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Dáil Éireann debate -
Friday, 13 May 1927

Vol. 19 No. 24

PRIVATE BUSINESS. - DENTISTS BILL, 1927—SECOND STAGE.

This Bill bears considerable resemblance to the Medical Bill. The agreement which gave rise to it follows broadly the lines of the agreement arrived at with regard to medical registration. There are many points of resemblance, but there are some points of difference, to which attention should be drawn. For instance, the positions of the medical and dental professions differ in this respect—that an unregistered person who practises dentistry or dental surgery commits an offence under the Dentists Act, 1921. There is no similar provision in regard to unregistered medical practitioners. The only disability a practitioner of that kind labours under is that he cannot recover fees. A person practising medicine who is not registered as a medical practitioner is not given the protection of the courts in recovering fees. That is provided by Section 32 of the Medical Act, 1858. Registered dentists, unlike registered medical practitioners, pay an annual fee for the retention of their names on the register, in return for the prohibition of the practice of dentistry by unregistered persons. Medical practitioners pay one fee on registration, and that ends the matter. The Dentists Act passed in 1921, which for the first time prohibited the practice of dentistry by unregistered persons, recognised that those unregistered persons who, without any degrees or diplomas, had practised dentistry for a considerable time prior to the passing of the Act, had acquired a vested interest, and provision was made for protection of that interest by Section 3 of the Act of 1921, which enabled those persons to be registered within a limited time, in spite of their lack of what has now come to be considered proper qualifications. The persons who took advantage of that section of the Act of 1921 locally referred to as the "1921 men," are quite a numerous body in the Saorstát. They number almost as many as the dentists whose qualification depends on diplomas and degrees. There are two representative bodies. The "1921 men" are represented by a body called the "Incorporated Dental Society." The other dentists holding degrees and diplomas are represented by a body called the "Irish Dental Association."

In the ordinary course of events the number, of course, of the 1921 men will tend to gradually diminish and finally disappear, until you have a situation in which there will be no person registered other than by virtue of degrees and diplomas. At the moment you have a large body, but with the passage of time that body will be a diminished quantity in proportion to the whole and will finally disappear. The representation of the new Board is that there shall be one representative of the 1921 men and four representatives of the qualified dentists—the dentists who hold professional degrees and diplomas. That is a rather rough and ready system adopted from the corresponding Act in Great Britain. Of course, as the number of 1921 men declined, and their proportion to the whole diminished, it is not unlikely that a change will have to be made in the composition of the Council. However, that is for the future. The relations existing between the General Medical Council and the dentists' profession in Great Britain are important, because the arrangements made here under our Bill are rather closely corresponding. Under the Dentists Act of 1878, which set up a register of dentists, the control of the register and of dental education was vested in the Medical Council, and that situation continued until the legislation of 1921. By the Act of 1921 a special Dental Board was established, and that Board was to deal with registration and with matters of the internal discipline of the profession, but administration of these matters was still, to a large extent, theoretically, subject to the Medical Council. Registration and professional control, as I say, were dealt with largely by the Dentists' Board, but dental education still remains under the control of the General Medical Council. It was provided that when the Medical Council exercised any of their functions under the Dentists Act that then two additional members, with special knowledge and experience of dental matters, were to be added to the Council. It is intended, under this agreement, and under the Bill which flows from the agreement, that the relations between the Dental Board here, in the Saorstát, and the Saorstát Medical Council shall correspond to the relations between the Dental Board in Great Britain and the General Medical Council. That arrangement is, I think, considered entirely satisfactory by the dentists' profession here, and it is the agreement envisaged by the agreement which we signed with the British Government and the General Medical Council.

I think this Bill is eminently satisfactory, and if anyone is under the impression that I thought the Medical Practitioners Bill was not also eminently satisfactory I wish to say that I consider it extremely so. I am not sure whether it is intended to get this Bill through before the dissolution or not, but there is no necessity for me making a speech at any length, because, as a matter of fact, agreement has been reached on nearly every point. There are one or two little points which will have to be dealt with in the Committee Stage, one in particular, in Section 41, where there are limitations placed upon the practice of surgeons. That will require an amendment in the Committee Stage. Under the English Act there is no limitation placed on the practice of surgeons as regards dentistry, but under this Bill there is a provision made which the medical profession are up in arms against. The surgeons do not want any restrictions placed upon their practice. Therefore, an amendment will have to be made.

I am going to put the other case, the case of the dentist. Where a registered medical practitioner is also a dentist the dentists claim that he should register as a dentist and be under the Dental Board, because it is possible for him to practise as a medical practitioner under his registration as a medical practitioner, and still practise dentistry. Under those conditions he would not be required to pay his registration fee, which in England amounts to £5 a year. I am quite at one with the dentists that he should be placed upon the dental register. It is to prevent that class of thing that they have endeavoured to put into the Bill some restrictions upon the medical practitioners. I say again that I think this measure is very much needed, almost more needed, at the present time, than the Medical Practitioners Bill, because, within the last couple of years, anyone could come into the country and practise dentistry as he pleased. There are no restrictions whatsoever. I support the Bill very heartily, and, with a very slight amendment that will be necessary during the Committee Stage, I accept it.

This Bill, containing 44 sections, was distributed in the afternoon of Wednesday. Since that moment we have had a regular glut of Bills. Quite a number of Bills originating in the Dáil, and a number of others which have come down with amendments from the Seanad, have been before us, and we are asked now to give a Second Reading to this new Bill. I do not know what the Minister's intentions are in regard to it. I may say that since the publication of the Bill I have had representations from three distinct interests in regard to it. My answer has been that it has not been possible to express any views upon it, or even to listen to any views upon it, because it has not been possible to read the Bill with any care or, in fact, to understand anything about it, except that it is to set up some kind of a governing body over the dentists' profession. I think it is necessary, before we examine a Bill of this kind, or even give it a Second Reading, that we should have some time, and that the people interested should have some time, to understand how it affects them.

For instance, you have in the schedule names of certain individuals actually stated. How are we to know whether those individuals are being dealt with fairly or unfairly? Deputy Sir James Craig has pointed out that there is a certain conflict between the medical profession and the dentists involved in the Bill. There is certainly the possible difference of interests as between the medical profession, the dental profession and the public. I say it is unreasonable to ask the Dáil even to give this Second Reading at this stage. I have no doubt that it is worth a Second Reading. But I am reminded of the Army Bill which, at an earlier stage of our history, was brought into the House. I think, in almost similar circumstances, at the tail end of a session, and passed without one minute's discussion, although it had, I think, some two or three hundred sections, because it was deemed to be urgent and necessary. It has never had any discussion since. This is a Bill brought in on almost the last day of a Parliament. We have had no information as to what the intention is in regard to it. If it is intended simply as a declaration that the principle of the Bill is approved by the Dáil, I am not going to oppose it, but if it is intended to go any further than that with the Bill, then I shall do my best to amend it to the utmost degree, and to introduce as many amendments as possible.

Not knowing what they are for!

If the intention is to pass it into law I would propose amendments.

For obstructionist purposes?

Purely obstructionist. I make that candid confession. I think it is straining the business of an assembly of this kind, on the eve of dissolution, to introduce a Bill of 44 clauses, in respect of which there has not been even a public discussion. The Medical Practitioners Bill has been, in its essence, publicly discussed for months. Here we have an entirely different situation created—a new Bill, about which neither the Deputies nor the public could possibly have got any information. I say if the intention is purely to give it a Second Reading and approval I am not going to make any great demur, but if it is intended to go ahead with it, then I shall do my best to have it delayed.

I am simply appalled at the attitude outlined by Deputy Johnson. This Bill is very urgent and I would expect more sympathetic consideration from him. I know he is very busy studying sugar, and that he has very little time for the study of medicine. Nevertheless, I submit that medicine, as provided for in this Bill, is far more important than the lengthy discussion we had yesterday, which was a repetition of previous speeches delivered in this House and a justification or falsification of a lot of prophecies. This Bill has been delayed too long. It has been before the public for a long time, but the public take no interest in anything that is medical. We cannot expect any interest amongst the public or even amongst the members of the Dáil. I am sorry the Deputy has selected this one Bill simply to assert the principle that he objects to rushing legislation. I think he might say that three months longer will not mean much. I think it will mean a great deal to allow for even three months longer the practice of unskilled or unpractised dentistry in this country. It means a danger to public life. Every day we have unqualified dentists coming over to Ireland knowing that the law is such that they can set up in this country and practise as unqualified dentists. I think that is a very serious situation and it should not be allowed to last another week. It is bad enough that it has lasted so long, and this discussion will simply be held out as an invitation to other unqualified dentists to set up here. I am really surprised; I am sure it was quite unintentional on the part of Deputy Johnson to do anything that would give an opportunity for the practice of unskilled labour. I think if there was an examination about some dentists setting up here—unqualified men—that it might be worth while to prevent their setting up for this reason: that there are a good many rumours of their bringing drugs, such as cocaine, into this country, ostensibly for the practise of their profession, whereas the drugs are really for sale amongst those addicted to the drug habit.

The point referred to by Deputy Sir James Craig can be dealt with on Committee. I share the feeling expressed by the Deputy on behalf of registered dentists as to the difference between registered dentists and registered medical practitioners. The registered dentist has to pay a fee for the retention of his name on the register. The registered medical practitioner also pays a certain fee, but, if practising dentistry, he has not to pay the registered dentist's fee by reason of the fact that he is a registered medical practitioner. I would be in accord with the principle that Deputy Sir James Craig stated on that. With regard to the objections to Section 41, it would be better, I think, to have these met by way of amendment. We could then consider whether, in fact, there is any flaw in the section. What I heard vaguely apprehended was that certain surgeons might be precluded from certain types of operations. Of course, that is not the intention, and, if the flaw is there, then on Committee we can see what should be done to rectify it.

Deputy Johnson enlarged on the effect of the schedule in certain matters. That to a certain extent means an enlargement of the number of the 1921 practitioners. These are men who, mainly by reason of service in the war, could have taken advantage of Section 4 of the 1921 Act. They are, to all intents and purposes, 1921 men, and the special considerations with regard to each of them might be examined, if necessary. These are really Committee points. The Bill comes forward founded upon an international agreement, exactly the same as that upon which the Medical Bill is based. The Medical Bill has been approved by this House, so that that side of the question has been definitely under consideration. This Bill proposes to set up a Council to regularise the whole situation with regard to dentistry which, as a profession, is, I think, in a state of complete anarchy at the moment. At the moment it is doubtful if there is any law whatever applicable to dentists. If there is any tribe from whom the public ought to get protection at the earliest possible moment, surely it is against the unlicensed quack dentists, who are responsible for a great deal of harm and, probably, many fatalities in the country. The Bill has been brought in to regularise the dental profession here, and so that it should be in accordance with the international agreement already sanctioned with regard to the medical profession. I do not insist that the Bill should go beyond the Second Stage now, but I simply want to indicate my point of view, that it is one of the Bills I would like to see passed immediately the House meets after the dissolution. It is a Bill that, I think, should not remain over until the autumn. Every stage that is secured now will, at any rate, be a step forward towards getting it passed into law, say, in the month of July. That is the anxiety I have about the matter. I do not by any means insist on asking the House now, at the end of a session, to deal with the Committee Stage of the Bill, particularly if important points are going to be raised on it. If there is objection to taking the Bill beyond the Second Stage now I would not press the House to take it, but I do want to indicate to the House that the Government, in dealing with this Bill hereafter, will be urged to pass it into law at the earliest possible date, that is to say, in the month of July.

So far as I am concerned, and so far as the principles of the Bill as enunciated are a correct definition of what is in the Bill, I am in agreement, and whatever I may have to say on the matter will not be to prevent a Bill of this kind becoming law at the earliest possible date after it has had consideration. As I have already said, there are at least three interests concerned in addition to the public, and what their views may be I do not know, but I have a notion that the professional people interested who have been in communication with the Ministry in regard to the Bill have had no time to understand what is in it. I am not going to oppose the Second Reading, having heard the views of the Minister. I give him my assurance for what it is worth that the Bill ought to have the earliest consideration after the resumption.

That is all that is necessary.

I do insist that time be given for the consideration of the Bill before it becomes law.

Question—"That the Bill be read a second time"—put and agreed to.
Committee Stage ordered for Friday, 20th May, 1927.
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