Tuesday, 30 May 2023
Regulated Professions (Health and Social Care) (Amendment) Bill 2022: Committee and Remaining Stages
I move amendment No. 1:
In page 13, after line 42, to insert the following:“PART 5Definition (Part 5)
AMENDMENT OF DENTISTS ACT 1985
16.In this Part, “Act of 1985” means the Dentists Act 1985.
Amendment of Act of 1985
17.The Act of 1985 is amended by the insertion of the following Part after Part IV:“PART IVADuty of registered dentists and registered dental auxiliary workers to maintain professional competence
MAINTENANCE OF PROFESSIONAL COMPETENCE38A.(1) A registered dentist and a registered dental auxiliary worker shall maintain professional competence on an ongoing basis.Duty of registered dentists and registered dental auxiliary workers to demonstrate professional competence to the satisfaction of the Dental Council
(2) A registered dentist and dental auxiliary worker shall, whenever required by the Dental Council to do so, demonstrate competence to the satisfaction of the Dental Council in accordance with any requirement of the Dental Council under section 2(1).
(3) A registered dentist and a registered dental auxiliary worker co-operate with any requirements imposed on the registered dentist or the registered dental auxiliary worker by the rules
(4) The Dental Council may, by notice in writing given to a registered dentist or a registered dental auxiliary worker, who has given an undertaking, require the registered dentist or the registered dental auxiliary worker to co-operate with such an undertaking to the satisfaction of the Dental Council.
(5) A dentist or auxiliary dental worker shall comply with a notice under subsection (4) given to him or her.38B.(1) The Dental Council may require a registered dentist or a registered dental auxiliary to demonstrate competence to the satisfaction of the Dental Council in accordance with a professional competence scheme applicable to that dentist or dental auxiliary worker or otherwise.
(2) The Dental Council may require a registered dentist or a registered dental auxiliary worker who fails to demonstrate competence to the satisfaction of the Dental Council to attend a course or courses of further education or training or to do anything which, in the opinion of the Dental Council, is necessary to satisfy the Dental Council as to the competence of that dentist or dental auxiliary worker.
(3) Where the Dental Council considers that a registered dentist or a registered dental auxiliary worker—(a) who, being required under section 1(3) to co-operate with any requirements imposed on that dentist or auxiliary worker by the rules, has refused to so co-operate, has failed to so co-operate or has ceased to so co-operate,Duty of the Dental Council in relation to maintenance of professional competence of registered dentists and registered dental auxiliary workers
(b) has contravened section 1(5),
(c) may pose an immediate risk of harm to the public, or
(d) may have committed a serious breach of its guidance on ethical standards and behaviour, then the Dental Council shall forthwith make a complaint to the Fitness to Practice Committee.38C. (1) The Dental Council shall, not later than the first anniversary of the commencement of this section, or such longer period as the Minister for Health permits in writing at the request of the Dental Council, develop, establish and operate one or more than one scheme for the purposes of monitoring the maintenance of professional competence by registered dentists and registered dental auxiliary workers.Duty of employers in relation to maintenance of professional competence of registered dentists and registered dental auxiliary workers
(2) A scheme under this section shall not be established or operated until a proposal for it has been approved by the Minister for Health and the Minister for Public Expenditure, National Development Plan Delivery and Reform.
(3) The Dental Council, in respect of a professional competence scheme—(a) shall review the operation of the scheme periodically, and
(b) may, following such a review, make recommendations to the Minister for Health as to the steps that, in the opinion of the Dental Council, may need to be taken to improve the operation of the scheme.38D. (1) An employer of a registered dentist or registered dental auxiliary worker shall facilitate the maintenance by that dentist or dental auxiliary worker of his or her professional competence pursuant to a professional competence scheme applicable to the dentist or dental auxiliary worker concerned.Confidentiality
(2) Without prejudice to the generality of subsection (1), the employer may facilitate the maintenance of professional competence by a registered dentist or registered dental auxiliary worker it employs by providing learning opportunities for that dentist or dental auxiliary worker in the workplace.38E. (1) Subject to subsections (2) and (4), and to any agreement made, a person who acquires any information by virtue of the person’s performance or assistance in the performance of functions under this Act relating to any professional competence scheme shall preserve confidentiality with regard to the information and, without prejudice to the foregoing, shall not—(a) disclose the information to another person except where the disclosure is necessary for such performance or assistance, or(2) Notwithstanding subsection (1), the Dental Council may disclose information—
(b) cause or permit any other person to have access to the information except where the access is necessary for that other person to perform or assist in the performance of functions under this Act (including the functions of the Fitness to Practise Committee).(a) in the form of a summary compiled from information provided in relation to registered dentists and registered dental auxiliary workers participating in a professional competence scheme if the summary is so compiled as to prevent particulars relating to the identity of any such dentist or dental auxiliary worker being ascertained from it,(3) The Freedom of Information Acts 1997 and 2003 shall not apply to a record (within the meaning of those Acts) relating to any professional competence scheme.
(b) with a view to the institution of, or otherwise for the purposes of, any criminal proceedings or any investigation in the State, or
(c) in connection with any civil proceedings to which the Dental Council is a party.
(4) Nothing in this section shall be construed as prohibiting a disclosure of information pursuant to a court order.
(5) A person who contravenes subsection (1) shall be guilty of an offence and liable on summary conviction to a class A fine or a term of imprisonment not exceeding 6 months, or both.”.”.
I welcome the Minister to the House. This amendment concerns regulation, although not regulation that would specifically come under CORU. It is in relation to the need for the regulation of standards and continuing professional development for the dental profession. Currently, there is no legislative requirement for continuing professional development, only an ethical one. The Irish Dental Association has identified this as a gap in the legislation which, in its view, poses a significant risk to public safety.
This amendment was previously moved, as the Minister will know, by Deputy Shortall and it was rejected by the Dáil. Specifically, at that point, the Minister cited the urgent need to bring UK-based medical graduates into the HSE in July. He noted that the inclusion of this amendment would result in significant delay. The primary issues cited were technical, including compatibility with the current Dentists Act, which would need to be ironed out through the Office of the Attorney General, the Office of the Chief State Solicitor and fitness to practise. This would mean that the amendment would have to be redrafted and would have to come back before the Dáil and the Seanad. The Minister said he believed this would not be possible by July.
The amendment, as I said, concerns regulation. It relates to the need for the regulation of standards and continuing professional development. While it is not specifically within the ambit of CORU, I note the Minister previously submitted amendments to this legislation relating to the medical profession. This amendment is based on recommendations from the Irish Dental Association which wants to reform legislation that governs the practice of dentistry. It is troubling that a representative body is lobbying us, as legislators, to say the standards can and should be improved.
Going back as far as October 2021, the Irish Dental Association engaged with the Department. At that time, it identified a number of gaps in the Dentists Act 1985 which, in its view, posed significant risk to public safety. This included the legislative failure to require dentists and dental auxiliary workers to maintain their ongoing competence through continuing professional development. The failure to effectively legislate for this means dentists are very much out of step with other healthcare professionals, specifically doctors and nurses. This amendment is about raising standards and ensuring greater protection for patients. It is about addressing issues that have been raised by those in the profession.
I thank the Senator for the amendment. Essentially, while I cannot accept the amendment to this Bill, I support the intent of it. As the Senator said, there is not a statutory requirement for continuing professional development for dentists. Many dentists obviously engage in continuing professional development and the Irish Dental Association provides much of that. It is legislated for doctors and other healthcare professionals but not for dentists. It is governed under a 1985 Act, which needs to be updated. It is something I would certainly like to see being done.
I cannot accept the amendment now for several reasons, one of which is that there is a time sensitivity in this. We need to make sure UK medical degree holders and medical graduates can come here for their internships, and these internships commence in July. Therefore, there has been a real urgency with this Bill. I thank the Seanad for its support in scheduling this Bill to get it through Committee and Remaining Stages today. There is a new test at EU level, as prescribed by the EU proportionality test directive, which requires that any time we regulate like this, we must do an amount of work, including a stakeholder engagement, to justify why we are regulating. It is a good idea. The essential aim is to ensure that governments do not overregulate. However, that makes the process longer. The test would have to be carried out prior to the restrictions being enacted. It is not possible to do that because it would delay eligibility for UK medical graduates. Other work would be required in respect of the amendment tabled by the Senator, as supported by the Irish Dental Association. There are various changes we would want to make to it. In essence, there is a real timing issue. I support the objective of the amendment. It is something we need to do and will do as part of an upgrading of the 1985 Act generally. That legislation is out of date and there are various parts of it we want to upgrade. Continuing professional development is one such aspect.
I appreciate the Minister's response. I understand this proposal has been with the Department since October 2021. There has been plenty of time to consider it and he has had plenty of time to bring forward his own amendment. We must move forward on this issue. The Minister has admitted we need to take action on it. I ask him to look favourably on my amendment. Dentists and patients deserve a scheme that is fit for purpose.
I look favourably on the amendment but I cannot accept it in the context of this Bill. As we have discussed here previously, the current dental treatment services schemes is not fit for purpose. As we develop a broader response to oral healthcare, which we must do on a legislative basis, we certainly will be cognisant of this amendment within what will be a fuller updating of the 1985 Act.
I will not divide the House. I am conscious of the numbers. I appreciate the Minister's response. It was worthwhile to have the conversation again in light of the amendment put forward by Deputy Shortall in the Dáil. I hope we will see action on this issue as soon as possible.
I acknowledge the constructive manner in which the Bill has passed through both the Dáil and Seanad. I thank colleagues for their assistance. I also thank the Chairs in both Houses for facilitating its speedy progress. The legislation is really important as it will allow those graduating as doctors in the UK to come to the HSE for their internships. They will be delighted to be able to do that. I thank the Office of the Parliamentary Counsel, officials in CORU and the Medical Council and officials in my Department, some of whom are here today. Many people have put a lot of work into the Bill. It is quite technical miscellaneous legislation but it is really important for the various reasons we have discussed. We will now be able to bring in interns from the UK. In addition, we will able to regulate home care and social care professionals, which is another really important step. I thank colleagues in the Seanad, the Acting Chairperson and all the officials who have worked to get the Bill through as quickly as it has done.
I thank the Minister and his officials for progressing this legislation. Although technical in nature, it is very important because it ties up loose ends and provides for a more streamlined health service. We will all benefit from that. I thank everybody involved.
Gabhaim buíochas leis an Aire. He pushed for this legislation as soon as he became Minister. As we know, there are huge issues with the backlog in processing qualifications. The last thing we want is more bureaucracy stopping people coming in from the UK. Hats off to the Minister for driving the Bill forward. He had good support from his staff, but sometimes it takes a Minister to drive an issue. It is amazing what can be achieved when people put their mind to it.
I take this opportunity to acknowledge that today is World MS Day. We just had a brilliant briefing from MS Ireland. The organisation has a clear request, which would save the State approximately €18 million, for the appointment of a physiotherapist to each of the regions in the country. I said to the people giving the briefing that I would raise the issue with the Minister and mark the occasion. He is probably the best chance we have of getting that kind of funding for MS Ireland.
This is an important Bill. Sometimes, the good things that are done in this House go unrecognised. It is extremely important that we recognise this is a good Bill. It might be technical, but technical Bills can sometimes have a profound effect. The Minister's officials, his wider support team and the staff of the Office of the Parliamentary Counsel deserve credit for the small, incremental steps that have been taken over recent months and years. They are making a real difference to people's lives.
I echo Senator Garvey's point about MS Ireland. The Minister of State, Deputy Rabbitte, was in attendance briefly at today's presentation. As I said, small actions, such as that proposed by MS Ireland, can make a profound difference to people's lives. I have no doubt the business case in this instance has gone in to the Minister and that his officials are going through it, along with many more proposals. There will be many requests and it will not be possible to accept all of them. Even if there could be a partial response to the request by MS Ireland this year, with provision thereafter to be made on a multi-annual basis, people would be very happy.
The Minister is busy and does not need to hear us talking about a provision that is good. However, it is nice to acknowledge it. Well done to him.