I move:—
"That the Dentists Bill, 1927, be read a Second Time."
This Bill had gone through its second stage prior to the dissolution of the last Dáil. To get the full effect of the proposals now being brought forward, the Bill has to be read in conjunction with the Medical Act, the international side of the proposals there being very much in line with the proposals here. Inasmuch as there is a reaction between the General Medical Council and the Dentists' Council in England, it is proposed to have the same sort of relations established between the Free State Council and the Free State Dentists' Board, and there is necessity to have understood what the Board is, and what the practice heretofore governing the methods of the two bodies has been. Although there are likenesses and similarities between the two pieces of legislation, there are certain differences which should be adverted to at the start. They can be very easily summarised. In the first place, in regard to a person who is unregistered, and who practises dentistry, or dental surgery, and who commits an offence, the same thing does not hold as in the case of medicine. A person who is not a registered medical practitioner, and who continues to practise medicine in this country, does not commit an offence, but is subject to certain disadvantages in the matter of securing fees, but there is no such thing as an offence. Offences for the first time were established in the Dentists Act of 1921, and that particular situation is being continued by the proposals here.
Arising from that difference, there is a difference with regard to the register and with regard to the payments for the compilation of the register. A medical man pays one fee for entrance on the register and thereafter pays nothing for the continuance of his name on it. Dentists, on the other hand, in return for the definite setting up of practice by unregistered persons, pay yearly for the keeping of that register. Consequently, those who are registered may practise dentistry without committing an offence. When the 1921 Act first set up, or rather continued, the separation of the dental profession from the medical profession, it made that change with regard to offences that might be committed. It was recognised that there were actually practising in the late United Kingdom a great number of people who could not be described under the terms of the new legislation as qualified persons, but they acquired a right by the fact that they had practised for a certain period. and had been allowed to practise, and had also been allowed to go through a period of training with a view to securing a certain status in the country which, at that time, entitled them to practise.
Consequently, provision was made by which people, ordinarily referred to as "1921 men," people who were in a particular state with regard to the practice of dentistry, or dental surgery, in 1921, were permitted to continue, but any new recruits to that class were definitely precluded in the future. We have to view that situation here, and although demand has been made that inasmuch as our legislation is introduced in 1927 we should not have a 1921 class, but a 1927 class, and that we should admit to certain rights, in regard to the practice of dentistry, people who had been not merely registered in 1921, but who may have entered the ranks of the unregistered since 1921, and also that we should guarantee them the same rights as those guaranteed to the 1921 people in England.
It is not proposed to do that for two reasons. One reason is that the intention of the Act of 1921 would have applied here. I do not mean that there were legal doubts as to whether that Act did apply here, but those concerned with the interests of the two professions had an idea that whatever enlargement was made in the 1921 Act by the inclusion of the 1921 men in England, there should be no further enlargement, and sufficient notice was given to those intending to enter the profession that the 1921 class was going to be confined to those who entered that class prior to 1921. It is proposed here to limit, I do not like to say the completely unqualified men, as they have some titles to qualification, but those who have not the particular type of qualification necessary for admission to the profession of dentistry. It is proposed to limit them to those in practice prior to 1921. There is a further reaction from that on the position of the Council.
The composition of the Council or Dental Board is to be of nine members, of whom one is to be a representative of those 1921 dentists, and four who are to be representative of the profession other than the 1921 men. It is clear that these 1921, more or less unregistered, people will be a diminishing class, and that, whatever their importance is at the moment, an importance which entitles them to one representative on the Board, it will become less and less. It is considered as being absolutely essential that some time hereafter there will have to be a readjustment of the Dental Board to meet the new situation, and that, without any great doubt, the nominee of the 1921 men will sooner or later disappear from the Board. At the same time, these people are rather numerous in the ranks of dentists at the moment, and their numerical strength entitles them to representation, that is, if the Dáil proposes to admit the contention that the 1921 men should be given the right to practise dentistry in this country at all.
The duties of the Board are to a great extent lessened from what those of the Medical Council set up under the Medical Act will be. The Council functioning under the Medical Act has to attend to everything in relation to the practice of medicine in this country—to medical education, to the entry of people on the register, to the keeping of that register, and to the discipline and control of the profession, leading in the last resort to expulsion from the register. The same does not hold with regard to the Dental Board, which will have nothing to do with education. As far as discipline is concerned, it will have a certain control and is enabled to institute inquiries into the conduct of people practising dentistry in the country where anything requiring attention is brought before it. The Board, of course, will have the duty and the right to keep the register, but when it comes to the determination as to what course must be set out so as to lead to a licence to practise dentistry, and when it comes to a final determination as to whether his conduct is sufficient to warrant the then qualified dentist being struck off, in that respect there has to be the same relationship between the Irish Council and the Medical Board as under the 1921 Act exists between the Dental Council and the Medical Board in England. When dental legislation in regard to education or penal cases in England is before the Medical Council there has to be associated with the Council a certain number of representatives of the dentists, and that will hold here.
The Medical Council in Ireland will have supervision of dental as well as medical education, and will have pretty well a decisive say in striking people off the Dental Register. Those are the main differences, as well as some of the similarities, existing between the proposal with regard to dentistry and the proposal with regard to medicine. The Bill in its numerous sections deals largely with the position of the Council, how the appointments are to be made and what happens when resignations from the Board take place or occur in any other way, and also makes the usual arrangements the House will be familiar with from the other Act. Regarding the meeting of the expenses of the establishment of the first register, and as to how the expenses of all further registration have to be met, there are two schedules. One is the international agreement. In so far as it is to govern the relationship between the Dental Board in England and the Irish Dental Board it follows the same lines as the medical agreement. I will stress only one point, inasmuch as it has been misunderstood. I have noticed a remark referring to a similar agreement with regard to the medical proposals, that the old powers of the General Medical Council have been and are at this moment continued in force by that Act, and that as far as the General Medical Council is concerned there has been no change between 1909 and the present year. I would like to call attention to a phrase in the Dentists Bill similar to that used in the medical agreement. Clause 3 of the First Schedule refers to powers and jurisdiction continuing as heretofore and is limited by one phrase, the preparation and keeping of the Dentists Register, and any other purpose.
If that is understood, the full meaning of the agreement will be understood in so far as any domestic change affecting dentists is concerned. There is the fullest control and authority vested in the Dental Council of the Free State, or the Irish Medical Council, to act jointly so far as the control of people who have got their licence to practise in this country, either in dentistry or medicine, and who are in practice in this country, and whose conduct while in practice comes under review. The sole control as far as these people are concerned with regard to practice in this country lies with the Dental Board. The Medical Council and the Dental Board in England are completely precluded from jurisdiction, so far as matters of that domestic type are concerned. I will direct attention to another point. If the Dentists' Board had been continued with full control and authority as previously, this case might have occurred: that if a dentist qualified to practise here, and also has his name entered on the register in England, and his conduct has called for criticism by both these controlling bodies, it might happen that the Irish Dental Board, or the Irish Medical Council would consider his conduct sufficiently grave to warrant him being struck off the Dentists' Register here. The corresponding council in England, examining the man's conduct from the point of view of the man being on the register in England, might consider his conduct not sufficient to warrant deprivation of his licence, and might allow him to continue in practice. There would then be a conflict between the two Boards, and if the old state of affairs continued the over-riding authority would be the English Board, whose decision would be decisive, and the prohibition of the Irish Board would not be of avail. That is definitely precluded by Section 4 of the First Schedule, which ensures that where there is any conflict of the sort, that where what has to be determined is the right to practise in this country, it is what the Irish Board says, and not what the English Board says that holds.
The Second Schedule deals with a list of 12 names to which reference is made in an earlier section of the Bill. Section 24 says:—"The several persons named in the Second Schedule to this Act shall on passing an examination in dentistry prescribed and held by the Board for the purpose within seven years after the passing of this Act and on making the prescribed application and paying the prescribed fees be entitled to be registered in the Register." These 12 individuals are people who did not come in under the 1921 Act, as it was drafted and passed in England, and who, if we simply applied the 1921 conditions to them, would not be entitled, even on passing an examination within seven years, to practise dentistry in this country. Their cases are considered to involve sufficient hardship to warrant this particular exception being made in their favour. They are not actually qualified at the moment and are not entitled to practise, but if and when they pass within a seven year period an examination which shall be prescribed for them by the Dental Board, then and only then can they practise dentistry in this country. The reasons why these 12 people have been segregated cannot be detailed here at the moment, but if there is any desire to know when we reach the Committee Stage why one more than another has been put on, or why these 12 have been put on when certain others might have been put on who have not been admitted to the same type of favour or exception, we can discuss that in Committee of the Whole House or possibly better still, at a Special Committee. We can see whether these 12 people are better entitled to this exception being made in their favour than others whose cases may be raised. We can also see whether any addition should be made to the list, because each case hangs by itself. They are simply individual cases, and not all ruled by the same consideration. These are 12 people whose cases have been examined by a variety of authorities, and the consensus of opinion is that their cases warrant an exception being made in their favour. It will be for the Committee to consider whether the list should be cut down or enlarged or left as it is. I move the Second Reading of the Bill.