HL Deb 14 June 1999 vol 602 cc6-9

2.51 p.m.

Baroness Gardner of Parkes asked Her Majesty's Government:

What authority will be responsible for the maintenance of standards of dental treatment provided for patients in the mixed private and National Health Service dental clinics now opening in large retail premises and whether controls and consumer rights will differ between the NHS treatments and those provided privately.

Baroness Hayman

My Lords, large retail premises are no different from any other mixed dental practice. The General Dental Council is responsible for both the professional conduct and fitness to practise of all dentists in the United Kingdom. Additionally, health authorities and the Dental Reference Service of the Dental Practice Board are responsible for the maintenance of standards of treatment for consumers within NHS dentistry.

Baroness Gardner of Parkes

My Lords, I thank the Minister for that reply. As an elected member of the General Dental Council I discovered that its responsibility is to issue the educational curriculum and to pick up problems which have reached an impossible point, perhaps then having to take someone off the dental register. Does the Minister believe that there is a great gap between those two areas? Does she agree that an independent assessment system should be available—either run privately or provided by the Government at a cost? Many individuals now have private dentistry treatment either because they cannot obtain such treatment under the National Health Service or because they choose to do so. They should have some means of being assessed independently. Few patients have any idea technically whether they are being treated well, badly or indifferently.

Baroness Hayman

My Lords, the noble Baroness pinpoints an important issue. As are several other regulatory bodies, the General Dental Council is concerned that its powers and abilities are not as wide or sensitive as it would wish. It has proposed a number of amendments to the Dentists Act, including proposals for a private complaints procedure, which I think would be helpful, and a performance review scheme. That could be achieved through the order-making power to strengthen professional self-regulation in the Health Bill, which returns to your Lordships' House this week. There are opportunities for improvement there.

We shall shortly issue a consultation document on regulating private and voluntary healthcare. We shall seek views on whether the current exemptions from regulatory arrangements, including exemption for premises primarily used by dentists for treatment, should continue. I think that there are opportunities for improvement in this area.

Lord Bruce of Donington

My Lords, is the Minister aware that the issue is being overshadowed by the fact that the dental service is rapidly becoming a two-tier service under the present national health arrangements? Some attention will have to be given to that fact. Hard choices are now having to be made by people who can least afford to make them.

Baroness Hayman

My Lords, my noble friend is right to point out that we inherited a situation which was the result of the promises of the former government, who did not invest in dentistry and allowed the rundown of dental services. That led to the inequalities and difficulties which are highlighted in some parts of the country. We have taken positive and successful action to tackle some of the worst areas by investing in dentistry and through personal dental services pilots. Twenty-four new pilots were announced as part of the Government's vision of a more flexible, accessible and convenient health service.

However, there is a great deal to do here. It would be wrong to suggest that we can put the matter right overnight. I hope that the strategy which we shall publish later this year will take us further along that road.

Lord Clement-Jones

My Lords, the Minister referred to drop-in centres that were announced recently. The noble Baroness, Lady Gardner of Parkes, referred to retail developments. Are not these taking place in somewhat of a vacuum? The Minister referred to the strategy document being published later this year. The original intention to have a strategy was referred to in April 1998. Is it not high time that the strategy paper was published—and very soon?

Baroness Hayman

My Lords, I hope that we shall publish it before too long. But the most important aspect is to get the strategy right. We need to ensure that that strategy reduces inequalities in oral health status, improves access to NHS dental services, builds on the success of investing in dentistry and personal dental services, guarantees high quality services, and ensures that all members of the dental team can make the fullest contribution to improving services for patients. The major job is to get the strategy right, if we are to cover all those areas effectively. As I have said, I hope that the document will be published later this year.

Lord Rix

My Lords, is the Minister aware that according to the Office for National Statistics survey of 1997, 96 per cent of all non-disabled children attended for an annual oral check while only 72 per cent of children with a learning disability did likewise? Similar figures apply to adults with and without learning disability. What safeguards and standards are being set for the new-style clinics in regard to the reception, treatment and encouragement to attend of people with a learning disability, both adults and children?

Baroness Hayman

My Lords, the noble Lord highlights that in our strategy we need to make sure that we reduce some of the inequalities in oral health status which apply to different groups in the population, including the learning disabled, and in different areas of the country. We have to look overall at access to dental services from different groups which have particular difficulty. Community dental services in some parts have done good work in that field. I shall make sure that the points the noble Lord raises today are taken into account in consideration of the issue.

Baroness Oppenheim-Barnes

My Lords, does the Minister agree that, welcome though a complaints procedure may be—I am sure that it would be widely welcomed in consumer quarters—it is important that anyone involved in such proceedings should be expert but completely independent so that the advice he or she gives would give the additional help implied; and that, above all, the procedures should be easily available to those who may have to use them?

Baroness Hayman

My Lords, the noble Baroness is right. The procedures should be transparent and independent.

Earl Howe

My Lords, regardless of the position that the Government state they inherited, is the Minister aware that the number of adults registered with a dentist in the UK was 22.3 million in December 1997? However, the figure had fallen to 19.7 million by December 1998, a reduction of 2.5 million? What are the Government doing to make NHS dentistry more available to the many people who are unable to find an NHS dentist?

Baroness Hayman

My Lords, my noble friend suggests I say that we should not and would not have started from here. The problem created by the withdrawal from NHS dentistry will take time to turn around. However, we have received 282 bids for funding from investment in dentistry, which have been approved to the value of more than £8 million. That will enable more than 650,000 new patients to receive NHS care. However, some areas of the country have been complete deserts for NHS dentistry for some time and it will take some time to build them up and stop that being the case.