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Dental Services

Volume 951: debated on Tuesday 13 June 1978

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asked the Secretary of State for Social Services what progress he has made towards ensuring that dentists provide treatment under the National Health Service for all patients.

A settlement reached with representatives of the British Dental Association on 17th May ended the dispute over expenses. The way is now open to a return to normal working with dentists offering the full range of treatment under the National Health Service.

Is my right hon. Friend aware that much of that agreement is still unacceptable for a large area within the profession? Does he recognise that there are now whole areas of the country where dentists no longer accept National Health Service patients and intend to keep it that way? Is he also aware that many of his hon. Friends, including myself, accuse him and the Chancellor of the Exchequer of deliberately starving the National Health Service dental service of funds so that private patients will continue to contribute a far larger share of the cost of upkeep of the National Health Service? Therefore, will he now institute immediate steps to make good this deficit?

On the first part of the question, the British Dental Association has reached agreement with me as Secretary of State. I very much hope that all dentists will co-operate. I am very hopeful that, as a result of this decision and the new agreement which provides additional resources for the dentists, the troubles will be ended. However, even during this period there has been a steady increase, month by month, in the number of treatments which have been provided under the National Health Service by dentists. As for the suggestion that the service has been starved, that is not so. There is a steady increase in the number of dentists as well as in resources made available for the service generally.

Would it not be easier to provide dental treatment for all patients who need it if water were fluoridated, since this would drastically reduce the incidence of dental decay?

I am in favour of fluoridation and I and my ministerial colleagues are doing our best to find ways to encourage it all over the country. Bit by bit, this is happening, and the majority of area health authorities have taken a decision in favour of fluoridation.

Does the agreement which my right hon. Friend has made get rid of the gross injustice to patients that it is not obligatory on the dentist to let them know whether he is treating them privately or on the NHS? Since he has concluded this agreement, will he now implement the working party report which I submitted to his Department two years ago, which would save much of the £223 million that we are now spending on dental services?

Some of the proposals made by my hon. Friend have been implemented and I am ready to look at some of the others. On the first part of the question, it has been very wrong and irritating for patients when dentists have not explained the situation exactly. We have drawn this to the attention of dentists. They are asked, as are other practitioners, to make the situation clear to patients so that they may know whether they are having treatment under the NHS or are expected to enter into a private agreement.

Will the Secretary of State now explain why, for the first time in this country, so many dentists who work in the NHS are going bankrupt?

I have no statistics of dentists going bankrupt. The hon. Gentleman will know that one of the difficulties which led to the rift between myself and the British Dental Association was the refusal of the Association to cooperate in the work of the dental rates study group and in the production of an up-to-date scale of NHS fees. This was partly because there was an objection to the system whereby they were expected to repay expenses which had been paid to them over and above what was required. That dispute has now ended. Dentists will be receiving an increase of 12 per cent. on authorised fees. That is partly an advance for expenses, and it is being made available during the course of this year. This will greatly improve the position of dentists.