I ask the House to give a Second Reading to this Bill, which regulates the profession of dentistry in this country. The Bill has been circulated to the House and is, with very few changes, and these only minor ones, the same Bill which has been brought to the point of Third Stage twice already. Previously, in introducing it, I stated that in order to get the full effect of the proposals some attention must be paid to the corresponding Medical Practitioners Act passed in May or June this year. The Bill regulates the internal arrangements with regard to the control of dentists in this country, and has, in addition, scheduled to it, and is founded upon an international agreement which is, with the necessary changes, pretty well identical with the international agreement which was passed regarding the control of medical education in the country.
I stated, when the Medical Practitioners Bill was before the last Dáil, that it was the declared intention of the Executive Council that for the future medicals who got their qualifying diplomas in this country should get them in examinations which would be conducted only by nationals of the country, and during the whole of their professional career in this country they should be disciplined by a council composed entirely of our own nationals. The same remarks apply to dentists, and this agreement, an international agreement upon which the domestic arrangements are founded, carries out accurately and fully what was stated to be the intention of the Executive Council long ago.
I will refer in greater detail to the Schedule in a moment. I would like, just at the beginning, to point out one or two items in which the details of this measure differ from the details of the Medical Practitioners Act with which it must be compared to get the full effects. It will be an offence for anybody not registered as a dentist to practise dentistry in this country under the Bill. The same does not hold with regard to the practice of medicine. A medical practitioner, at least one practising medicine without being registered, does not commit an offence. He is only precluded from securing fees in open court, and from that difference arises a peculiarity as between the two professions—that for the purposes of registration a medical practitioner pays one fee and thereafter he pays no additional fee for the continuance of his name on the register, but in the case of dentists, as the right of the dentist arises year by year and as he is protected by the courts, he is in fact charged that fee for every year in which his name continues to appear on the register. That is the main point of difference as between practice of the two professions.
There is a second point which depends not so much on anything essentially different between the professions but rather on the conditions which were found to exist when the Dentists Act of 1921 was passed. At that time there were certain people in the practice of dentistry who had not what were called recognised qualifications. There were a certain number of dental mechanics who had achieved a certain skill in their profession and they had been led to believe that at some stage or another they would be given equal right with those who had passed through a licensing Corporation and who had their education fully looked after by the professors or associates of the Corporation. In the 1921 Act cognisance was taken of the very large number of those who had attained a certain skill by actual practice, and it was decided that certain people, having attained a certain skill by practice, should be immediately admitted if certain conditions were fulfilled, the main condition being that for the seven or five years immediately preceding, that person had been engaged at some matter relating to dental work. There were certain other people given less extensive rights. They were allowed to present themselves for a prescribed examination within a certain period after the 1921 Act went through and thereafter were admitted to the profession.
These people are commonly known as the 1921 men, and it is the intention here to allow the same conditions to operate; that is to say, that the conditions which entitled a man to registration under the 1921 Act will operate under this Bill, but there will be no extension of the period from 1921 to 1927. In other words, it is not intended to date it back seven years, or five years, or even two years, which arises in certain circumstances, from the year 1927. The 1921 class was a fairly definite body of men who knew what rights they had. They made their claim and were apparently satisfied with the treatment given to them under the 1921 Act, and any person who pursued some type of dental practice in this country, knowing that he was outside the terms of that Act, but relying on the hope that thereafter there would be some extension of these terms to suit people up to whatever period this Bill would be introduced, did so at his own risk, and there is no obligation towards him. It is certainly not intended under the provisions of the Bill that any extension to that class should be made so as to enlarge it to the still greater number who would claim admission if the period were up to 1927 and not 1921.
There is a third difference between the control of the profession and the control of the medical profession. There is a Medical Council set up under the Medical Practitioners Act which deals with all matters connected with the practice of medicine. It deals with the qualifying diplomas, with the courses leading up to them, with the keeping of the register, the erasure of names from that register, and with the disciplinary control and action that might have to be taken leading to the expulsion of names from the register. That is entirely in the hands of medicals. In the case of dentists, a Council will be set up under this Bill which will be composed of certain nominees of the Medical Council and of certain people who will be elected by the dental practitioners in the country. The Dentists Council, as such, will keep the same relation with the medical profession as was previously given to them under other Acts elsewhere. The strict dental body, as such, has only rights with regard to keeping the register and the entry of names on that register. Once it comes to the point of education, and when it comes to the further point of disciplinary control, then the right lies with the Medical Council of the Free State, and to that degree there has been maintained the relations that have hitherto existed between these two bodies of professional men.
The international agreement is, from many points of view, the important item in this Bill. Outside the international agreement the Bill simply indicates that there is going to be a Council composed in a certain way, that that Council will have certain duties put upon it, that it has the right of incurring expenditure, but that that expenditure has to be met in certain ways, that certain people will be entitled to be registered on the first register under the Bill, that thereafter certain other people will get rights as these rights arise, either by examination or by entry on the dentists' register, and there are a variety of provisions dealing with the ordinary internal arrangements of the practice of dentistry in this country. Outside that there is this other agreement.
I have said, with regard to the medical agreement, that the aim of the Executive Council was stated to be that medical students entering upon courses leading to professional qualifications in this country should have their courses regularised only by nationals of the country; that they should be subject, during the continuance of their professional lives in this country, only to the control of a body of our own nationals. While insisting that that should be the case for those qualifying here and intending to remain in practice here, it had to be remembered that, in the case of medicine especially and to a less but yet considerable degree in the case of dentistry, certain students get their qualifications here, but intend, either at the beginning or for all time, to live their professional lives outside the country. The only way in which these men could get the great right, the very widespread right, with regard to practising in other countries was by getting their names entered, in the case of medicals, on the general medical register, and in the case of dentists on the dentists' register. Some provision had to be made to cater for these people, and the arrangement come to is that set out in the agreement scheduled to this Bill. The one point on which there seemed to be any likelihood of conflict was this: One can imagine a dentist getting his qualifications here, getting himself entered on the register here, and getting himself, by the reciprocal arrangement established under the Bill, entered on the register in England, and being afterwards, in the course of his professional life, accused of what is called infamous conduct in the professional sense, and then of having his case tried, as it would necessarily have to be tried professionally, by the English group and by the Free State group. There might be this conflict, that on examination of the case the Free State authorities might decide that the case warranted expulsion or erasure from the register, while the English Council might decide, as far as they were concerned, that the case did not warrant erasure from their register. If that should happen to be the case in respect of any dental practitioner, there would have been a conflict if this arrangement had not been made, because the General Medical Council would have tried to exercise what at that time they believed to be their over-riding right and what, prior to the establishment of the Free State, was their over-riding right with regard to the practice either of dentistry or medicine in this country.
The agreement forbids that and definitely states that there is no such over-riding right in any council with regard to the practice of dentistry in this country other than the Dental Council of the Free State. If a case such as I refer to occurred under this arrangement, the Irish Dental Board could strike that man off the Irish Register, but if that dentist still remained on the English Register by virtue of the fact that he was not found guilty of the offence as viewed by the English authorities, then his English right does not entitle him to come back to this country and practise dentistry or medicine here. That was the only point on which there seemed to be any likelihood of conflict. However, this point has now been determined, and the agreement that has been come to is entirely in our favour.
For the future it is quite accurate to say that the whole of a man's professional life in either dentistry or medicine when continued in this country will be under the control of a body composed only of Irishmen, at least of a body composed or nominated in the way set out in this Bill.
There were two minor matters that had to be attended to. The case that I have referred to would involve another embarrassment: that the same individual for the same alleged offence might find himself adjudicated upon and subjected to inquisition by two different bodies. In order to relieve the individual of that embarrassment that point has been met in paragraph 6 of the Schedule: that is to say, where the offence is with regard to conduct in Gt. Britain or Northern Ireland then the General Dental Board inquires first and reports to the Free State Dental Board. If, on the other hand, the conduct about which any inquiry is to be made occurs in the Free State then it is the Board to be established under this Bill which first takes cognisance of it and inquires, and which then reports to the other Council. There is complete reciprocity and a complete arrangement between the two parties on this matter.
Paragraph 5 is a small matter of machinery. It has really very little relation to any contingency that is likely to arise on this side. It is mainly a matter with regard to English legislation on the whole matter of dental legislation. It simply states that in the event of any examinations of a new university at any time hereafter created in the Free State becoming qualifying examinations for the purposes of the Medical Acts that that university shall have the same powers of holding examinations as if it were a medical authority for the purposes of Section 18 of the Dentists Act, 1878.
The full meaning of that paragraph is simply this: that in order to give any new university or qualifying corporation established in this country reciprocal rights with the English authorities there would have to be passed through the English legislature special legislation adverting to the establishment of the new college here, and stating that, for the purpose of practice in England, it was a suitable body. By having this paragraph any new university can be brought within the scope of the legislation already operative in England, and by a mere order the particular qualifying corporation can be made have the same powers as any of the English corporations have.
The agreement, therefore, does carry out what was said: that the control of dentists qualifying in this country should be, during their professional lives, entrusted to Irishmen; that the establishment of any corporation giving the right to practise in this country should be entirely at the disposal of a group of Irishmen and that investigations as to whether or not a corporation has the power to grant licences and diplomas leading to dental practice must be always under the supervision of a group of Irishmen, and of Irishmen only.
The agreement sets out as a complement to that: In the third paragraph the important words right through are "for the purpose of the preparation and keeping of the Dentists' Register," defined in an earlier section as being the register of dentists kept in England. That is to say, that for the purpose of deciding whether or not a man could be admitted to practise in England, and for that purpose only, there are certain rights and jurisdictions given to an English group, or at least to a mixed English, Scotch, Welsh, and Irish group. That paragraph, however, should not be misread so as to lead anyone to believe that there is control by any group outside this country of the qualifications that entitle a man to practise here, or if the offences which, when adjudicated upon, lead to a man's erasure from the register.
There is a clear and definite distinction between people qualifying here and continuing the whole of their professional lives in this country. They are entirely under the control of an Irish body. There is the additional point that there is a recognised composite body on which we have representation and which will have certain rights and jurisdictions here for the purpose of keeping a General Dentists Register, and for the purpose of establishing whether or not a corporation can give a degree which will entitle to registration on that particular register. There is a clear and distinct difference between the register to be kept here and the control of the register to be kept in England and the method of its control. The Bill, outside the international agreement, simply allows for the setting up of a certain body and for certain nominations to be made here and certain obligations to be met, and for everything that flows from that, such as the power to charge fees, the power to keep a register, and the power to enter people on the register and to make erasures as occasions arise. On certain of these details I understand there is not the completest agreement. That was announced previously, and I do not suppose that the opposition to certain sections, notably Section 43, is to any degree lessened since the Bill was first introduced. These are details of a type that can be dealt with on the Committee Stage. Previously, when this Bill was given a Second Reading, the suggestion was made that it should be sent to a Select Committee in order that the individuals mentioned in the Second Schedule should have their cases better examined, and that additions, if necessary, if a case were made for them, could be made to the Second Schedule. Later on, when the Bill was sent to the Select Committee, and when it was discovered that the Select Committee was not likely to be very long at work, a further arrangement was made: that a Departmental Committee be set up before which claimants who believed they had a proper case would be able to make their case to have their names included in the Schedule. It was suggested that their cases should come before this Departmental Committee, and that later the Dáil could be presented with the Committee's recommendation, with a statement from the Minister as to whether or not these recommendations should be accepted.
The Committee has been at work. The Select Committee, of course, has disappeared, but a Departmental Committee has been at work, and a certain number of cases have been put before it. I have not had any discussions with the Committee recently. I gather that something in the neighbourhood of forty cases, in addition to these twelve, had been put forward, and that in no great number of cases was the Committee convinced that there was any substantial reason for admitting fresh cases to the Schedule or for any enlargement of the terms of the Bill. However, the exact number will be a matter that will arise on the Third Stage. I simply ask the Dáil on this agreement to give a Second Reading to the Bill, which allows for the regulation of the profession of dentistry in this country and which admits a certain international agreement allowing dental students who qualify in this country, but who do not intend to pass their professional lives here, to get certain facilities which, before the establishment of the Saorstát, were always open to them.
