§ Mr. Ennals
the dispute arises from the continuing refusal, since July, of the professions' representatives—the British Dental Association—to take any further part in the Dental Rates Study Group's activities unless an agreed procedure for correcting retrospectively for over or underpayment of practice expenses, known as the balance sheet, is immediately dropped. the study group advises Ministers about the level of fees necessary both to reimburse dentists on average and to remunerate them in accordance with the recommendations of the Doctors' and Dentists' Review Body. The balance sheet procedure was introduced in 1974 at the request of the British Dental Association as a safeguard against those effects of inflation which might not be fully reflected in the study group's forecasts. the arrangement worked satisfactorily until this year when evidence became available that actual practice expenses in 1974–75, the latest year for which firm Inland Revenue figures are available, were on average £299 less per practitioner than was paid through NHS fees—i.e., an over payment of £299 and pointing to larger over payments in 1975–76 and 1976–77.
I cannot simply ignore these over payments, any more than I could ignore under payments to the profession. I have a responsibility to the taxpayer and, at a time when strict cash limits are being applied to other parts of the NHS, there 657W can be no question of fortuitous bonuses to the dentists. I have, however, offered on several occasions to limit this year's adjustment to the £299 over payment in 1974–75 and to discuss with the profession the least painful method of dealing with the over payments. I have also offered to consider changes in the system for the future, if only the association will return to the study group to discuss them and to enable it to resume its function of advising Ministers about the level of expenses. So far my offers have been rejected.
I very much regret that this dispute has arisen, and I am anxious to find a speedy solution not only in the interests of the dentists themsleves but in the interests of the patients, since the longer the dispute is left unsettled the greater the danger that patients will suffer.