|Draft Dentists Act 1984 (Amendment) Order 2001
Mr. Simon Burns (West Chelmsford): It is a particular pleasure to serve under your chairmanship, Mr. Hurst, as a fellow Essex Member of Parliament. I congratulate the Minister on introducing her first statutory instrument. Given that this is a novel experience for her, Opposition Members hope that she will adopt a novel approach towards us and be the first Minister to answer the questions asked by the Opposition during proceedings of this nature. Trying to get an answer from a new Labour Minister has, over the years, been rather problematicin fact, it has been rather like extracting teeth.
As the Minister said, the order amends the Dentists Act 1984 and will create a smaller council that is able to meet more often and operate more strategically. An increased proportion of the new council's membership will be drawn from the professions complementary to dentistry. It will also have an increased lay membership, which, as the Minister rightly said, is an important move forward that will strengthen and enhance the council's operations.
Conservative Members do not oppose the order, but that does not mean that we do not have several questions that we wish to ask the Minister. I hope that she will have the opportunity this afternoon to respond to them. The Minister spoke about article 5 of the order, which, on the face of it, will abolish the statutory education committee. However, the functions relating to education will, the Minister has reassured me, continuealthough not on a statutory basis. I welcome that reassurance, and I am glad that it is on the record so that there can be no misunderstanding about it.
Article 6 creates a new statutory committee of the GDCthe continuing professional development committee. That dovetails with article 8, which amends the 1984 Act to oblige the GDC to make rules requiring registered dentists to undertake professional training and development. If I have accurately and correctly interpreted the order, nobody could disagree with those provisions, but will the Minister elaborate on how the Government expect that the measures will really work?
As the Minister is also aware, the British Dental Association fully supports the aims behind the order. Having recently spoken to dentists in my constituency and in London who expressed enthusiasm for this move forward, I have no reason to doubt that support. It is vital to update practices as circumstances dictate, and for that reason the Opposition will not be opposing the order. [Interruption.] With respect to the hon. Member for Reading, West (Mr. Salter), I did not think that I had made the most startling or earth-shattering statement in saying that. It is self-evident that the order commands widespread support and is for the common good, advancement and improvement of professionalism and training within the GDC.
Mr. Martin Salter (Reading, West): It is important to put on record how much Labour Members appreciate responsible opposition.
Mr. Burns: I am grateful to the hon. Gentleman, but in my four and a half tortuous years in opposition, I assumed that all our opposition was responsible. However, I welcome his comments.
Given the importance of the issues behind the order, why have the Government taken so long to reach this stage? There is genuine widespread support for the improvements, but it has taken an inordinate amount of time to my mindand, I suspect, to many othersfor the Government to place an order before the House so that it may become operational.
Why are the poorly performing dentists' performance review scheme and the modernisation of fitness to practise not included in the order? As the Minister said in her introduction, a whole package of improvements and changes is needed. We all know that this is a first stage and that subsequent orders will be introduced with improvements and changes. Those orders are presumably being prepared at the moment. Why does this order deal with only half the package? Given that the Government have been in power for four and a half years, why have they not been speedier in introducing a full package of proposals that could take effect in one go, rather than proceeding in this lackadaisical, slow, step-by-step way?
As we have before us the first stage of the changes, when does the Minister expect the next stage to come before Parliament? These issues are important, not simply to us but to the profession, because it does not want the uncertainty that inevitably comes when changes are on their way but no time scale is given for their introduction. Will the Minister give us an answer on that, in the context of what seems to many of us a snail-like approach to the development of the package?
I can assure the Minister that we shall not be dividing the Committee because we believe that the order represents a positive step forward that will help to enhance the professionalism, standards and performance of the council and the dental profession.
Dr. Evan Harris: Despite not being from Essex, Mr. Hurst, I welcome the opportunity to serve under your chairmanship. I also welcome the Minister. In my experience, she usually answers the questions that are put to her, and she is especially good compared with some of her colleagues. Whether that is a comment on her excellence or on their poorer performance is a matter on which our views may differ.
My first point concerns the general approach to self-regulation. By recognising the need for a professional majority on the GDC, the order makes it clear that the Government recognise that professional self-regulation, not political regulation, of the health professions is the way forward. Can the Minister specify whether that is her general approach, despite her recognition of the need for change? I am always dubious about the term ``modernisation'', which tends to cover a range of proposals, some of them not very modern or progressive. It would be helpful to have the matter clarified.
The question of when the rest of the changes will be introduced is important, and the hon. Member for West Chelmsford (Mr. Burns) hit on a serious point when he asked what had caused the delay. It is fair to say that, in 1999, the Government felt the need for an order-making power because few, if any, changes had been made to the 1984 Act during the preceding 17 years, during many of which there were Governments of a different complexion, with whom the responsibility for much of the delay lies. Has the delay since then been down to the fact that the GDC and the profession are determining the way forward, or to the Government thinking long and hard about whether they agree? Of course, consultation will have been necessary, but if the Minister can flesh out the time scale, members of the Committee will be able to understand the delay and determine how long it will take to introduce the other regulations that are hinted at, but not specified, in the order.
I could choose to address many of those regulations, but I mention specifically the regulation of professions allied to dentistry. I understand that no qualifications are currently required to be a dental nurse, although many skilled people perform that role. The term ``nurse'', however, usually implies an undergraduate or even postgraduate qualification. In an era in which people can advertise services, we need to press on to ensure that there is adequate regulation by the GDC, or another body, of people working in such professions.
How far do the regulations and the Government's welcome reforms on clinical governance extend to dentists who practise purely in the private sector? Does anything in the order apply only to NHS dentists? Dentists who work only in the private sector are described as a small number, but that number seems, at least in my constituency, to be increasing.
I turn now to the abolition of the education committee as a statutory committee. The GDC's statutory duties are vested in the council itself, and not in the committee. Have the Government considered the virtue of having a committee with statutory powers, which allows people co-opted to it to exercise their expertise at a statutory level? The worry is that an advisory education committee with outside influence will hear advice and might agree with it, but the GDC, not having first-hand input from those co-opted experts, might not wish to follow it.
On the Government's proposed reforms for a council for the regulation of health care professionals, my party is keen to see best practice identified and applied to each of the regulatory committees.
Given that this is one of the first orders made under the order-making powers in the Health Act 1999, does the Minister think that the approach taken to the dental profession has any lessons for changes to other professions which we will no doubt discuss in future Committees? Does this represent a new model or are these urgent changes based on an old model, which may change following the passage of future legislation establishing the overweening council?
I return to my first question. What will be the process of consideration by the House for all subsequent orders? It makes a difference to how we perform as parliamentarians if we know that we will have a chance under the affirmative procedure to think again about any subsequent changes promulgated on the basis of the order.
Michael Fabricant: It is a pleasure to be able to speak here today. I share with the Minister an interest not only in motor cycling but in better health carein this case, dental care.
This is an interesting afternoon for me. I am a member of the senate of the Engineering Council, and at half-past two I had a meeting at the Institution of Civil Engineers to discuss a similar change in regulations regarding the Engineering Council. That necessitates changes in the Privy Council orders and will require a statutory instrument. This order, which I mentioned in the meeting, deals with an expansion of the type of membership of the board, but a contraction of its numbers. That is a mirror image of the changes that are occurring at the Engineering Council, which will soon be known as the Engineering and Technology Board. The separate regulatory board will probably be called the engineering council of the United Kingdom.
Tara Phillips of the GDC was helpful and electronic in e-mailing me some information today. I want to ask the Minister some general questions, which I am sure that she will find easy to answer. I shall not repeat those of my hon. Friend the Member for West Chelmsford or the hon. Member for Oxford, West and Abingdon (Dr. Harris).
In future, there will be registration of the entire dental team. As the hon. Gentleman said, that will improve the protection available to patients. The fact that dental nurses do not require registration may give patients cause to worry that a nurse has not been adequately trainedalthough I hasten to add that all the dental nurses who have treated me seemed very well trained. Can the Minister clarify exactly when dental nurses will be registered in the same way as practising dentists?
According to the GDC, there should be a new complaints scheme that is separate from the GDC scheme covered by the order. When will that measure be presented to the House?
What combination of forces is generating this change? Is it being driven primarily by the GDCthere would be nothing wrong with thatwith the Government reacting by introducing the order, or has the Department of Health been pro-active in making suggestions for the GDC to consider? That will influence both the speed of change and the speed with which future orders are laid in Committee.
I wish the Minister well, yet again. I hope that from time to time she will attend meetings of the all-party motor cycling group.
|©Parliamentary copyright 2001||Prepared 14 November 2001|