HL Deb 09 December 1999 vol 607 cc1445-7

6.56 p.m.

Lord Burlison

rose to move, That the draft regulations laid before the House on 2nd November be approved [30th Report from the Joint Committee, Session 1998–99].

The noble Lord said: My Lords, on behalf of my noble friend Lord Hunt of Kings Heath, I beg to move the Motion standing in his name on the Order Paper. These measures, which have the support of both dental auxiliaries and dentists, should be seen in the context of two key elements of government policy: improving the quality of public service, including the National Health Service; and deregulation where it can be carried out without compromising the protection of the public.

The dental auxiliaries concerned are dental hygienists and dental therapists. While working under the direction of a registered dentist, dental hygienists may scale and polish teeth and dental therapists may, in addition, extract deciduous teeth from children and undertake simple fillings.

The amendments have been requested by the General Dental Council, which is required to maintain rolls of registered dental hygienists and dental therapists under Section 45 of the Dentists Act 1984. The amendment to regulation 2 of the primary regulations would enable dentists and any members of the public who choose to consult the rolls for dental hygienists or therapists to identify those who have additional qualifications. It could help dentists recruit auxiliary staff to their practices or enable patients to select practices with any special expertise they require.

The amendment to regulation 4 simplifies the procedure by which the hygienists and therapists apply to remain on the rolls. The primary regulations require them to complete an application form to submit with the retention fee. With the increased use of standing orders and direct debit mandates for paying regularly recurring charges, the form has become redundant. Receipt of the payment gives the General Dental Council sufficient notice that the hygienist or therapist wishes to remain on the roll.

The amendment to regulation 6 provides for increases in the fee for retention on the roll from £20 to £25 and for restoration to the roll from £5 to £10. The fees were last increased in 1996. Even with the increases, the fees are less than a quarter of those paid by dentists. The amendments to regulations 23 and 27 provide for both dental hygienists and therapists to insert temporary dressings. The reason for this minor extension in their permitted duties is that, while treating patients, both hygienists and therapists sometimes find broken or missing fillings. If all the registered dentists in the practice are engaged in treating other patients, they can only advise the patient to return as soon as the dentist is next free. With a temporary dressing inserted, the patient can make a new appointment to see the dentist at a mutually convenient time.

I hope that my explanation has been helpful and that the House will support the regulations.

Moved, That the draft regulations laid before the House on 2nd November be approved [30th Report from the Joint Committee, Session 1998–99].—(Lord Burlison.)

7 p.m.

Lord Colwyn

My Lords, when dental matters are discussed in your Lordships' House one can always rely on the noble Baroness, Lady Gardner of Parkes, to say a few words. However, she was on the Woolsack and she has no doubt just left the Chamber for a well-earned rest.

I welcome the regulations. I am delighted that the word "denturism" was not in the Minister's speech. It was discussed in the First Standing Committee on Delegated Legislation in the other place, but I do not think it is relevant to the regulations. However, I am slightly concerned about the 25 per cent increase in the General Dental Council retention fee. I am about to pay my own retention fee for next year, which I know has increased. I am not sure by exactly how much, but I do not think it is 25per cent. However, in view of the Government's demand for efficiency and savings, I hope that they will keep an eye on any similar increases which might affect the dental profession.

I am delighted to see regulations 6 and 7. They legalise something which most caring hygienists and therapists have been doing for many years. If a filling was knocked out while the teeth were being cleaned it would be ridiculous if a temporary dressing could not be put in place. That has been done for many years and it is now to be legal.

Perhaps I may conclude by asking the Minister two questions. First, can he confirm that with the new regulations all patients who are treated by therapists and hygienists still have to be seen by a general practitioner and have that course of treatment prescribed? Secondly—I should know the answer to this question as chairman of Dental Protection—in view of the fact that the Health Act now makes indemnity compulsory for doctors and dentists, can he say what is the status of therapists and hygienists? Do they have to have indemnity in order to carry out their treatments? I welcome the regulations.

Lord Burlison

My Lords, I thank the noble Lord for his helpful remarks. I know that he is a practising dentist and therefore has much greater knowledge than I in this area. It is helpful both to myself and to the industry generally that he should comment on the regulations.

The noble Lord asked about the annual retention fee for dentists. There has been a 50 per cent rise. The noble Lord is probably not too happy about that. If he does not already know, it rises from £90 to £135. The noble Lord also asked about dental auxiliaries and whether the dentist will still oversee their work. That will be the position because they work under the supervision of the dentist or a dental practice. It is for the dentist and the dental auxiliary to agree the detailed working arrangements.

The noble Lord asked about indemnity. I can confirm that it is the Government's intention to put general dental practitioners under a statutory obligation to have personal indemnity insurance. The insurance would cover the actions of the dental auxiliaries as they would be working under the supervision of the dentist.

On Question, Motion agreed to.