided constructive opinions about moving towards a purchaser-provider relationship in the longer term. We are now dealing with other issues raised in the Green Paper and I hope that we can make some progress on that. We sent officials around the country to garner opinion from dental practitioners. It was a comprehensive and proper survey and we are now considering the results of that comprehensive test of dentists' opinion.

§ Mr. Wigley
Does the Minister realise that he, the Secretary of State and Ministers in the Welsh Office are talking absolute nonsense on this matter? They claim that 126 salaried dentists are available, but in my area, which has an establishment of four dentists, only one has been recruited. That is hardly surprising when the salary being offered is £15,000 a year. When will the hon. Gentleman open his eyes to the crisis facing people looking for dental treatment?

§ Mr. Malone
The fact that the hon. Gentleman must recognise is that, since 1992, adult registrations have risen substantially and the number of dentists practising within the NHS has also risen. He cannot say that a service where expenditure has risen by some 53 per cent. in real terms since 1979 is in decline; it is not. Of course there are concerns that must be dealt with—that is why we looked at Bloomfield, that is why we published the Green Paper and that is why we have had the most significant consultation exercise for dentists that has been undertaken in recent years.

§ Mr. Illsley
Is there not now a real crisis in NHS dentistry, with a rising number of areas in which NHS dentistry is not available even to existing registered patients? Bearing in mind that the proposals to which the Minister referred will take some years to come to fruition, how will he ensure that NHS dentistry is restored to those areas now?

§ Mr. Malone
The Government undertook, in discussions on the Green Paper and during the consultation period, to underpin the provision of NHS dentistry, and the profession as a whole has welcomed that. I hope that we can make progress so that we can get the total provision of dentistry back on to the stable footing that we all want.
The hon. Gentleman is wrong—NHS provision is made by dentists who give NHS cover, by family health services authorities directly employed dentists or by community dental services in other areas. The service exists and it is working. Everyone who needs dental treatment under the NHS gets it.

§ Mr. Allason
Does the Department have a policy on deregistration? Is my hon. Friend aware of the suspicion that a large number of dentists are making any excuse to deregister their patients because of the lack of NHS remuneration? One constituent of mine was refused further treatment by a dentist when he failed to keep an appointment. Although that was obviously an expensive inconvenience for the dentist, it appears that no other dentist in the same FHSA is willing to take on that constituent.

§ Mr. Malone
If my hon. Friend will write to me with details of that particular case, I will be happy to consider it. The system of continuing care payments ensures that somebody remains registered for two years. I am not sure whether the case that my hon. Friend raised falls into the category of someone rolling out after the two-year period, which happens frequently.