Prison Dental Service (Hansard, 4 July 1986)

§ Baroness Ewart-Biggs
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government how many penal establishments were unable to offer to the prisoners dental treatment comparable to that available to the general public in 1985–86 and how many prison dental clinics were cancelled during that period.

§ Viscount Davidson
My Lords, as far as I am aware in the financial year 1985–86 dental service was temporarily restricted to emergency cases at two establishments. A normal service is now being provided at both. Regrettably, dental sessions sometimes have to be cancelled because prison officers are not available to escort and supervise patients. The problem has been confined in the main to a small number of remand establishments. Information on cancellations is not routinely collected centrally but I shall try to obtain it and will write to the noble Baroness.

§ Baroness Ewart-Biggs
My Lords, I thank the Minister for that somewhat reassuring reply. In view of the basic principle that a prisoner is entitled to the same medical care as anybody else, and the concern shown by the association for prison dental surgeons that the budgetary constraints were more widespread, can he assure us that in the coming year no arbitrary financial ceilings will be placed on penal establish-ments and that dentists should be guided by the normal consideration of the need of patients?

§ Viscount Davidson
My Lords, as with all public expenditure, there has to be a system of budgetary control. In advance of the financial year, each establishment is given a financial allocation for dental treatment for the year. Because expenditure levels are dictated by patient demand, the allocations are inevitably to some extent arbitrary. However, they are adjusted as the financial year progresses, if necessary. I assure the noble Baroness that there is no question of patients being denied essential treatment because of financial constraints.

§ Baroness Gardner of Parkes
My Lords, will the Minister tell me how dental surgeons in prisons are remunerated? Is it on a salaried sessional basis? Is he aware that there is a greatly under-used capacity of national health dentistry available and that many general practitioners would welcome having suitable prisoners brought to their surgery for treatment, as I do myself, to help to fill the gaps?

§ Viscount Davidson
My Lords, I am afraid I cannot cap the last remark in my noble friend's question. The surgeon is paid in the same way that he is paid within the National Health Service, part of the charge being paid though the Dental Estimates Board and the patient's contribution being met by the Prison Department. Dental surgeons contract to provide treatment under the Health Service usually within prisons, in a dental surgery equipped and provided by the prison department.

§ Lord Elwyn-Jones
My Lords, is it not important when considering this matter to remember that prisoners are sent to prison as punishment and not for punishment?

Lord Davidson
My Lords, all I can add is that they have the great advantage of getting their dental treatment for nothing which is probably why the queues are slightly longer than outside.

§ Baroness Ewart-Biggs
My Lords, is the Minister aware of the rather unsatisfactory system that exists that when a remand or convicted prisoner is expected to move to another prison the dentist is not allowed to start the necessary treatment? Does he agree that it would be better if dentists were permitted to start the treatment and that the dentist in the establishment to which the prisoner was moving was given instructions and details of the treatment already carried out?

§ Viscount Davidson
My Lords, there is a problem when the prisoner is moved from one remand establishment to another. At the busier remand establishments the medical officers have to be selective about the referral of non-urgent cases and to give priority to those patients who are expected to remain in the establishment long enough for a course of treatment to be completed. It is up to the dentist to send the prisoner's records to the dentist in the prison to which he is moved.

§ Baroness Gardner of Parkes
My Lords, is the Minister aware that there are some forms of treatment which it would be unsatisfactory for one dentist safely to leave to another to complete.

§ Viscount Davidson
My Lords, my noble friend knows much more about this than I do.