§ Sir Peter EmeryTo ask the Secretary of State for Health what action she is taking to reverse the present shortages of NHS dentists in the south-west.
§ Mr. MaloneAt 31 December 1994 the number of dentists under contract to family health services authorities in the south-west was 1,245, 32 more than at 30 June 1992.
400WFamily health services authorities can apply for permission to appoint salaried dentists in areas where there are shortages. We have recently given approval for two salaried dentists to be appointed by Devon family health services authority and for one salaried dentist to be appointed by Gloucestershire family health services authority.
The Green Paper, "Improving NHS Dentistry", proposes a wider role for the community dental service to treat those who cannot have ready access to general dental services.
§ Mrs. BeckettTo ask the Secretary of State for Health how many family health services authorities have appointed salaried dentists; how many salaried dentists have been appointed since July 1992; for what additional provision district health authorities have contracted; and if she will make a statement.
§ Mr. MaloneThe number of family health services authorities that have employed salaried dentists and the number employed are shown in the table. In addition to those family health services authorities listed, Berkshire, Devon, Dorset, Hampshire, Hereford and Worcester, Kingston and Richmond, Northamptonshire, Gloucestershire and Solihull have also been granted permission to employ salaried dentists. At 30 September 1992 there were 2,191 whole-time equivalent hospital and community health service staff in England, excluding hospital practitioners and clinical assistants who also work as general and dental practitioners.
Table 1 number of salaried dentists for whom a contract has opened since 31 July 1992 by family health service authority FHSA Salaried dentists Total 137 Cumbria 1 Derbyshire 3 Cambridgeshire 7 Norfolk 3 Kensington, Chelsea and Westminster 14 Essex 2 City and East London 22 Kent 11 Greenwich and Bexley 6 Bromley 1 Lambeth, Southwark and Lewisham 22 Surrey 5 Merton, Sutton and Wandsworth 1 Wiltshire 2 Isle of Wight 2 Buckinghamshire 6 Cornwall and Isles of Scilly 5 Gloucestershire 4 Somerset 6 Staffordshire 2 Cheshire 8 Lancashire 2 Manchester 1 Salford 1 This is the count of the number of salaried dentists who have contracts with FHSAs.
This is not the number of salaried dentists employed at the requested dates.
(Some salaried dentists have "open contracts" with FHSAs.
This means they are ready to work when required but are not actually working).
401W
§ Mrs. BeckettTo ask the Secretary of State for Health how many letters concerning problems in gaining access to NHS dentistry have been received by her Department from individuals in the last five years; and if she will list those organisations that have written to her on the subject.
§ Mr. MaloneSince February 1990, the Department of Health has received approximately 350 letters from members of the public which were exclusively concerned with problems in gaining access to national health service general dental services.
The Department has also received a similar number of letters from hon. and right hon. Members, community health councils, local authorities, professional organisations and patient groups.
Family health service authorities continue to be the best source of information on the local availability of general dental services, and all authorities report that they are able to help patients to find NHS dentists.
§ Mrs. BeckettTo ask the Secretary of State for Health what was the total sum paid out to general dental practitioners working with the NHS in each month since April 1991.
§ Mr. MaloneThe information is shown in the table.
Payments to general dental practitioners working with the rational health service in England in each month since April 1991 Month 1991–92 £ million 1992–93 £ million 1993–94 £ million 1994–95 £ million April 92.3 118.9 101.1 104.3 May 93.4 118.8 103.6 105.2 June 95.8 114.0 103.0 110.7 July 102.1 117.0 102.8 109.9 August 106.8 115.7 103.9 109.9 September 94.1 103.2 98.8 104.0 October 101.4 100.9 100.9 106.6 November 110.7 104.3 103.7 111.10 December 113.3 104.5 98.5 109.8 January 103.1 108.6 100.8 106.6 February 117.3 101.4 104.2 — March 116.7 97.7 100.1 — Notes:
- 1. The data are for England only and are drawn from monthly cash-based financial information system reports submitted by family health services authorities and the Dental Practice Board. The January data are the latest available for 1994–95.
- 2. Expenditure figures show the total of all general dental service payments in each month, including payments for salaried dentists and emergency dental service clinics. The figures also include the cost of employers' superannuation contributions.
§ Mrs. BeckettTo ask the Secretary of State for Health what is the average cost per course of(a) NHS dental treatment, (b) private dental treatment and (c) all dental treatments for an adult patient in 1993–94, 1992–93, and 1991–92.
§ Mr. MaloneThe available information is shown in the table. Information on private treatment is not available centrally.
402W
Average cost per adult course of treatment in the general dental service in England for the financial years 1991–92 to 1993–94 year Average cost £ 1991–92 39.80 1992–93 39.11 1993–94 36.18 Source:
Dental Practice Board.
Note:
- 1. The information refers to the general dental service only. The cost shown is the fee paid to the dentist.
§ Mrs. BeckettTo ask the Secretary of State for Health what is the average annual number of courses of dental treatment for an adult patient in England; and what is the average cost to(a) the NHS and (b) the patient.
§ Mr. MaloneThe information requested is shown in the table.
Information for courses of treatment completed in the year ending 31 March 1994 £ Average number of courses of treatment per adult patient 1.62 Average annual cost to the NHS of treatment per adult patient 31.34 Average annual cost to the adult patient £27.27 Notes:
- 1. The average number of courses of treatment per patient has been estimated from a sample of 70,000 courses of treatment.
- 2. The costs shown are the costs of adult treatment. Regular continuing care payments are not included.
- 3. The average to the patient represents the average for all adults, not the average to charge payers alone.
§ Mrs. BeckettTo ask the Secretary of State for Health what level of satisfaction was recorded by the British social attitudes survey about NHS dentistry in each year since 1993.
§ Mr. Malone"British Social Attitudes: the 11th Report", 1994–95 edition, found that 58 per cent. of respondents surveyed in 1993 were satisfied or very satisfied with national health service dentists. A further 18.6 per cent. were neither satisfied nor dissatisfied. The comparable figures from the 9th report, 1992–93 edition, were 75.3 per cent. and 16.2 per cent.
Family health services authorities report that they can help patients to find national health service dentists. The Government meet over two thirds of the cost of the general dental service. All those under 18 get free treatment and a quarter of treatments are provided free or at reduced cost.
§ Mrs. BeckettTo ask the Secretary of State for Health how many patients in each family health services authority, and in total, have requested help in finding a dentist since July 1992.
§ Mr. MaloneThe information will be placed in the Library. Family health service authorities consistently report that they can help patients to find national health service dentists.
§ Mrs. BeckettTo ask the Secretary of State for Health by how much payments to dentists have exceeded Government estimates for each year since 1987; and how much was paid by Government and how much by patients.
403W
§ Mr. MaloneThe information is shown in the tables.
Overpayment of general dental practitioners fee income, 1987–88 to 1993–94, Great Britain Total payment (to all DRSG principals) "Gross" payments (£ million) (1) "Net" payment (£ million) (2) 1987–88 (5.003) 22.722 1988–89 49.276 74.494 1989–90 (13.645) 12.256 1990–91 54.582 17.921 1991–92 192.604 128.140 1992–93 65.001 62.920 1993–94 (49.354) 4.143 () Denotes a negative amount.
Overpayment of general dental practitioners fee income, 1987–88 to 1993–94, Great Britain: payment by Government Total Payments (to all DRSG principals) "Gross" payment (£ millions) "Net" payment (£ millions) 1987–88 (3.544) 16.095 1988–89 34.379 51.974 1989–90 (8.511) 7.645 1990–91 35.171 11.548 1991–92 131.203 87.290 1992–93 45.536 44.078 1993–94 (34.609) 2.905
Overpayment of general dental practitioners fee income, 1987–88 to 1993–94, Great Britain: payment by patients Total payments (to all DRSG principals) "Gross" payment (£ millions) "Net" payment (£ millions) 1987–88 1.459 6.627 1988–89 14.896 22.520 1989–90 5.134 4.611 1990–91 19.410 6.373 1991–92 61.400 40.850 1992–93 19.466 18.843 1993–94 14.745 1.238 Notes:
- 1. Column (1) shows the difference between actual gross fee payments made to dentists in the financial year and the estimates made of sums due to GDPs in the Dental Rates Study Group. The estimates include allowances for GDPs expenses. For 1993–94 an expenses allowance was not formally agreed but a notional amount decided upon for administrative and monitoring purposes.
- 2. Column (2) shows the difference between target net income (after balancing) and the actual net income, allowing for the practice expenses incurred. This is calculated using information from a special exercise carried out by the Inland Revenue.
- 3. DRSG principals are essentially general dental practitioners who have worked in the GDS for the whole of the financial year in question.
- 4. The overpayment sums have been allocated to patient and Government by using total net and gross expenditure figures.
- 5. Payments made under determinations 11-1X of the Statement of Dental Remuneration (eg maternity payments, seniority payments and direct reimbursement of expenses) are not included in the above.
- 6. The net payment figures for 1987–88 excludes the balancing adjustment for associate dentists (£225 "underpayment" per principal; £3.37 million in total). Subsequent to 1987–88 this adjustment was not required.
- 7. The figures in columns (2) and (4) for 1993–94 are provisional, and are subject to revision.