Baroness Gardner of Parkes
Main Page: Baroness Gardner of Parkes (Conservative - Life peer)NHS: Dentistry Services
Baroness Gardner of Parkes Excerpts
Baroness Gardner of Parkes
To move that this House takes note of the availability of National Health Service dentistry services.
Baroness Gardner of Parkes (Con)
My Lords, I declare my interests as a retired dentist and a national health pensioner. It is good that we have this opportunity, on the last sitting day before the Recess, to debate the present situation. The Table Office produced the wording about the “availability” of NHS dentistry. Sadly, a more accurate title would refer to the lack of availability, as whole areas of the country have no dentists offering NHS treatment.
Many Australian dentists came to Britain at the time I did, in the 1950s. That was because there was no work for many new graduates in Australia. At the end of the Second World War, places at university—in my case the University of Sydney—were offered to anyone who had served in the forces. Teaching had to be on a sessional basis, so the laboratories and clinics were in constant use and able to produce many more dentists than if they had just the one session a day.
When many Australians came to Britain in the 1950s, there were about 150 new dental graduates each year, but there was work for only about 50. In Australia, dentists got jobs digging dams or making roads—anything that could provide a job for a living wage. No one seems to know who discovered the need for dentists in the UK, but word spread quickly and hundreds of new Australian dentists arrived by ship at Tilbury—there was no such thing as a quick flight in those days. Colleagues were on hand to explain how to register, obtain dental practice insurance cover and find a job. My knowledge is of the London area: there were plenty of jobs going and lots of children were in desperate need of dental treatment.
It was a shock to discover that a popular 21st birthday gift in the north of England was a full clearance of one’s permanent teeth. That is hard for us to believe now, when we would do anything to save our teeth. While some dental implants are done in the UK, I keep meeting people—even staff who work here—who tell me that they have taken up an offer to go to Budapest to have crowns fitted because it is cheaper there and very well organised. It really is a different world, dentally, from that of the 1950s.
When it was discovered who needed dentists in the UK, people found themselves going to different areas of the country. Their descendants remain in many of those places. I came in the early 1950s and was given a right to stay for six months. I think I asked to stay for a year, but was told, “No, no, we’ll only give you six months”, so I took it. By the end of the six months, they were willing to give us a bit more because, by then, we were involved in the National Health Service.
I served on the local dental committee and the Inner London Executive Council, and I was the first woman ever appointed to the Standing Dental Advisory Committee for England and Wales. That was in 1968.
Kevin, my husband for 50 years, arrived about a year after me. That was because he had won the oral surgery prize. If you had achieved such a special result, you were offered a year on the teaching staff in Sydney. A number of graduates did that and then came over the following year. We eventually bought a dental practice from an elderly Canadian dentist in a poor area on the fringe of the City of London. The houses were all red brick, 200 years old and owned by St Bartholomew’s Hospital. The whole area had quite bad subsidence. As you sat in the dental chair in the surgery premises, you saw that the doorway ran downhill—or uphill, depending on which way you were looking at it. It certainly was not level, and it was pretty worn out by the time we got there.
Many people wanted only a tooth out. We used to charge half a crown, but there was a donation to put in a bottle. That suited a lot of people, because they came in only if they were in trouble with pain. People were not minded to go to the dentist for routine things except, as I mentioned, in the north of England, where things were quite different.
During the years we were there, the area was gradually taken over through compulsory purchase by the GLC, which demolished the lot and rebuilt. It is hard to believe how grim the area was in those days, yet it had a wonderful atmosphere. Patients usually came from their houses in carpet slippers and hair rollers to have whatever was needed done to their teeth. They all went hop picking in Kent, which was how they afforded summer holidays. It is different now; no one goes hop picking because it is all done by machine. Who would have believed that that funny little old area would now be considered so smart? Old Street is the place for high technology; it has come a long way since we were there. A lot of people have been rehoused further out.
It is extraordinary that the number of adults seen by an NHS dentist has fallen in recent years. That surprised me; even if only those who had been going had kept going, the numbers should not have fallen. I do not understand why that is. Perhaps people have moved out; perhaps more people live further out; perhaps they want a dental practice closer to where they live. I was surprised to read that Portsmouth does not have a single dentist offering to take NHS patients; that has not been widely publicised. The numbers seen —in thousands—are set out in the briefing that I know has been sent to most noble Lords.
Also extraordinary was the speech made by Kenneth Clarke, which reversed the situation. In 1988, Kenneth Clarke wanted to introduce national health examination fees. In those days, noble Lords used to go and have a bit of a snooze in the big chairs in the Library after lunch—they are more active now. I went in and said something a bit noisy to wake them up, and then asked them to come into the Chamber and listen to the debate. I did not want to make up their minds for them; I just wanted them to hear what was said. They did, and this House voted to retain free dental examinations. The Bill then went back to the Commons, where Kenneth Clarke made a lengthy speech about why the Commons should agree to reverse the position back to what it had been. He also attached financial privilege so that we could not debate it again. That was a tragic situation; the opportunity had been there, but it was the beginning of the end for national health dentistry.
National health dentistry is now not meeting people’s needs and the biggest worry of all is treatment for children. If they do not get treatment early in life, when they really need it, you can never reverse the damage once the baby teeth are lost. I read in the Manchester Evening News that children are willing and able to have dental treatment under general anaesthetic and huge numbers of clearances are being done, but no one is willing to take on general treatment. There are no general anaesthetic slots available for other operations in Manchester because the clearance of children’s teeth is taking up the full capacity for treatment under general anaesthetic. That is a sad situation and I hope something will be done about it.
I hope today’s debate will send a message that we want NHS treatment to continue. It is very important for those receiving dental care to have that facility available. I beg to move.
Baroness Gardner of Parkes
My Lords, it has been fascinating listening to the debate—so many interesting points have been raised. I thank all noble Lords who have spoken and very much appreciate the points the Minister made.
There are a few things I should point out. A noble Lord said that there should be a form to fill out to get extra financial help. I remember those forms. They came from people only a few times and had 25 questions on them. The patients had no hope of understanding them. It took 15 minutes or more of my time to go through the questions, one by one, filling out yes, no or whatever it was. It should be clear who should get help, so something much simpler could handle that issue.
A noble Lord referred to patients pulling out their own teeth. I never felt sympathetic about that because, to pull out your own teeth, they have to be loose. It can be a hard job getting out teeth; that last little bit hangs on. I think it is someone whose teeth are probably just about ready to fall out who would be taking out their own teeth.
There is a very important issue about six year-old molars. Lots of parents are keen to be sure that their children have no bad baby teeth, and others think they do not matter because they will be replaced by other teeth, but six year-old molars come through behind baby teeth. Because of that, people tend to miss it and not check that point for the child.
What the Minister said on fluoridation was very good; she gave us some hope. As an Australian, I must say that Australians have had it for 60 years now, almost everywhere, except for those on a local river or rainwater tank. But it is important to keep it at the optimal level, not the maximum or anything else. That is why there has to be a good water authority that can take fluoride out, as well as put it in. That is essential; you do not want it to be uncontrolled.
I have repeatedly asked questions in the House about Manchester and Birmingham. The answer has always come back that there is no difference in the health pattern for cancer or any other condition, but the big difference is that Manchester has no fluoridated water and the worst possible teeth, and Birmingham has very good teeth, because it has had a fluoridation scheme for so long. People need to be aware of those few things. Interesting and relevant points have been made. I could not speak more highly of what my colleague said on that contract set-up. I ceased to have that a long time ago. I again thank all noble Lords who have contributed.