§ Lord Colwyn asked Her Majesty's Government:
§ What steps they are taking to keep practising dentists abreast of developments, in view of the advances in understanding of dental treatment.
§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)My Lords, dentistry has seen considerable changes in materials and techniques as well as approaches to clinical problems. The Government therefore consider it important that dentists in practice should undertake regular refresher training. Such training, funded by the department, is provided specifically for dentists providing National Health Service general dental services. Over and above this the department has now sent the first of a series of training videos to all NHS dental practices in England.
§ Lord ColwynMy Lords, I thank my noble friend for that informative reply. While assuring him that the majority of my profession is in favour of the initiative by the DHSS, may I ask him whether he has received any representations from the British Dental Association, particularly in relation to the timing of the distribution of this video and of the press release which seem to have become reversed? Secondly, can he explain why the video sent to every national health practice in the country should show a technique which is not available under the National Health Service?
§ Lord SkelmersdaleIt did not, my Lords. The scale of fees for general dental practitioners already includes payment for the treatment of the early signs of tooth decay using the technique shown in the video. We shall shortly be discussing with the profession whether any clarification of the description of this treatment in the scale is needed in the light of developments in clinical practice. I am indeed aware that the profession is concerned that dentists did not receive their copies of the video until after the public launch and that they felt disadvantaged when patients were aware through the media before them. I can confirm that this will not happen again.
§ Lord EnnalsMy Lords, I am sure that the Minister will understand the lack of wisdom I would show if I were to become involved in this discussion between two experts. I have two questions. The first is: to what extent is the need for training facilities and courses for dentists, as opposed to time for treatment of patients, taken into consideration in assessing the 7.9 1216 per cent. pay award in the Doctors and Dentists Review Body? Will he comment on the need for the training that is referred to in this Question and the extent to which that is reflected in the Government's White Paper on primary health care?
§ Lord SkelmersdaleYes, my Lords, in answer to both those questions. Training is of the essence and it is important that the dental profession, as any other publicly-funded profession, produces value for money. The Government are concerned that dentists who have been absent from active practice for long periods for whatever reason and dentists in practice should undergo some refresher training either to continue in their practice or before they re-enter a practice. We have made this quite clear in the White Paper, and in our discussions with dentists we shall continue to pursue it.
Earl Baldwin of BewdleyMy Lords, is the Minister aware of the growing concern at the continued use of mercury in amalgam in dental fillings? Will he comment on the conclusion of the Swedish health authorities that mercury in amalgam is a toxicologically unsuitable material?
§ Lord SkelmersdaleMy Lords, I am aware of the growing concern on this matter. That is why the issue was put to the committee on toxicity in 1986. The committee stated that in its opinion the use of dental amalgam was free from the risk of systemic toxicity and only a few cases of hypersensitivity occur.
§ Lord LeatherlandMy Lords, will the Government get their teeth into this problem?
§ Lord SkelmersdaleMy Lords, I can truthfully say that, speaking on behalf of the Government, I have been studying this problem for quite a long time.
Viscount St. DavidsMy Lords, on behalf of many people and in the form of a question may I express intense appreciation of the vast distance that the profession has advanced in recent years, which makes it almost a pleasure to go to the dentist rather than to the old horror torture dungeon one used to expect in years long ago?
§ Lord SkelmersdaleMy Lords, that is exactly why training is so important.