§ Mr. Bill O'BrienTo ask the Secretary of State for Health if he will make a statement on the estimated(a) over and (b) under spend for each quarter of 1997–98 in respect of the NHS dental budget. [22561]
§ Mr. MilburnThere is no fixed allocation for expenditure in the General Dental Service (GDS). Expenditure is affected by a number of factors including patient charge contribution. GDS expenditure, net of patient charges, for the two quarters of 1997–98 for which figures are available are as follows:
Net GDS expenditure—England 1997–98 £ million April to June 237.5 July to September 236.5
§ Mr. CannTo ask the Secretary of State for Health if he will estimate the current cost of introducing free dental preliminary examinations in the United Kingdom; and what plans he has to bring forward proposals to that end. [22769]
148W
§ Mr. MilburnThe annual cost of abolishing charges for dental examinations in the United Kingdom based on December 1997 costs, would be about £75 million. This makes no allowance for any resulting increase in the number of examinations or in the amount of treatment provided.
Dental charges are being examined as part of the comprehensive spending review, which is looking at all aspects of the Department's spending in the context of the Government's election manifesto commitment
if you are ill or injured there will be a national health service there to help; and access to it will be based on need and need alone—not on your ability to pay, or on who your general practitioner happens to be or on where you live".
§ Mr. CannTo ask the Secretary of State for Health what arrangements he has made for emergency dental treatment for those who are deregistered following the change of period for continuing care payments. [22768]
§ Mr. MilburnPatients are not being deregistered by this change. The registration period for both adult continuing care and child capitation payments was harmonised at fifteen months with effect from 1 September 1996. Regular attenders will be unaffected by the change as their registration period will roll forward when they attend their dentist. The registration of those patients who have not attended the dentist for fifteen months will lapse.
Dentists are free to re-register any patients whose registrations have lapsed. It is for dentists to decide whether they wish to accept any patient onto their list.
Dentists can treat any patient as an occasional patient for emergency care. Health authorities may also make arrangements for dental treatment of patients in urgent cases, when dentists in their area are not normally available to provide treatment.
§ Mr. CannTo ask the Secretary of State for Health if he will commission a study to evaluate the costs per item of treatment carried out by(a) community dentists and (b) general dental practitioners. [22770]
§ Mr. MilburnWe have no plans to do so. The General Dental Service (GDS) and the Community Dental Service are complementary services and are not directly comparable. The fees paid for each item of service in the GDS is set out in the Statement of Dental Remuneration, a copy of which has been placed in the Library.
§ Mr. CannTo ask the Secretary of State for Health what current studies he has commissioned to analyse the benefits of preventative dentistry. [22771]
§ Mr. MilburnWe monitor the combined effect of preventative and restorative dentistry through regular surveys of adult and child dental health. The next survey of adults is due to take place this year and of children in 2003.
§ Mr. CannTo ask the Secretary of State for Health what has been the cost to his Department of continuing care payments for dentists in each financial year since the scheme was initiated; and what estimate he has made of the comparable cost had the payments been made on a 15–month basis. [22767]
149W
§ Mr. MilburnIn October 1990 the new dental contract was introduced. From this date, general dental service dentists received continuing care payments for adult patients who were registered with them for National Health Service treatment. The cost of payments made in respect of continuing care for the financial years 1990–91 to 1996–97 in England is set out in the table. Expenditure in 1990–91 and 1991–92 reflects the introduction of the new contract and is therefore not comparable to later years. No estimate has been made of the comparable cost had payments been made on a 15-month basis.
General dental service: Cost of continuing care payments1 for year ending 1990–91 to 1996–97 England Year Continuing care cost (£) 1990–912 13,921,120 1991–92 89,639,544 1992–93 109,105,816 1993–94 105,616,458 1994–95 108,162,318 1995–96 107,429,935 1996–97 108,170,299 1 Continuing care payments were introduced in October 1990 with the introduction of the new dental contract. 2 Figure is for six months from October 1990.
§ Mr. CannTo ask the Secretary of State for Health if the sums allocated to the remuneration of general dental practitioners are cash limited. [22774]
§ Mr. MilburnNo. Neither health authorities nor individual general dental practitioners are subject to fixed budgets for general dental services.
§ Mr. CannTo ask the Secretary of State for Health what plans he has to recognise the GDPA for purposes of negotiation. [22772]
§ Mr. MilburnNone. The General Dental Services Committee is the organisation recognised by my right hon. Friend the Secretary of State as being representative of the dental profession for the purposes of consultation on the general dental services.
§ Mr. CannTo ask the Secretary of State for Health what have been the rises in real terms in NHS payments to general dental practitioners in the last five years; and how these have compared with(a) the retail prices index and (b) real rises in income for non-manual workers. [22773]
§ Mr. MilburnGross expenditure in the General Dental Service in England was £1245.97 million in 1991–92 and £1323.07 million in 1996–97, a rise of 6.2 per cent. in the five year period. In real terms, when compared to the GDP deflator, gross expenditure fell by 7.6 per cent.
Changes in gross expenditure cannot be compared directly with the retail prices index and the income for non-manual workers. Gross expenditure includes not only income for general dental practitioners but also payments to meet practice expenses and additional payments such as maternity allowance, sick pay, seniority payments etc. Levels of expenditure are also linked to the volume of National Health Service dental services provided by dentists.
Dentists working not less than 2 days per week in the GDS, had average earnings of about £50,000 per annum from the NHS in 1996–97, after expenses.
150WInformation on the rise in the retail price index and the earnings of non-manual employees at April each year as reported in the "New Earnings Survey 1997" (Table 30) is available in the Library.
§ Mr. ChaytorTo ask the Secretary of State for Health if he will extend the registration period for NHS dental treatment to 24 months from the end of the month in which the patient last visited his or her dentist. [22283]
§ Mr. MilburnThe National Health Service (General Dental Services) Amendment (No. 2) Regulation 1996 SI 1996/2051, which implemented the changes to the registration period, were laid before Parliament on 6 August 1996, and came into force on 1 September 1996.
We have no plans to review this policy, which will improve value for money by focusing payments to dentists on those patients receiving active care from them.
Any savings generated will be put back into the General Dental Service, in a targeted way to achieve better oral health for the population.