§ 2.48 p.m.
§ Lord Colwynasked Her Majesty's Government:
§ What advice they have taken to justify the use of the Cosmetics Directive to impose a restriction on dentists' clinical freedom to prescribe and treat patients by means of tooth whiteners.
§ Lord CheshamMy Lords, the Government have no wish to interfere with the clinical freedom of dentists in treating and improving the dental health of their patients. However, legal advice from the Department of Trade and Industry, the Department of Health and the European Commission indicates that they consider tooth whiteners to be cosmetic products and therefore their supply falls within the scope of the Cosmetics Directive.
§ Lord ColwynMy Lords, I thank my noble friend for that Answer. However, I regret that I cannot show the same delight as was shown for the previous Answer. I declare an interest as a practising dental surgeon and register an interest as to why the Question is being answered by the DTI rather than the Department of Health.
Is it not a massive bureaucratic mix-up when a Cosmetics Directive issued by the DTI, quite rightly, to prevent sales of this product to the public, prevents professionally qualified dental surgeons from using procedures which they have used safely and effectively for many years?
§ Lord CheshamMy Lords, I do not believe that it is a bureaucratic mix-up. Tooth whiteners are clearly cosmetics and not medical devices. That is a view shared by the European Commission and member states. It is also the opinion of lawyers in the UK Medical Devices Agency, the Department of Health and the DTI.
§ Lord PestonMy Lords, the noble Lord, Lord Colwyn, has ruined my best question! Is the Minister aware how puzzled many of us are about this matter? I gather that we are talking about hydrogen peroxide, which is freely available and is by no means the most 1165 dangerous substance that anyone can buy within the general medical field. I merely refer to aspirin, paracetamol or hundreds of other things, so the whole matter is a puzzle. However, the particular puzzle is that the Government must have agreed to this. Why did they agree to something which undermines the position of one of our more serious professions—the dental profession—in a way that makes us look absurd? That is apart from the fact that those of us who are pro-European feel that this kind of thing undermines the European Community in a most extraordinary way. It is poking its nose into things which so far as I am concerned cannot possibly be any of its business.
§ Lord CheshamMy Lords, there is a fairly simple answer with regard to hydrogen peroxide. I do not know whether the noble Lord has actually tried to drink some. It is fairly caustic and fairly dangerous. The Department of Health's toxicologists are not convinced that the kind of concentrations involved in tooth whiteners are safe. A 3.7 per cent. concentration of hydrogen peroxide taken orally can have some very nasty effects on people. At the moment the directive restricts the concentration of hydrogen peroxide present or released to 0.1 per cent.
§ Lord PestonMy Lords, I do not want to prolong this but in my younger days I thought that hydrogen peroxide was used by a certain class of lady for certain purposes. My question is about the position of a profession. If the noble Lord recalls the answer he has just given, he is saying that the alleged experts of his department—I emphasise the word "alleged"—are sufficient to override the views of professional people. That is what I am querying. To say the least, I am uneasy about it. I doubt very much—I ask this as a question—whether I am alone in querying this kind of interference in the way professionals behave.
§ Lord CheshamMy Lords, for dentists to be granted a change to the legislation, a case may be put to the European Commission in the form of a submission. That would be most appropriate from the dental profession and industry and would have assistance from the departments involved. Further, I should like to stress that there are outstanding anxieties about the long-term safety of these tooth whiteners, and any submission presented should address those.
§ Lord SkelmersdaleMy Lords, is my noble friend aware that the European Commission has a long and undistinguished history of overkill regarding preventive medicines and regularly in the past has exceeded the World Health Organisation recommendations? Has it done so on this occasion?
§ Lord CheshamMy Lords, I do not believe so. When it is a case of toxic substances being taken orally, it is totally appropriate to take every care.
§ Lord RichardMy Lords, can the Minister help me? As I understand it, this is a directive, and it therefore follows that the Government must have agreed with the 1166 directive. If he is being so critical of the directive today and is telling us that it should be amended, why on earth did the Government agree to it in the first place?
§ Lord CheshamMy Lords, I do not believe I have been that critical of the directive. I have suggested a way by which the dental profession, if it wishes to get a change to the directive, might do so. While there was a risk of toxic or dangerous substances being taken orally, I believe that we were right to agree to the directive.
§ Lord Stoddart of SwindonMy Lords, would not this directive have been discussed under the single market provisions and therefore would it not have been decided by qualified majority? If I am right, how did the Government vote?
§ Lord CheshamMy Lords, I shall have to write to the noble Lord.
§ Lord ColwynMy Lords, my noble friend the Minister was extremely helpful to me when the Question was first put down. Can he suggest a way forward for the dental profession on this matter? It is something which is of great concern to us. It is a treatment that has been available for many years but suddenly we are now told it is unsafe.
§ Lord CheshamMy Lords, I thought that I had already addressed that point. If the dental profession and industry were to make a submission to the European Commission, assistance would be granted by the departments involved. But I would again have to stress the safety angle with regard to the long-term safety of tooth whiteners.
§ Lord ReaMy Lords, in listening to the exchanges so far, the question that is uppermost in my mind is why the Government did not consult the dental profession in order to understand its position before agreeing to the directive.
§ Lord CheshamMy Lords, we were concerned about the possible dangers involved. We must go back to the thought that a 3.7 per cent. concentration of hydrogen peroxide taken orally can have some very nasty effects on people.