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Dáil Éireann debate -
Tuesday, 20 Nov 1984

Vol. 354 No. 1

Dentists Bill, 1984 [Seanad]: Second Stage (Resumed).

Question again proposed: "That the Bill be now read a Second Time".

Earlier I referred to the need for the Minister, and the Dental Council, to give a degree of consideration to the problem of dental technicians. I accept that this is not as heady an item as the previous issue but, nevertheless, it is of importance. It has been suggested to us that as two provisions in the medical Practitioners Act, 1978 and the Opticians Act, 1976 facilitated the incorporation into the new legislation groups of people who had been acting in a freelance operation outside the network of legislation prior to the passing of those Bills, this method could be applied in this case also. I do not know if that is the right answer. It is very important, even if denturists or dental technicians are to be involved in the area of fitting and manufacturing of dentures, that there should be an insistence by the council and the Department on proper training and standards. There should not be any equivocation about that area of training so that there will not be any chance of slipshod standards or any type of unsatisfactory methods operating in that respect. People have been operating — I understand that the number is about 250 — and I am not aware of any major dissatisfaction with their work. I suspect that the largely mechanical job of fitting and manufacturing these dentures is one which could be handled by people who are qualified and trained but are not necessarily dentists. It should be possible to introduce a formula to allow for people to be open to training or retraining and then facilitate them by allowing them to operate or provide a service under the Bill.

We would all be loath to put out of business people who have been giving a service and who, as far as I am aware, have not been unsatisfactory although there may have been individual complaints as there is about every profession. In the course of his speech in the Seanad the Minister referred to the timing of the establishment of services auxiliary to the dental profession. He hoped that they would come into being very early after the passage of the Bill. It might help if those discussions took place soon so that any marginal fears there might be about those working in the area of dental hygiene or other peripheral areas of dentistry might be dealt with rather than waiting for the passage of the Bill and the establishment of the council. I am arguing for earlier rather than later dialogue with those who have a legitimate interest in this area of activity.

I hope that all the moves implicit in this Bill will not give rise to any form of monopoly and will not result in dentistry and allied activities being controlled by a small group. Nobody wants that. I know that is not the intention of the Minister or the Government nor is it the desire of the Dental Board or the dental professional groups. We should ensure that this does not happen.

I am pleased to note that this very comprehensive legislation is not permeated by reference to statutes of over 50 or 100 years ago, in other words, it is not legislation by reference, as one of the Senators referred to it. I commend that approach to other Ministers who might make legislation a little more intelligible to lay people and to Members of this House by excluding where possible references to existing Bills and by incorporating the full amendment in the up to date provision in the Bill as presented in this House so that we will know exactly what we are talking about without the aid of a veritable small reference library.

The original proposal to amend this legislation goes back to 1927. That says a little about the way we order our affairs in this House. I am not suggesting that this Bill is the same as the Bill suggested at that time, but this gives an indication of how little attention, legislatively speaking, has been given to this area over those decades. I hope this measure is successful and I ask the Minister to reply to the points I have raised.

At some stage, rather than taking one Bill after another, we should have a forum where we could look at the cumulative effects of all these new Bills and regulations in terms of the minutiae involved in sections and subsections and in terms of the implication of their enforcement and the other regulatory practices that are inevitably involved. I am not sure that we, collectively, want a society that is so tightly regulated as might happen if we continue down that road. This is something this House has not had a chance to consider, but if that chance presents itself and if we reach the conclusion that we want such a society, I will be happy to go along with it. In the meantime I would prefer if we did not continue to have a tightly regulated society by what we might call default or by stealth.

The implications of what I am speaking about will be visible in other legislation. The current legislation I am speaking about would include the Nurses Bill, the Air Transport Bill, the Broadcasting Bill and so on, all of which put the State in the central control position as opposed to the individual or the free group. I am not sure if that is properly the role of the State. If it is, we should discuss it because that presents a fundamental change in the kind of society we have, a change in respect of which I do not believe there is a mandate at present. This Bill brings a fair amount of sense and order into an area in which it is to some extent lacking. I wish the Bill and the Minister every success.

I am glad of the opportunity to contribute to this debate. As Deputy O'Hanlon said, we in Fianna Fáil welcome this Bill and in general find it acceptable. Therefore, I do not intend to take up too much time of the House.

This Bill provides for the establishment of a council to be known as the Dental Council which will provide for the registration and control of persons engaged in the practice of dentistry and to provide for other matters relating to the practice of dentistry. It also attempts to cater for the area of auxiliary dental workers. Prior to this the affairs of dentists and the dental organisation were catered for by the Dental Board which was set up over 56 years ago, in 1928. During these years it has served the profession well, for which we owe the members of the board our thanks. They have acted as the watchdog of the profession, and the service the dental profession have provided for the country speaks for itself.

This board shows a new concept in that not alone are the profession adequately represented but, for the first time, the consumer is included. This is a concept which is acceptable to the profession. In relation to the membership of the board, I have had a number of visits during the past week from various groups with vested interests in this area. I had a deputation from the Irish Association of Dental Prosthesists. They requested that they should have at least one member on the council — Deputy Keating referred to this earlier and is in agreement — in other words, that a member from the auxiliary dental workers' group should be on the council. The proposed Dental Council will comprise 19 members. I do not believe one out of 19 is an outlandish or unreasonable request. I urge the Minister to consider their request. I know the Minister can nominate four members to the council and he may include one of these dental auxiliary workers, but I would rather see them having a guarantee of membership on the council. There is no guarantee under the present structure. As I said, one out of 19 is not an unreasonable or outlandish request.

This Bill was initiated in the Seanad. There was a very extensive and worthwhile debate for which we should all convey our thanks to the Members of that House. It was a job well done.

It would be preferable if you did not either compliment or criticise the Seanad.

It is not unreasonable to compliment them. I do not intend to criticise them.

Somebody else might have a different view next time.

From speaking to a number of my dental colleagues and members of the Dental Association, I know that in general they find the Bill acceptable in its present form. They submitted approximately ten or 11 amendments which were acceptable to the Minister.

The Bill is being set up to register and control those in dental practice and to control their education and training. It provides for their membership and method of appointment to the council and most importantly, it provides for the recognition of both dental specialists and classes of auxiliary dental workers. I do not intend to go through the Bill section by section because that has been covered adequately by Deputy O'Hanlon and the Minister. This Bill is accepted by all sides and we will not be opposing it at this stage, although we will have some comments to make on Committee Stage.

The problems of dental care in Ireland are enormous. At present the service is trying to provide care for about 600,000 children and a similar number of eligible adults. As a member of a health board, I have seen the drawbacks in the present service either through lack of funds or lack of properly trained staff. We cannot claim to be providing a service that is urgently needed in the community. I will give one example. The ad hoc dental scheme has been abandoned in Cork due to a lack of funds. Dental hygiene has become a major factor in the practice of dentistry today, when the emphasis is on conservation rather than heretofore the practice of extraction.

Debate adjourned.