Charges for Dental Appliances and Treatment

Part of Orders of the Day — Health and Medicines Bill – in the House of Commons at 4:11 pm on 14 April 1988.

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Photo of John Greenway John Greenway , Ryedale 4:11, 14 April 1988

I have a great deal of sympathy for those who argue that phasing out free dental examination is not the right step to be taking at this time. However, I ask those who are thinking of joining the Opposition in the Lobby to reflect on the discussions that have been taking place in the dental profession for some months about the need for a new system of remuneration for dental practitioners. I dwelt on that point at length on Second Reading.

If all the diseases that a dentist looks for when undertaking an examination are as important and far-reaching as has been made out, the question we should be addressing is what contractual relationship a dentist should have with his patient. Clearly, the present remuneration system that rewards a dentist, regardless of who pays the charge, with a paltry sum of £3·90 for an examination is ludicrously inadequate.

There is another reason why that is so. In the past, when the dental rates study group has considered what fees to apportion to the various items of treatment that dentists carry out, the examination fee has always received little additional money. The reason is that dentists would be adequately remunerated through the treatment that was necessary. Thankfully, in this day and age, we see improving dental health. It is improving to such an extent that patients who have the good sense to go to their dentist regularly need little, if any, treatment. I can tell the House that many practitioners are increasingly finding that, after a routine examination, their patients require no treatment.

That is why the General Dental Service committee has proposed to the Department the need for a new annual registration contract. That contract would replace the present dental examination and screening arrangements. I warmly commend that scheme to the House. The argument should not be about what charge there should be per dental examination and who should pay it, but about what structure of remuneration we require.

There is not time in this debate to go into that aspect more deeply. However, can I tell my right hon. Friend the Secretary of State that I support what the Government have in mind. I can also tell him that I have lobbied for the contract throughout the dental profession and there is great support for it from many forward-thinking dental practitioners. I am disappointed that formal discussions on the new contract have not yet commenced. I believe that we should pursue the new contract arrangement, which the White Paper sets out, with all urgency, so that if, as I believe will be the case, the House votes to phase out a free dental examination, there could be an opportunity for us to phase out the free examination and introduce the new annual registration contract at the same time. That would send a clear signal to the public that regular attendance is what the Government want to see and to encourage.

On Second Reading, I made reference to a study that was being carried out on the subject of "Barriers to the receipt of dental care". That study—a very small one, based on just over 100 families—has now been completed and it indicates precisely those points which discourage attendance that I outlined to the House some four months ago. In particular, it shows that many people, despite the fact that they would be entitled to free examination and even free treatment on exemption if they went to the dentist now, do not attend because there is no perceived need to see a dentist.

The second thing which the White Paper stresses, and which during the Second Reading debate my hon. Friend the Minister of State said that he would take urgent action upon, is the need to launch a dental awareness campaign. I understand that discussions are already well advanced on a new scheme to be launched in the west midlands later this year. We must pursue that with real vigour.

I say again to the House what I said on Second Reading—that, if the money which the Government raise from the phasing out of free examination is used to encourage more people to visit the dentist and to help dentists to establish bigger and better practice premises, this measure will indeed be worth while.