We resume consideration of this Bill on Section 41, to which Senator Sir Edward Bigger has an amendment down which was before the House yesterday.
PUBLIC BUSINESS. - DENTISTS BILL, 1927—COMMITTEE STAGE (RESUMED).
The Seanad went into Committee.
CATHAOIRLEACH
I move:—
"Section 41—to delete the words ‘Medical Council' wherever they occur in this section, and to substitute therefor the words ‘Dental Board.'"
As the Minister is now present, I just wish to deal with a few points that I mentioned yesterday. As the Bill stands, it gives power to another body, namely, the Medical Council, to carry out certain most important functions relating to dentistry. One is the question of medical education. There are several reasons why this work could be better done by dentists. For instance, a Dental Board would be better able to apportion the time that candidates going forward for a dental degree would spend on different subjects relating to their profession, what time they would spend on dental work or on mechanical work, and so on, than a body of medical men. As I pointed out yesterday, it is necessary for the Dental Board to understand the standard of education in connection with the universities and colleges in the Dominions and foreign countries. I was looking through the list of Colonial dentists who have been registered under the English Act, and found that there are more Colonial and foreign qualifying bodies than there are in the British Isles.
It will be necessary for the Dental Board to understand everything connected with the standards before admitting graduates to its own institutions. Therefore, the Dental Board will be doing a certain amount of work in connection with education. I find also that the English Board has eight committees acting under it. They have a business committee and other committees, but the point I want to make is that four of the committees deal with education. Therefore, I cannot see why such an important body as the Dental Board in Ireland should not have the right to determine the course of education for people entering the dental profession and of making suggestions with regard to improvements, etc., in the curriculum.
Yesterday Senator Douglas opposed the amendment, because he had been told by dentists that they were anxious to remain under the Medical Council. I cannot understand how any self-respecting member of any profession or trade union would wish to delegate the most important functions relating to their profession or trade union to another body. I feel that the person who was speaking to Senator Douglas could not have understood the question. Another reason that Senator Douglas gave was that it might interfere with the agreement between Great Britain and the Free State. I do not think there is a scintilla of foundation for that. Up to yesterday I was under the impression that Senator Douglas was one who took his duties seriously, and that when he made statements here they were generally well-founded. I am now afraid that he must have swallowed a great many things during the last few years that perhaps were not founded on facts.
Senator Haughton made the statement yesterday that some of the dentists in Cork were not anxious for this amendment. I can quite understand that it is likely that dentists as a whole would rather have the Bill passed at once than have it delayed by the insertion of amendments. I know that they are most anxious that the position with regard to unqualified dentists should be brought to an end as soon as possible. I can quite see their point and appreciate it. But that is no reason why the Seanad should not make the Bill as perfect as it is possible to make it.
It may seem strange to some members of the House that, being a medical man, I would appear to oppose the Medical Council taking over this duty. So far as I know, there has never been any desire on the part of the medical profession to take control of dental work. I have spoken to a number of medical men with regard to this. Some of them were not even aware that the Medical Council had any power in this matter, while in other cases they were unanimous in stating that they did not see any reason why the Dental Board should not manage its own affairs.
We know that this country is crying out for efficiency. I think it is the duty of the Seanad to try in every possible way to give a lead and prevent inefficiency and over-lapping. If, in our individual capacities, we want a legal opinion, we go to a lawyer and ask him for it, and we adopt the same course if we need medical or surgical treatment by going to a physician or surgeon. If we have some dental trouble we go to a dentist. Why should we do in our individual capacities what we are not going to do for the State? The duties that are to be handed over to the Medical Council are the most technical and important in the whole Bill. Why should they be given to a body that does not contain a single dentist?
It is true that the Bill provides that three members of a dental bóard should sit with the Medical Council when questions of education are brought up, but even at the meetings which they attend, what can be done by three members out of total of fourteen?
CATHAOIRLEACH
You are wrong in saying, Senator, that the representatives of the Dental Board will only be present when questions with regard to education arise. The section says: "The Medical Council when exercising its functions under this Act." That is the only time the dentists will be there.
That is what I say.
CATHAOIRLEACH
When the Medical Council is acting under the Bill it will have three dentists to help it.
Three out of fourteen, and they would have to educate and convince their eleven colleagues on the Council about a whole lot of matters and that might be a very difficult thing to do. In any case, would it not cause a great deal of over-lapping and waste of time? The work, I suggest, could be much better done by a smaller body, the Dental Board itself. That Board will have to know exactly what the standards will and should be. I think that the proposed arrangement under the Bill will cause not only a great waste of time but a great waste of money. The Medical Council, no doubt, will be paid fees, but I do not know where the money is to come from. Certainly the fees that the Medical Council are to receive, as far as I can make out, will fall far short of the amount that they will require, and I fear that next year the Minister will be obliged to introduce a Supplementary Estimate. If he is obliged to do that, it is likely that questions will be put by Senator Farren as to why the Medical Council should get so much, questions somewhat on the lines of those that he put yesterday in reference to the Incorporated Law Society.
I have much pleasure in opposing the section as it stands. I do not know what the Minister's view may be, but will be pleased to hear it. It may be that the members of the Medical Council are appointed not so much from amongst practising members of the medical profession as from the different universities and colleges. I think at any rate that out of the eleven members to be on the Medical Council that seven of them are appointed by the universities. They may be professors of physiology or of pathology and so on, but there is no practising medical man to be on the Council as far as I know. I do not know what may be the reason for that. I think it would be far better to have this work done under the terms of my amendment than under the conditions laid down in the section as it stands.
It seems to me that the question before the House is what body is going to fix the standard of education for dentists. What is troubling my mind on this question is this: Which of the two bodies is the more likely to keep the standard up? I would be inclined to vote for whichever body is the more likely to keep the standard of education up. My own view is that the General Medical Council is more likely to keep the standard of education up than the dentists, and for that reason and, as at present advised, I would be opposed to the amendment.
As against the views stated by Senator Brown, I suggest that the Dental Board, composed of members of that profession, would be more inclined to maintain the prestige of the profession than a body composed of medical men, dentists, and one person nominated by the Executive Council. Under the amendment before the House you will have, so to speak, an examining body ready to hand. In the other case, you will have to select three dentists to act as representatives on the Medical Council. Under the amendment you will always have an examining body ready to hand, and there will be no need to have any sort of elaborate functions attached to it. I think, therefore, that the House should adopt the amendment.
CATHAOIRLEACH
But the three additional members are to be appointed by the Dental Board.
That will involve a new and unnecessary procedure.
I do not want to repeat the arguments I used yesterday with regard to the amendment, but as Senator Sir E. Bigger has suggested that I made statements yesterday— apart altogether from an expression of opinion—which were utterly unfounded, and then went on to state that I said dentists did not desire this amendment, I would like to repeat what I said yesterday. I stated that a leading dentist, who had been previously Secretary to the Dental Association, told me that the Irish Dental Association had considered this very point, and were of the opinion that in the matter of education they did not desire an amendment of the kind now before the House, and that they would gain more by the association of this matter with the Medical Council than they would by having it placed under the control of the Dental Board. I quite recognise that is a matter of opinion, and that the Seanad is not at all obliged to pay attention to what the Association says. I would like, however, to make it clear to the House that the statement I made yesterday was simply a statement and nothing else. It was simply a matter of opinion expressed by me.
I would just like to supplement the statement that was made yesterday by Senator Douglas. He told us of an experience that he had and what a leading member of the dental profession said to him. Last evening, I consulted a leading dentist as to the views of his profession on this matter. I may say that the views that he expressed to me coincided precisely with the views which, as Senator Douglas stated, another member of the dental profession had expressed to him.
Whatever dentists or doctors may think, this House has its own responsibilities in this matter and we should face up to that responsibility regardless of what individual dentists have said or have not said. The procedure adopted here seems to me to be overlapping and illogical. The Dental Board, I take it, is set up to have the same relationship to the dental profession that the Medical Council naturally has to the medical profession. But you start right away by, so to speak, passing a vote of no confidence or, at all events, declaring a limitation in your confidence in the capability of the Dental Board by allocating to another body the right to say what standard of education shall be set by that body. It is quite right that there should be an association between the dental profession and the medical profession, but surely you have got that on the Board by having three members of the Medical Council on it.
I understood that in the proposal before us they were to be removed.
They are not.
They are in the next amendment.
I am dealing with the amendment before the House. Under the Bill you have three members of the Medical Council. The Executive Council is given the right to appoint another representative, and it is fairly safe to assume that he also will be a medical man. Surely that is a sufficiently close association between the dental profession and the medical profession without handing over to the Medical Council the right to veto, or rather to prescribe the form of examination, and then of going through the cumbrous methods of co-opting or getting three members of the Dental Board to go on the Medical Council temporarily for this purpose. It would be better from that point of view, if you are going to give the Medical Council a majority on the Dental Board, to do the thing decently and decide the whole thing at once. Senator Brown has suggested that the Medical Council is the body that is more likely to set a high standard of education. But surely the members of the Dental Board on the Medical Council, being themselves qualified dentists and on the register and acting together with the representatives of the Medical Council, will have sufficient self-interest to make the examinations as high as possible. They are not going to be in favour of setting a low standard, thereby increasing the number of their own competitors. If these representatives are incapable of discharging the functions set out here under Section 41, then they are not fit to be on a Dental Board at all.
I do not know that it is necessary that the standard of examinations should be set too high, thereby making it prohibitive for anybody except the son of a wealthy person to enter the dental profession. A large part of a dentist's work is mechanical. There is only a comparatively small amount of it that can be said to be of a medical or surgical kind involving prolonged studies and a high literary standard of education. Many members of the Medical Council are members of a university. They are nominated by the universities, and very probably, from a selfish point of view, will make the standard of education perhaps very high, higher perhaps than it is desirable to have it, from the viewpoint of equity, to all sections of the citizens. If that is the object, I certainly would oppose any handing over of those rights to the Medical Council. In any case it seems to me to be a wholly illogical, unnecessary and expensive system. As to the question where the funds are to come from to remunerate the Medical Council for its services, might I point out that the funds for the Dental Board have to come from the dental profession? Must they also pay the Medical Council for discharging duties that are taken out of the hands of the Dental Board because, presumably, the Dental Board cannot be trusted with them? In other words, is the State to step in and pay for the discharge of those duties?
I think that we are placing the Dental Board in an absolutely humiliating position by seeking to take from it this important duty. We should either hand over that duty entirely to the Medical Council and let them decide it or discontinue what is proposed to be the constitution of the Dental Board—that is, the medical profession having representatives on it. What is the necessity for them being represented on the Board if they themselves are going to prescribe the form of examination quite independently of the Medical Board, except to the extent that two or three members from the Dental Board may make representations to them? I cannot see the logic of it at all. I do not know the reason why, except that it is probably copying what has been done somewhere else for reasons that are not obvious or present here, this present arrangement is suggested.
Senator Sir Edward Bigger, who is associated with the Medical Council and is an authority on matters of this kind, gives it as his opinion that it is an unreasonable arrangement, and that should go a long way to convince unprejudiced people in the matter. In the other House the medical profession certainly made their mark on this Bill. They dominated the whole discussion, and it was quite obvious that whatever view they put forward there was carried, because the Minister himself was defeated.
Once.
Their views carried anyway. I think that in Senator Sir Edward Bigger we probably have a more eminent and experienced member of the medical profession in this House than they have in the other, and I hope that his views in regard to this matter will carry some weight.
I want to say at the start that in this matter Senator Sir Edward Bigger speaks neither for the medical profession as a whole nor for either branch of the dental profession. I have been in touch with all three, and the opinions that they have given me are quite contrary to what Senator Sir Edward Bigger has stated here. The Senator is acting entirely as an individual and in direct contravention, I think, of the majority view of those associations. There is one point that I think should be stated clearly at once. It is that I got my information not from individual dentists. I have been in touch with the main dental associations of the country, and their view is distinctly this: that it will suit the dental profession better to have this question of education left as it is here —that is to say, that the Medical Council will have associated with it for all purposes in which the Medical Council has jurisdiction three members.
The matter of fees was raised. That does not arise and is a red herring drawn across this, and not a very good one either. Whatever duties the Dental Council perform entailing expenditure, that expenditure will be met by fees collected from the dentists, and whatever expenditure the Medical Council have to perform will be met by fees drawn from medicals. That is the beginning and the end of this fees question. There is the further point that Senator Douglas alluded to with regard to the agreement. I do not know whether Senator Douglas went so far as to say that it was a breach of the agreement.
The statement I made was that it might possibly upset the working of the agreement.
It will upset the idea behind the agreement. Turning to the agreement they will see in sub-section 3 of the First Schedule:
"...for the purpose of the preparation and keeping of the Dentists' Register the Dental Board and the General Medical Council and their respective officers shall have and may exercise in relation to persons, medical authorities and matters in the Irish Free State all such powers, jurisdictions and authorities under the Dentists Acts as the said Board and the said Council had and might exercise under the Dentists Acts for that purpose in relation to persons, medical authorities, and matters respectively in Ireland."
If it were for no other reason, that is a sufficiently good reason for having the present arrangement with regard to dental education in the hands of the Medical Council and for having associated with them for that purpose the three members appointed by the Dental Board. I do not think it can go to the point that there could be any complaint from the other side that there has been a breach of the agreement in any way, but I think it will upset the harmony one would expect to arrive at through this arrangement. Senator O'Farrell talked of the overlapping that will ensue as a result of this method— limited method as he called it—of selection. That is because I think Senator O'Farrell does not understand what is under consideration. If they were an engineering body, entirely divorced from dentistry, and it was proposed to hand over the control of dental education to them, one would say there was something peculiar, and that there was no confidence in the Dental Board. For at least three years the course for a dentist is almost entirely basic with the subjects for the medical man. Right through his course he is dealing with subjects that have a big relation to the medical side. If one looks at the faculty of dentistry in any university, one will find that the faculty is over-weighted with medical men, and that the actual dental men in the dental faculty are a small minority. We are told that the dentists should know what they require. The main reason given to me by the Dental Association as to why they do not want to control dental education is that all the dentists in Ireland are what they describe as working dentists, and that there are no full-time academic men engaged in the universities. The dentists associated with the universities are part-time men. They may know all the necessary biology and physiology in their early years, having passed through the course, but there it ends. There could not be found in the profession men who could be full-time professors in dental subjects, and they could not man at the moment even the Dental Council. Full control of dental education would mean controlling the professors of medical subjects in certain universities. If that system were adopted, you are going to have certain professors subject to the control—as far as medical men are concerned—of the medical body, and subject—as far as dentists are concerned—to the dentists' body. The arrangement is a sound one, and in harmony with the agreement made on the other side. It does not entail any greater expense than by giving the Dental Board full control.
What about the 1921 men?
I cannot say. I think they are a disappearing force.
They are the most numerous.
Yes, in this sense, that they are people not professionally qualified, and are being admitted under this Bill to the dignity of professional men.
They are qualified, but have not a university education.
They are not qualified, leaving the university out of it. There is a considerable number of dentists who have never gone to a university and are qualified men. They have gone through dental colleges. A considerable number of people who were never near a university in their day are qualified men. A number of people have been practising dentistry illegally for years, and it is proposed to allow them to become professional men. Their rights cannot be added to after this Bill is passed. As I have said, they are a disappearing number. I have not had an expression of their views as to whether the Medical Council should control dental education. I do not know whether their views could be taken for or against this suggestion. I think it is the view of the Medical Council, of medical men generally in the country, and of the Dental Association that this body which it is proposed to set up is more likely to insist on a good standard with regard to dentistry than a dental body pure and simple. I say that without wanting to reflect on the capacity or willingness of the dental body to insist on a standard, but I am expressing the opinion they are working dentists and it would make such a demand on their time that they could not do it. You have a Medical Council of whom a large number are people who are full-time lecturers or professors in universities on medical subjects. I am against the amendment, and I think it would be disastrous both from the point of view of a standard and the harmony that should exist between the two bodies if the amendment were passed.
What does the Minister mean by full-time lecturers? I take it the lecturers are appointed by the universities. Does the Minister mean that while full-time medical men are appointed there are no full-time dental professors?
The dentists do not want to take these full-time professorships in universities. In the University I am best acquainted with there are several full-time professors, but there are others, such as professors in surgery, who are only part-time. All the dental men are part-time, and there are no full-time professors of dental subjects in the universities. No dentist has asked there a full-time post. They are mainly looking to their profession, to working and not to teaching.
With reference to Senator Brown's remarks regarding a higher educational standard, I think the education is most suitable that best enables a man to do his work. There is a great advance going on in dental science. Dentists are aware of this. They can make a suggestion to the universities but the question of examination is in the hands of the universities and colleges. As the Minister has pointed out, when it comes to making a suggestion for improvement it can be made much better by men who have devoted their whole life to the work. Senator Douglas mention the agreement. I have studied that carefully, and I know of the working agreement between the British and Irish Dental Boards, but I can see nothing to interfere with a domestic matter of this kind. The dental profession has never been consulted. I have consulted several teachers, including some professors, and they have no wish or desire that the matter should be left to the Medical Council. I was not speaking yesterday on behalf of the medical men. I had no authority to do so, and they never asked me to do so. I was speaking to this House, as I said yesterday, in the best interests of the House and of the State. As regards education, it is quite true the universities have a number of permanent, whole-time professors. At the same time in the colleges there are a good many part-time teachers. As to the distinction between part-time and whole-time professors the course for the dental profession is quite different to that for the medical profession.
In the latter years only.
Yes, quite different. Since the matter was raised here yesterday I have made it my business to get into touch with two of the most prominent dentists in the city, outstanding men, and they told me that the arrangement I am suggesting would be an ideal one.
I think most of us have very little technical knowledge about this all-important question. During the Great War the question of dentistry was brought prominently before the public. There was surprise that there were so few qualified dentists in the whole of the British Islands. I think the total number was about 5,000. One of the reasons why more were not sent forward for this important profession is that it was so easy to commence practising dentistry, some people taking up the practice of it who knew as much about it as I do myself. This Bill seeks to safeguard the interests of dentists not only to the satisfaction of the profession but of the entire country. As Senator Brown has so well said in a few sentences, the main question is to see to it that the education of those engaged in dentistry is kept up to the highest possible standard. The dentists themselves, and I believe the majority of the medical men, believe that it could best be done under the control of the Medical Council. I am sorry that Senator Sir E. Bigger, himself a member of that Council, does not consider it is the best body to look after the interests of the dental profession.
Amendment put. The Committee divided, Tá, 14; Níl, 21.
Tá
|
William Barrington.Sir Edward Coey Bigger.J.C. Dowdall.Michael Duffy.Michael Fanning.Thomas Farren.P.J. Hooper. |
Cornelius Kennedy.Thomas Linehan.General Sir Bryan Mahon.William John Molloy.Joseph O'Connor.John T. O'Farrell.Dr. William O'Sullivan. |
Níl
|
T.W. Bennett.John Bagwell.Sir Edward Bellingham.P.J. Brady.Samuel L. Brown, K.C.Mrs. Costello.John C. Counihan.The Dowager Countess of Desart.James G. Douglas.Sir Thomas Grattan Esmonde.Sir Nugent Everard. |
Mrs. Stopford Green.Sir John Purser Griffith.Benjamin Haughton.Arthur Jackson.Right Hon. Andrew Jameson.Patrick W. Kenny.Francis MacGuinness.James MacKean.Bernard O'Rourke.Siobhán Bean an Phaoraigh. |
Amendment declared lost.
CATHAOIRLEACH
That disposes of the other two amendments standing in the name of Senator Sir E. Coey Bigger.
I move:—
Before Section 45 to insert a new section as follows:—
"45. Nothing in this Act shall be construed to justify the imposition of a fine or penalty upon any persons who have hitherto been employed as dental mechanics and who after the coming into force of this Act continue to execute purely mechanical work in the repairs of or improvements to plates, whether such mechanics are employed by registered dental surgeons or not; or shall be construed to justify the imposition of any fine or other penalty upon any person who, for the relief of pain, extracts a tooth at the urgent request of the sufferer, when the services of a registered dentist are not immediately available."
In bringing forward this amendment I hope I will not be trespassing on the province of the Senator who has made the interests of the poor man's son his own. The facts in connection with it are, shortly, these. There are a number of men who are dental mechanics and they propose to be mechanics and nothing else. There is no idea involved in the amendment that they should become dentists, or practise the extraction of teeth or do any surgical kind of work. They serve their apprenticeship, for, I think, a period of five years to get their trade. They become very skilful in their work and are then employed by dentists. Frequently it happens, as in the case of other professions, that there are dentists who fall on bad days, and who become unable to continue the employment of these men. When that occurs they are compelled to fall back upon their trade. They undertake all sorts of mechanical work. For instance, they deal with artificial teeth, and if a plate is broken they are given the job of mending it. This has nothing to say to the ordinary practice of dentistry. I know from what various Senators have said to me they have a kind of feeling that at the back of the resolution there is some idea of allowing unqualified men to come into the profession of dentistry. There is no such idea. The amendment is strictly confined to the men who at present are earning their livelihood as dental mechanics, with or without intervention of employment by qualified dentists. I want to make it clear that they are not to be deprived of their livelihood. Far too many are unemployed in this country, and we do not want to swell their ranks. We do not want men earning an honest livelihood to be deprived of that livelihood. The men for whom I speak do not want to be allowed to go up for examination to enable them to become qualified dentists. All they want is to be allowed to continue to earn an honest livelihood. It seems to me it would be very unjust to deprive them of that opportunity. It would be an analogous case supposing merchant tailors were looking for protection if they endeavoured to prevent journeymen tailors through the country repairing clothes and doing odd jobs. It seems to me it is only reasonable to provide that these men should not be prosecuted and fined, or prevented from carrying on their trade as they have done in the past. The amendment provides that it is only those who have been exercising certain duties in the past who will be allowed to continue in the future.
CATHAOIRLEACH
I cannot see any penalties under the Bill. There is power to remove a man from the register for unprofessional conduct. That would not apply to your men. They would never be on the register. Section 35 makes it punishable by a penalty for them to procure a false entry to be made, but there is nothing I can find in the Bill that under any circumstances could impose a penalty on the men you want to protect.
I would refer Senators to the section dealing with "the employment of mechanics or apprentices by a registered dentist to carry out under the supervision of such registered dentist any work which is usually done in a dental workshop." We want that extended to the men not employed by registered dentists who are working on their own.
CATHAOIRLEACH
You are talking of a fine or penalty. There is no such fine or penalty imposed. You want to exempt them from that particular section. Under Section 44, which you say prohibits the employment of these men, there is no penalty imposed. As I understand, what you want is to bring them within the provision of Section 44. Is that right?
No. What I want is to have them permitted. The case could be met by taking out the words in sub-section (c) of Section 44: "Under the supervision of such registered dentists."
CATHAOIRLEACH
If you think they are hit by that section the thing would be to amend it, but I do not see how you say the section puts a penalty on the man who employs.
The point is that if we amend this section in a way such as that it would allow people to be brought in in the future that we do not want to bring in.
CATHAOIRLEACH
Can you not protect the people you want to protect by making an exception under that section in favour of these people? All I am pointing out is there is nothing in the Bill, so far as I can find out, that imposes any penalty on these individuals.
Does not Section 4 provide that "Every person who acts in contravention of this section shall be guilty of an offence under this section, and shall be liable in respect of each such offence on summary conviction thereof to a fine"?
CATHAOIRLEACH
That only applies to a person who employs unauthorised individuals.
Suppose you had the sub-section:—
"(1) Subject to the provision of this section it shall not be lawful for any person on or after the date of the passing of this Act to practise or to represent or hold himself out whether directly or by implication as practising or being prepared to practise dentistry or dental surgery unless such person is a registered dentist."
So that if a dental mechanic proposes to extract teeth that is practising dentistry and he is then liable to a fine.
CATHAOIRLEACH
That is the thing Senator Barrington says he does not want.
A man of that type can extract teeth and practise dentistry and not be subject to any fine.
That is the second part of the amendment.
CATHAOIRLEACH
I was dealing with the first part.
I am not putting forward the amendment as an ideal one.
CATHAOIRLEACH
Would it be sufficient for your purposes to say: "Nothing in this Act shall be construed to justify the imposition of a fine," taking the last part and ruling out the first?
Very well, sir.
CATHAOIRLEACH
Of course you know more about it because you have looked into it better than I have. But looking at it first glance it does not seem to me that there is a penalty imposed with regard to the first part of your amendment at all. There is nothing in the Bill that I can find to apply to it; but I think there is something in the Bill covered by the last part of your amendment.
Undoubtedly. That is put in with an entirely different object; it is to deal with a state of affairs that I alluded to on the Second Reading of the Bill.
CATHAOIRLEACH
Is there anything in the Bill that prevents your dental mechanics—men who never want to be registered—from continuing to act as dental mechanics?
No.
I am not a skilled lawyer, but I am rather afraid that a lawyer with a great amount of skill might bring them under it, and I want to make it quite clear that he cannot. I now come to the second part of the amendment. There are a great many people that I know of in the West, where there are no dentists, even where doctors and chemists are not available. A poor fisherman or a man living out in the wilds of Connacht or Clare gets a violent toothache; he would do anything to get rid of the pain, and he goes to somebody, I do not care whom—hitherto it has generally been a blacksmith—and he asks him to pull that tooth to relieve him of the pain. Under the Bill, if the blacksmith does so, he will render himself liable to a fine of £100. I do not say that a fine of £100 will ever be inflicted on him, but that is the position he is put in. I want to make it clear that in those circumstances that man will not be rendered liable to a fine of £100.
CATHAOIRLEACH
That applies to anybody in the Free State, whether he is a dental mechanic or not.
This has nothing to do with dental mechanics.
CATHAOIRLEACH
Your amendment deals with two entirely different things.
Precisely.
CATHAOIRLEACH
I see nothing in the Bill that requires the provision of the first part of the amendment. What is there in the Bill that prevents these men, who do not want to register, who do not want to practise as dentists, and who are merely mechanical assistants, going on and acting as such in the future? I can find nothing.
I put the case up to the people who came to me that I could see nothing in it, but they said that they had a wholesome fear—and I must say I more or less agreed with them—of the machinations of the lawyers. They would like to have it perfectly clear that there is not even a penalty being attached to their doing so. I beg to move the amendment.
I do not know whether the first part of the amendment is under discussion or not. Section 44 talks about the prohibition of the practice of dentistry by unregistered persons, and sub-section (3) goes on to say:
"The provisions of the foregoing sub-section shall not operate to prohibit the employment of mechanics or apprentices by a registered dentist to carry out under the supervision of such registered dentist any work which is usually done in a dental workshop."
That at any rate exempts certain of the people that the Senator was speaking of. Whether there is a prohibition of other people who do not do something which can be construed as practising dentistry or dental surgery I cannot say. I am rather inclined, from hearing the Senator, to think that there is a gap in the Bill and that it should be stopped. But I do not see a way to stop it at the moment.
My suggestion is that the case would be met by the elimination from sub-section (3) (c) of the words "the employment of dental mechanics or apprentices by a registered dentist to carry out under the supervision of such registered dentist any work which is usually done in a dental workshop."
CATHAOIRLEACH
These words are put in to protect the very men you want protected—"The provisions of the foregoing sub-section shall not operate to prohibit." That is put in for their protection, and you want it put out.
No. What I want put out is that they must be employed by a registered dentist. Under this section as it stands——
Under this section as it stands they can be employed as before.
By a registered dentist?
CATHAOIRLEACH
And if they work on their own account purely as mechanical assistants there is nothing in the Bill to prevent them.
Would the Senator take it this way: Will he agree that sub-section (3) (c) of Section 44 should exempt those who are employed by registered dental surgeons?
Quite.
The amendment reads: "whether such mechanics are employed by registered dental surgeons or not." Supposing the amendment were cast in that form, where is the section in the Bill that this is to meet?
I think Section 44, sub-section (3).
Sub-section (3) exempts certain people. They are some of the people he attempts to cover in his amendment. They are people described as employed by registered dental surgeons. The Senator's amendment says: "Nothing in this Act shall be construed to justify the imposition of a fine or penalty upon any persons who have hitherto been employed as dental mechanics and who after the coming into force of this Act continue to execute purely mechanical work in the repairs of or improvements to plates, whether such mechanics are employed by registered dental surgeons or not." To what section does he propose to move that? To what section is it relevant? Where is the section imposing a penalty on such people?
The penalty is in Section 44, sub-section (4).
Not for these people, for other people.
CATHAOIRLEACH
The only point I see—and I think this was probably in the minds of those who spoke to the Senator on the matter—is that they may fear that because certain conduct on the part of those mechanical assistants is not prohibited while they are acting in the employment of registered dentists, if they are acting on their own account they are by implication to be punished.
That is exactly the point.
CATHAOIRLEACH
But of course you cannot punish people by implication. If you have a penalty it must be expressly imposed and the offence must be clear.
I am very glad I put down the amendment to get from you that expression of opinion.
We may provide on the Report Stage of the Bill a section to which this amendment will be relevant, because it may be necessary to have this type of dental mechanic prevented, and prevented under penalty, from carrying on in this way. The work is purely mechanical work in the repair of plates. They have not, for instance, to fit into a person's mouth whatever the material is from which a mould is taken. Would that be regarded as mechanical work in regard to a plate? If it is I certainly think it should be under the supervision of a dentist. Even the case that the Senator gave, where out of an artificial set of teeth one tooth was dropped, one goes to one of these men not working under the supervision of a registered dentist, to get it put in. I wonder has the Senator asked any of his medical friends what are the causes of cancer in the palate or the inside of the jaw and if he was not told that very often it comes from a badly inserted plate and a badly fitted tooth.
Has the Minister got any medical authority for stating that cancer comes from badly fitted teeth?
Decidedly. I have heard that stated over and over again, and if that is the kind of thing that the Senator wants to have done not under the supervision of a registered dentist I think we will have to take steps to block it. The second portion of the amendment deals with the question of the person who is suffering from a toothache and who has not available any of the people mentioned here—"a registered pharmaceutical chemist, chemist and druggist, or druggist, or a licentiate apothecary." To meet that case the Senator brings in an amendment which, of course, would tear the whole Bill to pieces. It would allow for the quack dentist to come back again. What is to prevent a dentist doing what the bonesetter does at the moment? The bonesetter's relation to the medical profession is that he cannot get his fee, and the practice, I believe, adopted by those people is that before you get into the consulting-room of any bonesetter you pay the fee and it is all over; you get your treatment after; if it is good, well and good, and if it is no good you have no remedy. What is to prevent a quack getting a man to sign a statement that he is doing the work at the man's urgent request and for the relief of pain? The whole question would then turn upon whether the services of a registered dentist were immediately available. There is a tremendous amount of loopholes through which a quack could get back into our midst, and this Bill is to clear the quack out definitely. In the circumstances of which the Senator has spoken, does anybody believe that the local blacksmith, if brought before a court, would be fined? He would not be fined in the circumstances which the Senator spoke of. It will make the local blacksmith less anxious to pull teeth for people and it will make people less anxious to go to him when this clause is there and when the penalty is there.
I do not think he is ever anxious to do it.
CATHAOIRLEACH
Looking at this again, I do not see that we are doing any injustice to the people you represent, but if you look at Clause 1 of Section 44 you will see that it governs all the rest of the clauses. They only deal with persons who, either directly or by implication, are practising or preparing to practise dentistry or dental surgery. It never could be held that a mere mechanic is a person either practising or preparing to practise dentistry or dental surgery any more than a skilled mechanic who makes surgical instruments, or a man who makes wooden legs, could be said to be preparing to practise surgery. So that I think they are quite safe. The second part of the amendment is another matter. I am not dealing with the second part at all. I think the first part is out of order, as there is nothing in the Bill to which it could apply.
I am very glad to have extracted that expression of opinion.
CATHAOIRLEACH
I think the second part is in order.
Amendment, by leave, withdrawn.
I would like to know from the Minister if sub-section (1) of Section 44 makes it a crime for a person who is not a qualified dentist to extract a tooth without payment. People do practise medicine and receive no payment. I know parts of the country where quacks—ladies—profess to cure jaundice by tea made from dandelion, and it is a serious consideration that they do practise, and to a fairly considerable extent. I do not know whether it is permissible under this Bill to practise dentistry, such as extracting teeth and so on. I know that the first tooth I had pulled out was with a bootlace. It was customary for people to put a piece of twine about a loose tooth and hack it out. Is it an offence under sub-section (1) of Section 44 for dental practice to be indulged in, even though no payment is made?
I think so.
CATHAOIRLEACH
With regard to the Schedules, they were referred yesterday to a sub-committee to look into the cases listed and the amendments, and also certain further applications which had been sent in to the Clerk asking to be put on Schedules. The House agreed to the appointment of a sub-committee whose duty it would be to report to the Committee. That sub-committee, I understand, met yesterday, and I am informed that they think, in the interests of those persons, the matter should be adjourned, and that a further interval should be allowed to give an opportunity to people to send in additional applications. Some people appear to be under the impression that the fact that they might apply to be put on the Schedules is not generally known. They suggest, accordingly, that further consideration of the Committee Stage should be postponed now until we have received a report from the sub-committee, and they asked to have the time for the sub-committee considering the report extended.
The committee met this morning and decided to give extended time to the 16th April, by which all applications should be sent in, addressed to the Clerk of the Senate.
CATHAOIRLEACH
The Minister does not object, and if there is no objection on the part of the House we will take it that they agree.
I think the arrangement was really following the Minister's suggestion.
Will it be necessary for candidates to attend personally before the committee?
CATHAOIRLEACH
That will depend on the information they supply to the committee. If the committee want it supplemented by attendance probably they would require a candidate to attend. That must be left to the sub-committee. If the information before them is not sufficient, and if they ask for more and cannot get it, they will reject the application. I think they will not do so until they give candidates an opportunity of supplementing the information.
I am interested in a candidate from Dunmanway. It is a long way for a person to come if it is not necessary to do so.
CATHAOIRLEACH
I cannot say what the sub-committee will do about that. I imagine that if the evidence he has furnished is not sufficient they will call upon him to come up.
Will any advertisement be issued?
CATHAOIRLEACH
I am afraid that would not be wise.
The three principal daily papers were kind enough to insert a notice, when the Bill was going through the Dáil, that applications would be received up to the 6th January, and that obtained as much publicity as the Press could give it.
CATHAOIRLEACH
I think we will leave the matter as it is.
Progress reported.