Mr. Eric Martlew (Carlisle): I will check in Hansard, but I think that the hon. Gentleman just said that dentists will pull teeth out instead of filling them because they get more money for that. Is that really what he is saying about our dentists? I am sure that that is on the record.
Mr. Lansley: It is, and my hon. Friend the Member for Hemel Hempstead (Mike Penning), who knows these things well, will produce some data to support it when he speaks.
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Mr. Eric Martlew (Carlisle): If I accept what the hon. Gentleman says on this issue, does he accept that the same principle should apply to general practitioners?
Mr. Lansley: No, I do not. Dentists already have a mechanism for charging patients. Since the late 1940s, there has been a clear expectation that the system of co-payment applies to NHS dentistry, but not to other NHS services - and I have no intention of changing that.
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Mr. Martlew: I hear what the hon. Gentleman says about rural areas, but if we take my constituency for example, people from rural areas go to the city to register. Is that not the case in many areas?
Norman Lamb: They may access dentists in urban areas, but they cannot register because they are not allowed to. However, many older people in rural areas, including my constituency, struggle to get to an NHS dentist, and that problem needs to be addressed. Everyone accepts that some people cannot access an NHS dentist, but Professor Steele says that for such older people, the problem is of great concern.
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Mr. Eric Martlew (Carlisle): Thank you for calling me to speak, Mr. Deputy Speaker. If you think I am going on too long, you can remind me to sit down.
The last time that I spoke on dentistry was in the spring of 2006, when my constituency had a major problem of dentists opting out. There was one disgraceful incident in which a dentist who had done so wrote to his patients and told them that they had to come and apply the next day, and that if they did not, they would not get on to his list. He was actually giving out raffle tickets to the lucky ones who were going to stay with him.
Since then, however, things have improved greatly. We now have about 10 new dentists in Carlisle and Penrith, with more on the west coast. We have a large practice staffed by European dentists right next to my office in the centre of the city. They are not Polish, but German. The reason why the Germans are coming over here is that they can make more money working for the NHS in this country than they can working as dentists in Germany.
We have progressed greatly, and I was particularly pleased to receive an invite to the opening of the Carlisle dental centre on 25 February this year, which I will always remember. It is not only a multi-million pound emergency centre, but part of the Cumbria and Lancashire dental school, so we are now training dentists for this rural area. One of the arguments for training there is, "Where they train, they settle." In contrast to the Conservatives, who closed two dental schools, we have opened two of them, so things have improved greatly - and rightly so. I worry about what would happen if a Conservative Administration came in, because we know that they started the rot when they broke the contracts of NHS dentists - I know that that goes back a long time - and closed the dental schools. We have to ensure that that does not happen again.
Fluoridation, which is an issue that angers me, has been discussed. I agree with the hon. Member for Mole Valley (Sir Paul Beresford) on that subject. I remember that this issue was on the agenda when I was the chairman of a health authority more than 32 years ago, when I suspect that the hon. Gentleman was training as a student dentist. I suspect that he was told that fluoride improved the health of children's teeth, yet we have done almost nothing about it.
On the west side of Cumbria, fluoride has been in the water for 40 or 50 years, and people are not dying early - if they were, it would probably be blamed on Sellafield rather than fluoride anyhow! The reality and fact is that fluoride improves the health of children's teeth. I suspect that most Tory Back Benchers would argue that fluoride should not be put in the water, yet it is a scientific fact that it works. My Government, however, have also failed to get this issue brought forward as it should have been. We should have encouraged water authorities to increase fluoridation year on year, but we have stalled. I remember voting in favour of fluoridation on a free vote in this Chamber about three or four years ago, but I suspect that no real progress has been made since then. Consultation will be used as an excuse for doing nothing. We must move forward on this issue.
I shall speak briefly about charges, which have not been much mentioned. In fact, my hon. Friend the Member for Staffordshire, Moorlands (Charlotte Atkins) mentioned them, but not in the context of how charges put people off going to the dentist. It is difficult to go to the dentist anyhow in that we know it is likely to be painful, but finding that there is a charge makes it worse, which shows the difference between the GP service and the NHS dental service. It may always have been the case, but we have to remember that some working people in this country simply cannot afford to pay the charges, so they will put off going to the dentist as long as they possibly can and then go to the emergency services.
In an ideal world, I would stand up to say that if we are serious about universal access, we should abolish these charges. If I look to the future, however, I see other major priorities for the NHS and financial constraints on Government spending. Although this has been done to some extent, my appeal to the Minister is to give some assurance in her reply that a Labour Government will acknowledge the fact that many people find it very difficult to pay those charges, never mind going private. The hon. Member for Mole Valley spoke about patient choice - choosing to go private or choosing to go to the NHS - but if people do not have the money, there is no choice.
Sir Paul Beresford: When I started working in the NHS in this country, in east London, there were no fees. When the fees were introduced, patients started to question the work. They began to ask whether it had to be done, why it had to be done, why if it had been done last time it had to be done again, and so forth. The introduction of fees brought about monitoring of the dentist by the patient, and therefore it was a very good thing.
Mr. Martlew: I suspect that those who questioned whether the work needed to be done were those who could afford to go and see the hon. Gentleman. That is the point. I fear that a Conservative Government will take the view that this is an area in which they can put up the charges. We have already heard one Member say that he had experimented with NHS dentistry. My fear is that the Conservatives will raise the charges, because they are not really convinced that we need NHS dentistry. I suspect that most of them opt for private treatment.
We need an assurance from the Government that they will bear in mind the level of charges. I know that since 1997 we have kept them down, but we must bear in mind what people can afford, and the least that we can do is freeze charges for the foreseeable future.
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Mike Penning: ..... Earlier, the hon. Member for Carlisle said, again from a sedentary position, "I bet he's always gone to a private dentist," but -
Mr. Martlew: On a point of order, Mr. Speaker. That is not true. I did not say that about the hon. Gentleman.
Mr. Speaker: I am grateful to the hon. Gentleman, but I suspect that that represents a point of debate to which the hon. Member for Hemel Hempstead (Mike Penning) may or may not wish to respond.
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The Parliamentary Under-Secretary of State for Health (Ann Keen): ..... I thank my hon. Friend the Member for Carlisle (Mr. Martlew) for his comments on the improvements that have been made. He mentioned the important matter of charges, which is dear to the hearts of all Members, especially those on the Labour Benches. All children and about 30 per cent. of adults are exempt from charges.
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Mr. Martlew: Will my hon. Friend give way?
Ann Keen: Yes.
Mr. Martlew: I am sorry to interrupt my hon. Friend, but the Opposition would not give way to me. Does she know anything about the policy on making dentists work for five years? Will it apply to doctors as well? Would that not seem fair? Are the Conservatives going to make doctors work for five years for the NHS?
Ann Keen: My hon. Friend makes an excellent point. The proposal is certainly news to Government Front-Benchers today, but I think that we should expand on it; perhaps it is something that we should look at. It will be interesting to see how negotiations on it go with the BDA. Perhaps the Opposition will keep us informed, because much has been said today about the professionalism of our dentists. In fact, accusations have been made about the number of extractions that are deemed unnecessary.
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