§ Mr. KirkwoodTo ask the Secretary of State for Scotland if he will estimate the reduction in turnover experienced by dental practices in Scotland as a result of the Government's recent changes in method of remuneration.
§ Mr. Stewart[holding answer 18 January 1993]: There have been no recent changes in the method of dentists' remuneration. Since the introduction of the new dental fee scale in July 1992, turnover as reflected in gross income received by dentists in Scotland, which includes fees paid to dentists by health boards and charges collected by dentists from patients, has been at a higher level than in the comparable period for the previous year. From July to November 1992—the latest month for which figures are available—the total gross fees authorised to dentists (which include the value of charges paid by patients) were £56,379,000, compared with £56,316,000 for the same period in 1991.
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§ Mr. KirkwoodTo ask the Secretary of State for Scotland if he will publish a table showing the amount paid to dental practitioners in Scotland over the past three years at constant prices together with the planned level of expenditure for the next three years.
§ Mr. Stewart[holding answer 18 January 1993]: The remuneration received by dentists in Scotland for provision of NHS services as reflected in the total gross fees authorised for payment to dentists (which include the value of charges paid by patients) is shown in the table for the last three financial years. Estimates of expenditure for future years are not yet available.
Year Gross payments to dentists £ million Gross payments to dentists at 1991–92 prices £ million 1989–90 94.393 108.971 1990–91 111.463 119.165 11991–92 132.822 132.822 1 Figures for 1991–92 reflect the fact that dentists' average gross earnings for NHS work were significantly higher than the target average gross income (TAGI) set for that year.
§ Mr. KirkwoodTo ask the Secretary of State for Scotland if he will publish the assumptions used by his Department when seeking to estimate the fixed costs of a dental practice.
§ Mr. Stewart[holding answer 18 January 1993]: No such estimate is made by the Department. Average national health service dental practice expenses in Great Britain are estimated each year by the dental rates study group and full reimbursement of these costs to dentists on an average basis is included in dental fees.
§ Mr. KirkwoodTo ask the Secretary of State for Scotland how many courses of dental treatment were undertaken in each of the past five years.
§ Mr. Stewart[holding answer 18 January 1993]: The figures for 1991 and the preceding four years are contained in the table. The figures from 1 October 1990 are for adults only as under the new dental contract introduced from that date children are now treated under capitation arrangements to provide continuing care, and information is not recorded on individual courses of treatment. The number of children registered with a dentist under these arrangements at the end of the calendar years since October 1990 is shown separately in the table. The number of courses of dental treatment undertaken in Scotland for 1992 is not yet available. To the end of November 1992 —the latest month for which figures are available—a total of 2.357 million courses of adult treatment had been undertaken, and a total of 0.72 million children were registered with dentists.
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Million Number of courses of treatment Number of children registered (as at December) 1987 2.987 n/a 1988 3.053 n/a 1989 3.144 n/a 1990 January to September 2.316 n/a 1990 October to December1 0.545 0.29 1991 2.485 0.66 1 New contract for General Dental Services introduced on 1 October 1990.
§ Mr. KirkwoodTo ask the Secretary of State for Scotland what is the method of arriving at payments for courses of dental treatment, materials and laboratory fees.
§ Mr. Stewart[holding answer 18 January 1993]: Dentists' remuneration for national health service work is set by a process of several stages. The Review Body on Doctors' and Dentists' Remuneration (DDRB) recommends a target average net income (TANI) which it considers dentists should earn from providing national health service general dental services, and the Government decide to accept or amend the recommendation and sets the TANI. The dental rates study group (DRSG) then forecasts the level of dentists' expenses (including materials and laboratory costs) for the coming year and adds this figure to the TANI to produce the target average gross income (TAGI).
The DRSG then applies a balancing mechanism to the TAGI figure to correct for any over or underpayments to dentists in previous years as a result of differences between forecast expenses and earnings and actual figures, and produces the amount due to the average dentist. Finally the DRSG forecasts the amount of national health service work that dentists will undertake in the coming year and sets the scale of individual payments and fees at a level that, taking account of the forecast amount of work, will deliver the TAGI due to the average dentist.
§ Mr. KirkwoodTo ask the Secretary of State for Scotland what recent representations he has received from dentists in Scotland regarding the current system of remuneration; and if he will make a statement.
§ Mr. Stewart[holding answer 18 January 1993]: My right hon. Friend has received a wide range of representations from dentists. The Government recognised the concern about the current system of dental remuneration and therefore commissioned Sir Kenneth Bloomfield to undertake his fundamental review of that system. Dentists were invited to contribute to the review.
§ Mr. KirkwoodTo ask the Secretary of State for Scotland how many dental practices in each health board area have opted out of national health service dental treatment in the last 12 month period for which figures are available.
§ Mr. Stewart[holding answer 18 January 1993]: According to information held by health boards, in the last 12 months one general dental practitioner in Fife health board area and one in Tayside health board area have left their dental lists because they no longer wish to provide national health service dental treatment.
§ Mr. KirkwoodTo ask the Secretary of State for Scotland in which towns in the Borders health board area dental practices have gone private in the last 12 months for which figures are available.
§ Mr. Stewart[holding answer 18 January 1993]: According to information held by Borders health board, in the last 12 months no general dental practitioner has left the Borders health board dental list in order to provide private treatment only.
§ Mr. KirkwoodTo ask the Secretary of State for Scotland when he expects the Bloomfield review committee to report on the future system of remuneration for dentists.
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§ Mr. Stewart[holding answer 18 January 1993]: Ministers have now received Sir Kenneth Bloomfield's report on his fundamental review of dental remuneration.