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The noble Lord said: My Lords, on behalf of my noble friend Lord Hunt of Kings Heath, I beg to move the Motion standing in his name on the Order Paper. These measures, which have the support of both dental auxiliaries and dentists, should be seen in the context of two key elements of government policy: improving the quality of public service, including the National Health Service; and deregulation where it can be carried out without compromising the protection of the public.
The dental auxiliaries concerned are dental hygienists and dental therapists. While working under the direction of a registered dentist, dental hygienists may scale and polish teeth and dental therapists may, in addition, extract deciduous teeth from children and undertake simple fillings.
The amendments have been requested by the General Dental Council, which is required to maintain rolls of registered dental hygienists and dental therapists under Section 45 of the Dentists Act 1984. The amendment to regulation 2 of the primary regulations would enable dentists and any members of the public who choose to consult the rolls for dental hygienists or therapists to identify those who have additional qualifications. It could help dentists recruit auxiliary staff to their practices or enable patients to select practices with any special expertise they require.
The amendment to regulation 4 simplifies the procedure by which the hygienists and therapists apply to remain on the rolls. The primary regulations require them to complete an application form to submit with the retention fee. With the increased use of standing orders and direct debit mandates for paying regularly recurring charges, the form has become redundant. Receipt of the payment gives the General Dental Council sufficient notice that the hygienist or therapist wishes to remain on the roll.
The amendment to regulation 6 provides for increases in the fee for retention on the roll from £20 to £25 and for restoration to the roll from £5 to £10. The fees were last increased in 1996. Even with the increases, the fees are less than a quarter of those paid by dentists. The amendments to regulations 23 and 27 provide for both dental hygienists and therapists to insert temporary dressings. The reason for this minor extension in their permitted duties is that, while treating patients, both hygienists and therapists sometimes find broken or missing fillings. If all the registered dentists in the practice are engaged in treating other patients, they can only advise the patient to return as soon as the dentist is next free. With a temporary dressing inserted, the patient can make a new appointment to see the dentist at a mutually convenient time.
Lord Colwyn: My Lords, when dental matters are discussed in your Lordships' House one can always rely on the noble Baroness, Lady Gardner of Parkes, to say a few words. However, she was on the Woolsack and she has no doubt just left the Chamber for a well-earned rest.
I welcome the regulations. I am delighted that the word "denturism" was not in the Minister's speech. It was discussed in the First Standing Committee on Delegated Legislation in the other place, but I do not think it is relevant to the regulations. However, I am slightly concerned about the 25 per cent increase in the General Dental Council retention fee. I am about to pay my own retention fee for next year, which I know has increased. I am not sure by exactly how much, but I do not think it is 25per cent. However, in view of the Government's demand for efficiency and savings, I hope that they will keep an eye on any similar increases which might affect the dental profession.
I am delighted to see regulations 6 and 7. They legalise something which most caring hygienists and therapists have been doing for many years. If a filling was knocked out while the teeth were being cleaned it would be ridiculous if a temporary dressing could not be put in place. That has been done for many years and it is now to be legal.
Perhaps I may conclude by asking the Minister two questions. First, can he confirm that with the new regulations all patients who are treated by therapists and hygienists still have to be seen by a general practitioner and have that course of treatment prescribed? Secondly--I should know the answer to this question as chairman of Dental Protection--in view of the fact that the Health Act now makes indemnity compulsory for doctors and dentists, can he say what is the status of therapists and hygienists? Do they have to have indemnity in order to carry out their treatments? I welcome the regulations.
Lord Burlison: My Lords, I thank the noble Lord for his helpful remarks. I know that he is a practising dentist and therefore has much greater knowledge than I in this area. It is helpful both to myself and to the industry generally that he should comment on the regulations.
The noble Lord asked about the annual retention fee for dentists. There has been a 50 per cent rise. The noble Lord is probably not too happy about that. If he does not already know, it rises from £90 to £135. The noble Lord also asked about dental auxiliaries and whether the dentist will still oversee their work. That will be the position because they work under the supervision of the dentist or a dental practice. It is for the dentist and the dental auxiliary to agree the detailed working arrangements.
The noble Lord asked about indemnity. I can confirm that it is the Government's intention to put general dental practitioners under a statutory obligation to have personal indemnity insurance. The insurance would cover the actions of the dental auxiliaries as they would be working under the supervision of the dentist.
The noble Lord said: My Lords, we are here to debate the maternity and parental leave regulations which will fulfil our manifesto commitment to help working parents balance their work and family responsibilities.
Last year, the Fairness at Work White Paper set out our industrial relations agenda of minimum standards underpinned in law, based on partnership. This agenda encourages employers and employees to work together towards a better climate of employment relations. The White Paper set out our agenda for a family friendly future--a package of decent standards and rights at work to help people balance their work
The White Paper set out our proposals to introduce parental leave and to simplify and improve maternity rights. We set our sights on a coherent package of rights embodied in a single set of regulations. In the White Paper, we gave a commitment to consult further where necessary. In August this year, we published a consultation document on our draft maternity and parental leave plans, followed up by draft regulations in September. We received more than 300 responses. Not surprisingly, the consultation on our draft regulations revealed different priorities between employers and employees. Employers want the flexibility to plan parental leave around the operation of the business; employees want the flexibility necessary to fit in with the demands of their caring responsibilities.
What was clear was that we faced a challenge in implementing parental leave in a way that would satisfy the concerns of business and the needs of parents. We believe our parental leave scheme meets this challenge and achieves a fair and sensible balance between the needs of the business and of the workforce. We are also implementing the regulations with a light touch, as we said we would. We are guaranteeing minimum standards, but we are enabling employers and employees to make their own arrangements as far as possible through collective, workforce or individual agreements on how to introduce parental leave best suited to the requirements of all concerned.
The regulations guarantee minimum standards which every parental leave scheme will need to meet. Both parents, mothers and fathers, will be able to take 13 weeks' parental leave to spend with their child until the child's fifth birthday. Adoptive parents will be able to take leave to spend time with their adopted child over a five-year period from the date of placement for adoption. In addition, we are providing increased flexibility for parents of disabled children to help them cope with the extra demands they face. Parents of children who receive disability living allowance will be able to take parental leave up until their child's 18th birthday.
Individual workplaces can come to their own arrangements about practical matters such as how much notice the employer should give, the circumstances when postponement may be acceptable and whether leave can be taken in single days or longer periods, or a mixture of these. This approach has been welcomed by both sides of industry.
Where agreements are not reached, then the fallback scheme will automatically apply, setting out a simple formula so employees will know how to exercise their rights. Under the fallback scheme, most parents will be able to take leave in blocks or multiples of one week, up to four weeks a year. Parents will need to give their employer three weeks' notice when they want to take the leave, and employers can postpone leave for no more than six months if the employee's absence would
In addition, under the fallback scheme, parents of disabled children can take leave in blocks of less than one week, which will mean that they can take the occasional day off work to accompany their child to medical appointments.The link to disability living allowance provides clear evidence of a child's disability and covers children who have learning disabilities or physical impairments.
In implementing parental leave, we are putting in place minimum standards, but we want employers to go beyond those standards where they can. Let me be clear. Minimum standards are essential, but they are only the start. We are laying down a baseline on which I hope employers will build.
These regulations are ground-breaking. They mean that parents will not have to face the dilemma of being a good parent or holding down a job. Parents can take leave, safe in the knowledge that they are protected from dismissal or less favourable treatment for taking the leave, and that they will be able to return to their same job. In some cases, where the leave lasts for more than four weeks and it is not practicable for an employer to hold open the employee's job, the employee will be able to return to a similar job, with terms and conditions at least equivalent to the previous one.
In our Fairness at Work White Paper, we gave a commitment to improve and simplify maternity rights. The Maternity and Parental Leave etc. Regulations will increase the length of ordinary maternity leave from 14 to 18 weeks, in line with statutory maternity pay. They will reduce the qualifying period for additional maternity leave from two years to one year, which will mean that more women will be able to spend up to 40 weeks at home with their new baby.
At the same time, we have tackled the complexity of existing maternity rights, bringing clarification to such issues as the employment contract, and simplifying the notice requirements. That has been almost universally welcomed and I am pleased to report that our efforts have been greeted with enthusiasm. Perhaps I may briefly quote from the Incomes Data Services journal, the IDS brief, which said that the first thing to be noted about the new rules is that,
Moved, That the draft regulations laid before the House on 22nd November be approved [1st Report from the Joint Committee].--(Lord Sainsbury of Turville.)
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