DENTISTS BILL (Hansard, 1 March 1956)

THE SECRETARY OF STATE FOR COMMONWEALTH RELATIONS (THE EARL OF HOME)
My Lords, this Bill has been given most exhaustive treatment in both Houses of Parliament and we now come to its final stage, the Third Reading in this House. One or two questions were asked of me on the Committee stage and as I was unable to be in the House when the Report stage was taken, perhaps your Lordships will bear with me while I deal with the points I was then unable to answer. The noble Lord, Lord Silkin, and I believe the noble Lord, Lord Haden-Guest, asked whether foreign dentists could be allowed to serve a kind of apprenticeship with practising dentists before, or instead of, taking the practical examination for which the Bill provides. The noble Lord, Lord Silkin, asked whether I felt that the Bill as it stood would enable this to be done. On the spur of the moment I said that, having read the Bill, I thought this was so. The answer I now have to give is really an elaboration of that statement. I believe we can achieve the substance of what the noble Lord, Lord Silkin, asks, though perhaps not exactly in the form in which he envisaged it.
Under the Dentists Act, which is clarified in Clause 28 of the Bill, practice on the public by an unregistered person is limited to students who are under the very close supervision of clinical teachers having no other task in hand except this supervision. That provision has been inserted in the Bill, very properly, to protect the public. It is a very necessary provision, for we have to remember that some of these foreign 74 dentists have been out of practice for a long time—some for as long as twenty years—and could not, before they were registered, start operating on the public without some fairly close supervision. To make them, in effect, apprentices would be to go back to the old dental apprentice system, which was discarded some time ago. The General Dental Council can have refresher courses where the foreign dentist will work, first, on what is called the "phantom head" and, secondly, on normal patients, subject to the supervision and safeguards which operate in clinical schools. I hope that this course will meet the views of noble Lords. It seems to have the advantage that there will be no danger to the public. There will be no difficulty in finding dentists willing to supervise foreign dentists under these conditions, and such an arrangement will be more acceptable to the foreign dentists as they will not then be open to legal charges through accidents which may happen or for other reasons. In practice, therefore, the substance of what noble Lords asked for can be achieved under the Bill through the General Dental Council.
Unfortunately, the noble Lord, Lord Webb-Johnson, is not able to be here to-day, as he has a cold, and he has asked me to apologise to your Lordships. He asked me why, in Clause 18, there is provision for a fine of £50 on a person who pretends to be a different kind of ancillary from what, in fact, he is, while later in the Bill there is provision for a fine of £500 for a person pretending to be a dentist when he is not. I believe that the noble Lord himself supplied the answer: the penalty of £50 is applied against a person who pretends to be a type of ancillary other than he really is—that is to say, for example, an oral hygienist who might pretend to be a more highly qualified type of ancillary. Clearly, however, it is a greater offence to pretend to be a registered dentist when one is not, and the fine of £500 applies, therefore, to anybody, whether he is an ancillary or not, who pretends to be a registered dentist.
The noble Lord, Lord Amulree, asked me what was the difference under Clause 19 between the degree of supervision envisaged in subsection (2) and that envisaged in subsection (3), but after I had been able to send him a letter on the subject the noble Lord kindly said that he 75 was convinced there was no discrimination and he accepted my explanation. I now feel the kind of relief I have often felt on getting out of the dentist's chair. We now come to the end of our discussions on this Bill, which I hope will be useful both to the public and to the dental profession in helping the latter to raise their status, thus leading to more recruits for the profession and to a better service. I beg to move.

§ LORD SILKIN
My Lords, we are coming to the end of the journey on this Bill. Obviously, it is not one of those measures which arouse very keen excitement, in this House or anywhere, compared, for example, with the subject we were discussing last Tuesday. Indeed, one noble Lord said then that it was all very well for the specialist to come here now and then, and hold forth on some very highfalutin subject and then walk out, but that it was for the ordinary humdrum people to talk about such subjects as the dentists. The noble Earl and myself are the humdrum people who are dealing with this humdrum affair. I am very satisfied with the noble Earl's statement as to the position of foreign dentists. This Bill has come before us so well explored in another place and (something I am not often able to say) was dealt with in another place in such a conciliatory manner that there was really little for us in this House to do. The points raised by the noble Earl were the only ones which required some ventilation. The Bill as it now stands is entirely satisfactory.
This is a very important measure, not only to the dentists but to the general public. We all recognise that to-day we are exceedingly short of dentists, and there is in this country a growing realisation of the importance of preserving teeth. We hope that the old days, when the early solution for toothache was to extract the tooth, are gone for ever. We know that ever greater skill is required to preserve teeth. With the great shortage of dentists, especially those available for the treatment of children, anything that we can do to increase the number of dentists in this country, and also to increase their quality, is well worth 76 doing and is of the highest importance. This Bill is a step towards increasing the number of dentists and improving their standing. It raises their status and dignity, and for the first time gives them a reasonable measure of self-government. They will now stand far higher in public esteem than ever before; and, as was said on the Second Reading of the Bill, there is no reason at all why young people should not readily enter the profession of dentistry. It is a well-paid profession, and if it stands high in the esteem of the general public, and its work is known and recognised as work necessary in the public interest, I think there are good grounds for hoping that increasing numbers of young people will enter it. We in this House, together with Members in another place, have done our best to raise the status and the dignity of the dentists. I hope that the result of our work will be a substantial increase in the number of dentists and a substantial improvement in the quality of the teeth of the nation.

§ LORD HADEN-GUEST
My Lords, may I, speaking as one who was for a good many years a school medical officer of the London County Council, add just a word or two to what my noble friend Lord Silkin has said? In the early days of the schools medical service there was no special provision for attention to be given to children's teeth, and the result was that, in many instances, children's teeth were allowed to decay. They decayed more in some districts than in others, depending on the amount of mineral substances in the water and so forth. In some districts teeth decayed very rapidly indeed; in others they did not. Apart from that, there was no attempt to give children hygienic instruction with regard to their teeth. When that was done in London and other parts of the country there was a great improvement in the teeth of the children.
During recent years, however, for reasons that I will not attempt to go into this afternoon, there has been a gradually increasing shortage of dentists. This has led to a certain degree of deterioration, and it is largely to meet that deterioration that this Bill has incorporated in it proposals for the employment of ancillaries. I venture to suggest that in practice the employment of these ancillary 77 dentists— that is, people who are sufficiently well qualified to do certain work on children's teeth—will be found to be one of the most valuable things that has been done in the dental world for a very long time. It is a practical step and it will do more to ensure the soundness of children's teeth than anything else that could have been done. Moreover, it is a step which has been agreed to by the great municipal school authorities as being a great advance in dentistry. It is not you and I, my Lords, who may go to a 78 dentist now and then for attention to our teeth, who are going to benefit from this step, but a large number of children suffering from a decayed condition of the teeth, which, if not properly attended to, would undermine their health.