Seventh report from the Select Committee on Estimates : together with the proceedings of the committee on 25th May, the minutes of evidence taken before sub-committee D and appendices, session 1948-49 : the administration of the national health services.

  • Great Britain. Parliament. House of Commons. Select Committee on Estimates
Date:
1949
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Licence: Public Domain Mark

Credit: Seventh report from the Select Committee on Estimates : together with the proceedings of the committee on 25th May, the minutes of evidence taken before sub-committee D and appendices, session 1948-49 : the administration of the national health services. Source: Wellcome Collection.

    65/152 page 35
    8 February, 1949.] [Continued. —s Mr. Selwyn Lloyd. 459. In anticipation of your answer may I ask you a very simple question? Is a dentist entitled both to be in the scheme and also to carry on private practice?— Yes, certainly. There are, as it were, the ‘the dentist. The individual member of the public is not forced to go to any dentist. ‘He can go to anyone. He has complete freedom to visit any dentist he likes who ‘will accept him under the _ scheme. Secondly, the dentist has complete freedom. if he has joined the scheme and is on a dental list he still has complete freedom to accept a patient or not to accept a patient. It must be clearly understood. ) Mr. Sparks.| That really means, then, that this practice about which I complained .-—and which is fairly considerable through- out the country—is one which is accepted as being right and proper by the Board? Is that it? Chairman. 460. I think this matter does not come within their function. Is that so?—It is not a matter for us. We have nothing to do with it. J am trying to inform you of what the actual position is. Chairman.| That is a matter for your local dental committee who keep an eye on the professional conduct of the people 'in their area. Mr. Sparks. 461. The question does arise on _ this matter of completed treatment. The fact /remains that there are cases where people _do start treatment and the treatment very often starts with the extraction of a tooth which is causing pain, and, in so far as that portion of the treatment is concerned, there are dentists who are making that the subject of a private fee and then the completed treatment is assessed under the health scheme and referred to the Dental Estimates Board, and the assumption is that that bill is paid for the completed treat- ment; but what I wanted to get clear is this: that there is no excuse, is there, for any dental surgeon refusing treatment in emergency cases on the ground that he has to get prior consent of the Dental Estimates Board? He is quite free to do it, in fact, and there is no objection raised by the Board?—That is the position. Chairman. 462. It is rather the opposite?—Abso- lutely ; indeed, we do not need to do any- thing; it is as if we did not exist. Mr. West. 463. With regard to this emergency treatment, does the patient have to sign a form that the treatment has been carried eut?—Yes. 464. And then that is sent in to the Board and examined and approved, I take it, and upon that the payment is made?. —That is correct. Chairman. 465. You have mentioned that extrac- tions can be done right off without any previous permission. Can you tell us of other types of treatment coming in that category?—-The treatment which can be done without prior approval comes in that large category of treatment which it has been the desire of the dental profession and, indeed, the State, to encourage, namely, the conservation of teeth, the saving of them rather than the extraction of them, and all fillings of teeth can be got on with immediately the patient and the dentist come in contact with each other; there is no restriction at all. Mr. West. 466. Do I understand that there is a flat rate prescribed for extractions or fill- ings irrespective of the particular difficul- ties that might be experienced in a par- ticular case?—There is a slightly varying rate of fee for fillings dependent on the size of the filling ; that is to say, you might imagine a small filling in the surface of a tooth: that carries a certain fee. There is another type of filling you can imagine involving the top surface and going over the side and extending down the side of a tooth: that carries another fee. When I say that all fillings can be done without prior approval, I would like the Sub-Com- mittee to realise that that means all normal fillings. If, however, for any reason it is decided either by the patient or by the dentist that gold fillings would be very good in the teeth, it is clear, | think, that gold fillings cannot be indiscriminately put into people’s teeth without some con- trol or at least scrutiny, and, where a dentist can give to the Dental Estimates Board clear information that the gold fill- ing is a clinical necessity, the gold filling is put into the patient's mouth without question, the approval of the Board is immediately given, and treatment proceeds. 467. The point I was trying to get at was this. Do I understand that the scale of charges which a dentist is entitled to charge under the scheme for work done is equal to or less than the general rate which prevails amongst private patients? Is it more profitable for him to force people into his surgery as private patients than it is to give them service under the scheme, and is that probably part of the explana- tion of the point my honourable friend has put forward?—I would not feel that it was incumbent upon me to answer that; I could talk about it, but I do not think it is the purpose for which I am_ here before this Sub-Committee. The fee which is permissible under the Health Service has
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