HL Deb 22 June 1921 vol 45 cc722-46

Order of the Day for the House to be put into Committee read.

Moved, That the House do now resolve itself into Committee.— (The Earl of Onslow.)

On Question, Motion agreed to.

House in Committee accordingly.

[The EARL of DONOUCHMORE in the Chair]

Clause 1:

Prohibition of practice of dentistry by unregistered persons.

1.—(1) No person shall, unless he is registered in the dentists' register under the Dentists Act, 1878 (in this - Act referred to as "the principal Act"), practise or hold himself out, whether directly or ly implication, as practising or as being prepared to practise dentistry.

(2) Any person who acts in contravention of the provisions of this section shall, in respect of each offence, be liable on summary conviction to a fine not exceeding one hundred pounds.

(3) Nothing in this section shall operate to prevent—

  1. (a) the practice of dentistry by a duly qualified medical practitioner; or
  2. (b) the extraction of a tooth by a duly registered pharmaceutical chemist or 723 duly registered chemist and druggist, where the case is urgent and no duly qualified medical practitioner or registered dentist is available and the operation is performed without the application of any general or local anaesthetic, or
  3. (c) the performance in any public dental service of minor dental work by any person under the personal supervision of a registered dentist and in accordance with conditions approved by the Minister of Health after consultation with the Dental Board to be established under this Act

(4) This section shall come into operation on the expiration of one year from the commencement of this Act or on the expiration of such further period not exceeding two years as His Majesty may by Order in Council direct.

LORD GREVILLEhad on the Paper two Amendments which would make subsection (1) read as follows:— (1) No person shall, unless (a) he is registered in the dentists' register under the Dentists Act, 1878 (in this Act referred to as "the principal Act'), or (b) who is on the separate list to be compiled and kept under section three of this Act, practise or hold himself out, whether directly or by implication, as practising or as being prepared to practise dentistry.

The noble Lord said: It will be within the recollection of your Lordships that, owing to the pressure of business on the Second Reading, the noble Earl in charge of the Bill and myself agreed to shorten our speeches then and deal in Committee with the points I desired to raise. The crux of my Amendments comes in Clause 3. Under the Bill the Government are proposing to transfer some 10,000 or 11,000 unqualified dentists to the list of qualified men, and a large number of dentists, for whom I am speaking to-day, are anxious that these men should not be transferred to the register of qualified dentists but to a separate register. The two chief reasons given by the Government for the Bill are the shortage of qualified dentists and their endeavour to put a stop to the practice of unqualified dentists. Personally, I do not see how, by adding unqualified men to a qualified list, you are really increasing the number of qualified dentists, and you will not help the shortage by transferring an unskilled man to a qualified list, because you do not make him any more skilled in the profession by so doing. All you do is to give him a false title and mislead the public.

During the Second Reading debate Lord Knutsford observed that unless the Bill passed good men would not join the pro- fession. In the Report prepared by the British Dental Association I find that the number of students in training in 1920 shows an increase, approximately, of 300 per cent, and the Report also states that:— It is abundantly evident that a considerable increase in the annual number of dentists qualifying may be safely expected. The placing of unqualified men on a separate register was strongly urged by the British Dental Association, but they were told by Sir Alfred Mond that if they pressed for it he would withdraw the Bill. They then agreed on the point, but that does not mean that the majority of the qualified dentists agreed. The British Dental Association went into the question of the shortage of dentists in their Report, and they state that— There is at present no actual shortage of qualified dentists available for school service, nor is such a shortage to be expected in the future. The majority of public appointments are school appointments. This Report does not seem to have received much public attention; I do not know why.

The Amendments standing in my name are really confined to these two points— (1)the transfer of these unqualified men to the same register as qualified men, and (2)the title which these unqualified men can take. I think your Lordships will agree that these are very moderate demands from qualified men. They have spent several years in passing their examinations and studying in hospitals, in order to qualify for their profession. The unqualified man merely has to start with a sign outside his door; and once he is transferred to the register he obtains a great many benefits.

One of the qualifications to be transferred to this list is "good personal character." Good personal character is, no doubt, a most estimable thing, but if you were told that in the absence of a qualified dentist some eminent divine was going to attend your teeth, you might derive great spiritual benefit, but I do not think you would obtain much physical consolation. I do not want to labour these points. In the Bill the unqualified man is allowed to call himself a dentist or a dental practitioner. I think the title of dentist is very apt to be misleading, whereas dental practitioner would. I think, enable the public to judge better which man they would consult— the fully qualified man or the unqualified man. It is in the interests of the qualified man and in justice to them, and in justice to the public, that I ask your Lordships to give support to the Amendments I have put on the Paper.

Amendment moved— Page 1, line 6, after (" unless") insert ("a"). —(Lord Greville.)


The Amendment with which we are actually dealing is really unnecessary, because if the next Amendment which the noble Lord is moving is accepted, that alteration will be made automatically. I will mention that before I deal with the main point.


Take the discussion upon it. It comes to the same thing.


The noble Lord has mentioned the qualified men, and has said that it is in their interests that he is moving these Amendments. Before I make any further observations I should like to read a telegram which I have just received from the British Dental Association. That Association is to dentistry very much what the British Medical Association is to medicine. It admits all qualified men. and all men registered under the Act of 1878. It is at present in session at Bath. This is the telegram:— British Dental Association in annual meeting assembled at Bath this day unanimously support Dentists Bill as submitted by Minister of Health.—(Signed) STUART CARTER, President. That is the view of the qualified men who are in session.


That is the Committee of the Dental Association?


Of the Dental Association. Dealing with the other remarks of the noble Lord, I should like to say that the object of the Bill is, as he has mentioned, to bring all those who are practising, or qualified to practise, dentistry under one government, and to exclude all other persons from the practice of dentistry. The number of persons actually practising dentistry, who are not registered under the Act of 1878, is at least two to one of those registered under that Act and possessing dentistry degrees. On the Second Reading of this Bill, the noble Marquess, Lord Salisbury, said that the Bill, if passed as it stands, would admit unqualified practitioners en bloc as fully qualified dentists. But, as the noble Viscount, Lord Knutsford. who was a member of Mr. Acland's Committee, said, this really is a misapprehension.

In Clause 3 of the Bill your Lordships will see the conditions under which the present unqualified dentist will be admitted to the Register. They are as follows. These men must not be less than 23 years of age, must be of good character, must have practised dentistry in this country during five of the last seven years, and that practice of dentistry must be their principal means of livelihood. There is also one other qualification: those persons may be admitted who are members of the Incorporated Dental Society. I venture to say that is a strict qualification, and one which, if justly and properly administered, as no doubt it will be, will adequately protect the public from the admission of charlatans to the practice of dentistry.


What will protect the public?


These qualifications—that the men must have practised for five out of the last seven years in this country, and so on. Supposing the noble Lord's Amendment were accepted, what would happen? Two lists would be prepared on the same register, instead of one list, as we propose, with the qualifications of each practitioner placed upon it. Anybody, therefore, who wishes to refer to the register and to see at a glance whether the man he wishes to consult has been placed on it under the terms of this Bill, or whether he would have been a registered dentist under the Act of 1878, can do so at once. Apparently, my noble friend wishes to have two lists. On the first, he wishes to put the men at present on the register, whom he proposes to call "dentists." The second will bear the names of those who are now practising, but who are un- qualified, the men who will be brought into the register by this Bill. These he proposes to call "dental practitioners." It seems to me that this is a very fine distinction, and I really do not see how many of the general public are to benefit by it. If anybody wishes to find out the exact qualifications of his dental attendant, he would be much more likely to consult the register and see exactly what they are than to judge from the titles of "dentist'' or "dental practitioner."

If my noble friend's point is to have a separate title for those who possess dental degrees, I would refer him to the clause which I am proposing to move after Clause 3. This clause is primarily intended to prevent fraudulent representations by people describing themselves as something which they are not, but it also has this effect—


Where is the noble Earl reading from?


It is at the bottom of page 3 on the Marshalled List of Amendments. If your Lordships are pleased to accept this Amendment of mine, it will make it an offence for any person to describe himself as a surgeon dentist unless he is in possession of a degree recognised by the Dental Board. That is to say, the Dental Board will have power to say that certain degrees are recognised and that certain others are not recognised, so that a person who has a bogus degree as a surgeon will not be able to describe himself under the Act as a surgeon dentist. All those persons at present on the register (except a very few people still practising, who were admitted by the Act of 1878, although holding no degrees) are holders of degrees in dental surgery, and will therefore have the exclusive right of calling themselves surgeon dentists. I may, perhaps, note, in parenthesis, that the Act of 1878 was very much less stringent than the present Act and admitted to the register all those who were practising dentistry at the time of the passing of that Act. This Bill proposes much stricter qualifications.

The question of the register is not a new one. It was very carefully considered by a Committee of the Privy Council under the Chairmanship of my right hon. friend, Mr. Acland. That Committee contained members representing every shade of opinion, qualified dentists, unqualified dentists, physicians, surgeons, civil servants, hospital authorities and members of both Houses, and after the most careful examination of witnesses they came to the conclusion that this was a fair and just arrangement to the qualified dentists, to the unqualified dentists, and to the public. I think that if your Lordships will study the Report of that Committee, which has been laid on the Table of the House, and observe the names of those gentlemen who constituted it, you will agree that their view is worthy of the very greatest consideration and respect.

The unqualified dentists, if fully admitted to the privileges of the register, are admitted thereby to the profession and are perfectly willing to come under professional control. As my right hon. friend, Mr. Acland, the Chairman of the Committee, said in a letter which was recently published in The Times, in answer, I think, to a letter from Sir Frederic Colyer:— It is very doubtful if they could be brought under control of the 9hepherd of the sheep if they are to be treated as goats and kept outside the sheepfold. Unless these unqualified men are granted the full status of their brethren who possess qualifications, how can it be expected of them that they will give up the free and unfettered position which they now occupy? Of course, noble Lords may say that they can be forced by Act of Parliament to accept this position, but I very much doubt whether Parliament would be willing to do so if this Amendment were inserted by your Lordships. The interest of the unqualified practitioner may or may not be strongly represented in this House, but in another place it is very strongly represented, and if this Amendment were insisted upon, I think that those in another place who hitherto have supported the Bill, would consider the conditions which my noble friend seeks to place upon unqualified men, who, as I have already said, are the majority of those practising dentistry, so onerous that it would be better to allow things to remain as they are, and so the benefits which would be obtained by this Bill would be lost. Therefore, I trust that your Lordships will not accept this Amendment, but will adopt the view of the British Dental Association as expressed in the telegram which I have read to your Lordships, and will pass the Bill as it stands.


My noble friend, Lord Greville, when moving his Amendment, said he spoke on behalf of the qualified men. I venture to think that that is not quite accurate, because your Lordships have already heard the telegram which I had hoped I should have the honour of reading, but which my noble friend, Lord Onslow, has "bagged" from me, and which represents the decision at which the qualified dentists, assembled in their meeting to-day in Bath, have arrived by unanimous resolution in favour of this Bill. Have any of your Lordships ever known the medical profession agree unanimously upon anything before? Yet they are unanimously in favour of this Bill, which a few lay people say is a great shame to them, because unqualified men are to be admitted on the same register as themselves.

I was on the Committee to which the Government referred this question, and when I saw my fellow-members I felt certain of one thing—namely, that we should never come to any agreement. I was not certain that there would not be murder done before the end of our sitting, because we had on that Committee the head of the unqualified dentists, we had a member of the British General Medical Council, one of the leading lights among the qualified dentists, a doctor from the Ministry of Health, a doctor from the Ministry of Education, myself, as a layman, another layman, and a Socialist. There you have plenty of opportunity for men representing such divergent interests to quarrel, but when we heard the evidence we were absolutely and entirely unanimous. The opinion that we came to and recommended, and which has now been adopted by the House of Commons, was that these unregistered men should be admitted to the same register as the qualified men.

It must be understood clearly that because a man is not on the register it does not follow that he is not qualified to do his dentist's work. He has had, very often, just as long a training as the man who has a medical qualification. The members of the Incorporated Dental Society have to have five years' training before practising as dentists, but we came to the conclusion that these unqualified men must be admitted to the register, for several reasons. In the first place, we found that in many districts in England there was no qualified dentist at all. Then we found that dental work for the rich was always done by the qualified men, and that the working classes only had the unqualified men. We realised that these unregistered men had been carrying on work which they were entitled to carry on under the laws of this country, that many of them were doing their work very well, and had spent money on their undertakings, their training and their establishment, and that they had vested rights which it was impossible for us to put an end to. But our main reason for putting them on the register was that we wanted control. We wanted to stop all the malpractices which were going on among these men. Unless you have them on the register it is impossible to obtain that control. So we recommended unanimously, and it has already been adopted I by the other House, that these men should; be put on the register, and should be, thereby, under control.

Your Lordships will realise, I am sure, that both sides have had to give and take. The professional men had to surrender their privilege of being the only men on the register, and their reward for giving way about that was that in future unregistered practice will be forbidden in this country. That is something very much stronger than has ever been suggested in the medical world before, because there is nothing to prevent you or me from setting up as a bone setter, or faith curer, or anything else; but under this Bill, if it passes, no one may practise dentistry unless he is on the register; and if a man misbehaves himself while he is on the register there is power to remove his name from the register. The professional man, therefore, as I have said, had to give way to the admission on the register of these men who have not the same degrees, although some have just the same experience as himself, and in return he has the provision that nobody is to work as a dentist unless he is registered. Then, the unregistered men do not get I everything. They have to come under the control of a Board not elected by themselves, not chosen by themselves, and on which they have only two representatives out of thirteen. The whole ethics of their profession is to be under the control of this Board. In return for that, they get the privilege of being on this register and of having their profession raised higher, because these malpractices will be stopped for the future.

You cannot take that away from them now, and put them on a separate register. Who wants this special list? My noble friend, Lord Greville, suggests that there should be a special list. Is that to be part of the register, or not part of it? If it is not to be part of the register, then we have no control over these men, which is what we desire; if it is to be part of the register, the recommendations that the Committee unanimously came to would give the public just the same protection, if they consult the register, as if we had this special list. We recommended—and I do not know whether the noble Marquess (Lord Salisbury), who is going to follow me, is aware of this—that on the register there should be the name of the man and how he came on the register, whether by medical degree or surgical degree or simply because he was in practice. Therefore, the public would have this protection, that if anybody goes to look at the register— and, of course, nobody ever does—he would find out whether his dentist was on that register because he passed his medical degree, or simply because he was in practice for the five years that we recommend.

I do not want to make a joke, but if you have, what my noble friend called a special list, a dentist would be able to call himself a "dental specialist," if he has got on to the register, because he is on that special list. And that is one of the titles to which we object. But how can you possibly prevent a man calling himself a dental specialist if he is on the register simply because he is on a special list All titles are misleading. The old Act tried to restrict the title. It said: "You must not call yourself a dentist, but you can call yourself a dental surgeon, or a dental practitioner, or a dental specialist." All those things were allowed, and every Colony has found that it is impossible to guide the public in dealing with the dentist by the title that he puts upon his door.

Who wants the special list? The Government do not want it. The qualified men in the dental profession do not want it; you have got that resolution from them to-day, and they have given good evidence that they do not want it. The unregistered men do not want it. The public do not want it. The Labour Members and other Members of the House of Commons spoke very strongly against it, and the Amendment which Lord Greville is moving to-day was withdrawn in the House of Commons because it would have risked the whole Bill, And, though your Lordships may have had hundreds of circulars from a few noisy but not wise people, I beg you not to run the risk of wrecking this Bill, which will not go through in another place if this Amendment is inserted. That is quite certain. It has already been tried and failed. If you pass this Amendment to-day you will wreck this very useful Bill, you will allow these ill practices to go on uncontrolled, and the public will not have the protection which this Bill gives. And there is hardly any Bill which has ever been brought forward which has had such unanimity of support.


I must say, after hearing the speech of my noble friend, that I feel it requires some boldness to say a word or two on the other side. There has been a body of technical medical opinion hurled at our heads at which the bravest might quail. There is; this Dental Association in England from which a telegram was read by the noble Earl, and there is my noble friend, who is himself a great medical authority, with a unanimous Committee to back him. But; I am not sure, when we come to consider the thing very closely, that the case is so formidable as it appears. In the first place, as for this reading of telegrams from authorities in the country, we still have a United Kingdom, and I have a telegram from Scotland which says:— Scotland agreed to the Second Reading in the Commons on the understanding that the Amendments would be left to the unbiased decision of the Committee. The Government officially opposed Amendments, despite understanding. Beg you to support Lord Greville in interests of good government and good faith.— MEDICAL DENTAL DEFENCE UNION. SCOTLAND.


Who are they?


The noble Lord perhaps knows better than I do. At all events, I have concealed nothing. I hold another telegram from Ireland. This is addressed to another noble Lord, not to myself:— Will you, on behalf of Committee of Irish dentists, please support Lord Greville's Amendment to Dentists Bill this afternoon. So we are not quite certain about this volume of technical opinion being all on one side. But may I put in a word very respectfully for another party to this controversy, which seems to me more important than the dentists, or the unqualified dentists, or even than my noble friend's Committee, and that is the patient. It is very easy for technical people to come to an agreement with other technical people and say, in the words of my noble friend at the Table here, "Let there be a little give-and-take between us. We dentists will give up a certain amount of our monopoly. You unqualified gentlemen will submit to a certain discipline. Nothing could be fairer or more English than to come to an arrangement like that, and we will admit you all to the register, and you will all come under discipline, and we shall all be a happy family." Yes, but what of the patients, the people who have toothache? Those are the people I represent here.

I do not very much care about the dentists or the unqualified dentists. I do not want to tie myself to the course which we ought to take in this debate, but I think that that point of view ought to be present with your Lordships. Observe that the change proposed to be made by the Bill of admitting the existing unqualified dentists is a very large one. The noble Earl, Lord Onslow, gave the figures just now. He said that the unqualified dentists were to the qualified dentists as two to one.


Rather more, I think.


Rather more than two to one. So you see it is proposed to dilute the dentists with double the number of unqualified dentists.


They are there now.


They are in existence, but they are not called dentists, and anybody can see that they are a different kind of people. They are to be admitted, and Parliament, by a stroke of the pen, is going to say that 200 per cent. more than the existing dentists—200 per cent, who are admittedly not qualified men—are henceforth to be treated as qualified dentists. That may be right, but I submit that it wants a great deal of showing. What is the case for the Bill itself? It is that the existence of these unqualified dentists is a great mischief.




In any case, do not let my noble friend say that all that is required is discipline. He is the last man to despise skill and training and professional experience. No, the case for the Bill is that the existence of a vast body of unqualified dentists is a great mischief.


No. We do not say that the existence of this large; number of unregistered men is a great mischief. We say that the fact they are uncontrolled is a great mischief, and that the only way to control them is to get them on the register.


Does my noble friend really mean that the whole point is a matter of control—that it does not matter what skill a man has as a dentist, or whether he knows a front tooth from a back one, so long as he is controlled, and that then he may call himself a dentist; then he may impose his non-professional want of skill on the public, and nothing more is to be done? It is evident that the case for this Bill is, no doubt that they should be brought under control, but, above all things, that you should have in this country henceforward a register of properly qualified persons.


In the future.


In the future. Yes, but why should the present generation be handed over to unskilled dentists, because in the future you will have a better arrangement? No. It seems to me quite clear that this arrangement is one which will suit the dentists perhaps, will suit the unqualified dentists and will suit future generations, perhaps; but by a rigid and, as it seems to me, an inevitable argument, it shows that the people who will suffer are the existing public—the patients who are alive at this moment and have trouble with their teeth. It was either my noble friend or the noble Earl opposite who said that after all a great many of these unqualified dentists were fairly well skilled persons. That may be; I think it is very likely the case. But a good many of them are not, and why should a guarantee be given to the public in respect of all these men who are ex hypothesi totally and absolutely unqualified? —I mean this body amongst them. I confess that seems to me to be an extremely strong measure. No doubt they would have a good personal character. That has nothing to do with it, as my noble friend pointed out. No doubt they have earned their living by it for five out of the last seven years. What has that to do with it? A great many charlatans have earned their living for five years. That appears to be to me wholly illusory as a protection.


Can the noble Marquess tell us any way in which we are to control these men who are guilty of mal- practices, unless they are registered men? Once they are registered we can control them. We are not handing over the country to unregistered men. They exist to-day. We are trying to stop them, and, in future, to make it illegal for them to practice unless they have their degree. How are we going to do it in any other way?


I will deal with that in a moment. What is it that my noble friend proposes? He does not propose that these men should be unregistered but that they should be put upon a different register. He proposes that they should be distinguished from the fully qualified dentist.


Is the noble Marquess referring to my proposal?


No; I am referring to the noble Earl's proposal.


That is my proposal, too.


I do not know what the noble Viscount's proposal is. I am referring, as I said, to the proposal of the noble Earl.


The noble Marquess will forgive me for interrupting him, but it is in the Bill that every dentist or dental practitioner, every man who is on the register, will have to state the reasons why he is on that register. If he has a degree it is because he is L.D.S. or D.D.S. If he is admitted by the Dental Board it will be so stated. So the distinction is stated in the register, which is what my noble friend wants.


It is true that if anybody inspects the particular register which is provided by the Bill, he will find all sorts of little notes opposite the names, but, as my noble friend said just now, that is very little protection. What we suggest for the consideration of your Lordships is that there should be a different register; not that there should be no register, but a different register, a register with a different name, so that the public may know perfectly well with whom key are dealing. If the public look at the noble Lord's list to see whether a man is admitted, I suppose the sort of thing they will find will be: "Admitted under Section 3 of the Dentists Act," and I am sure that will not inform the public. What we want is a broad distinction. If the noble Earl convinces me that the public are perfectly well protected under the Bill, of course both my noble friend and myself will be satisfied. But surely, if the public is not protected, we have a case. The arguments of my noble friend, Lord Knutsford, though they are very valuable as a contribution to the debate, do not appear to me to affect the point. There is, no doubt, a paucity of dentists. I know that he is right about that, because it was my business to take evidence upon the point at one time. But that is no reason why there should not be two registers. It is the case that the rich go to qualified dentists and the poor to unqualified men. It is true that there are vested rights; but that is no reason why there should not be two registers.

It would work perfectly well. What the public want is not what the profession wants, I submit. My noble friend, if I may criticise him very gently, seems to me to speak entirely from the professional point of view. It is not what the profession wants, but what the public want. When a member of the public goes to a dentist, or an alleged dentist, he wants to be quite clear that the dentist is on a particular register with a particular name, bears alone the name he is entitled to bear and is what he describes himself to be. That appears to me to be what my noble friend's Amendments will effect, and that is why I suggest that your Lordships ought I to consider them.

There is only one other argument left for me to deal with, and that is the familiar one that the House of Commons has passed the Bill in this form and will not pass it in any other. Therefore, your Lordships may as well adjourn, go away, and take no : more trouble with the Bill, because if you venture to insert any Amendments they will not be accepted in another place and I the whole benefit of the measure will be lost. That is an argument with which we are very familiar in this House, and it is one that is almost invariably addressed to us on any Bill that comes to us from another place. But I am happy to say that your Lordships have not taken very much notice of it. On the contrary, your Lordships take a Bill on its merits and, having discussed it with what wisdom you possess, you amend it if you think it is necessary and send it back to the House of Commons. Then one of two things happens. The Commons either agree to it, which is really the more usual case, in spite of what the noble Earl has said, or else they insist upon their original view and the Bill is returned to your Lordships' House. Then it is open to your Lordships either to insist upon your original view, or, if you think it more in the public interest, that is the moment at which to come to an arrangement with the other House and let the Bill go through. I do not want to say, of course, that it is a vital matter to pass my noble friend's Amendment, but after the noble Earl's speech I thought it right to lay the other case before the House to the best of my ability.


We have listened with great respect to the contribution of the noble Marquess to this debate. If I may say so, no cue is a better critic than he of any legislative proposals that may be brought before this House. At the same time, the main point is to settle dental practice in this country on a better basis. We all know that the state of the teeth of the people of this country is very unsatisfactory. It is not a very pleasant topic to talk about. The noble Earl says, "Never mind," and I am sure if he, with his very nice disposition in these matters, does not mind, I certainly do not. One reason why the teeth of the people of this country are so bad is that dentistry is in an unsatisfactory state. Young men will not go through the curriculum and become dentists when they know perfectly well that they can act as dentists without going to that expense and trouble. The consequence is that the dental schools find great difficulty in securing a sufficient number of students.

In order to mend the present state of affairs if is obvious that you must submit to some anomalies. It is a very unpleasant thing to have to recognise a number of unqualified persons, as the Bill proposes to do, but if we allow this opportunity of settling the matter to pass, there is grave danger that we shall have no settlement and that we shall be faced with the difficulty that the present unsatisfactory state of affairs will continue for a very considerable period. Nothing could be more unfortunate than that. We all know that professional men are not apt to admit unprofessional persons to the exercise of the privileges they themselves exercise. It does not matter whether they are lawyers, or doctors, or dentists, and it is obvious that before the dentists agreed to this proposal they satisfied themselves that there was no other method of carrying out the reforms in dentistry which they, as dentists, know are absolutely essential for the health of the people of this country. I put it to the noble Marquess, and to the noble, Lord who moved this Amendment, that they should think very seriously before they do anything that is likely to wreck this Bill. It is really a very serious matter.


It will not wreck the Bill.


The noble Marquess says the Bill will not be wrecked, but he knows very well, as we all know, how easily Bills are wrecked, and how slight Amendments, which often seem innocuous, wreck Bills. For some years I have taken a keen interest in this subject, and I know bow necessary it is that steps should be taken to improve the practice of dentistry in this country. If I may say so, I am speaking to-day—and I do not often trouble the House—because I have been bombarded by a number of friends who, like myself, have been taking a keen interest in this topic, and I appeal to the House not to allow this Bill to fall through on this point. The noble Marquess says that if the, Bill contained the, safeguards I which he mentioned he would not oppose, it. I do not know whether lie has read the Bill, but if he has not read it, I would ask him to do so, because it, contains the carefully considered proposals, first of all, of the Committee which was set up to I take evidence on the, matter; secondly, of the British Dental Association; and thirdly, of the Government.

The noble Marquess read a telegram from a body which is called the, Scottish Dental Defence Association. It is, of course, open to any one to send the noble Marquess a telegram with a name like that. I could send him a telegram from the Fleet Street Dental Reform Association, and I have no doubt I could word the telegram in a very journalistic manner so that it would read very well to the House, and might appear to be very impressive. But any one who has any acquaintance with the various associations which are formed for the purpose of advocating I certain views knows how necessary it is that one should first of all ascertain exactly of what the association consists. There is no doubt at all as to the status of the body mentioned in the telegram read by the noble Earl who is sitting in front of me. That is the recognised Association representing dentistry in this country.

This House, if I may say so, will undertake a very serious responsibility for the people if they do anything which is calculated to have the effect of defeating this Bill and depriving us of this opportunity of getting this question settled. I agree with the noble Marquess when he said that it is not our duty here to consider the dentists, qualified or unqualified. Our duty is to consider the public in this matter. We have to look after the public, and the condition of affairs in this country in regard to the people's teeth is to-day most unsatisfactory. There arc not sufficient qualified dentists to go round, and it is the duty of this House, and of everyone who is interested in the health of his fellow-countrymen, to see that stops are taken for the purpose of putting dentistry on a proper professional footing within a comparatively short period of time. That may necessitate certain anomalies during a temporary period, but it is well worth while to endure those evils in order to secure the good which will certainly result when dentistry has been placed on a proper footing, as this Bill I proposes to place it.


The noble Marquess told us about the poor. In my view, the best way to protect the poor is to I protect them from dentists who are not under proper control. It would be a great misfortune if this Bill wore lost through the insertion here of Amendments which might be opposed in the House of Commons. I know that the Dental Association have agreed to the admission of these gentlemen with reluctance, but they see the absolute necessity of having some body which would exercise control over dentists. I listened to the speech of my noble friend, Viscount Knutsford, who, I think, said almost everything that can be said in support of this measure. I may add, however, that when I was Paymaster-General I took the greatest interest in our old soldiers at Chelsea Hospital, and I was very much impressed always by the reflection that their lives would have been much happier if their teeth had been properly treated. I think it is of the greatest importance that our people should have proper dentistry. Especially is that so in the case of the poor. If there are to be more dentists, let them be dentists over whom some body has control. I believe that the British Dental Association has done splendid work in admitting these gentlemen so that they may have them under control. I hope, therefore, this Amendment will be defeated.


I do not intend to detain the House for more than a moment, but I wish to make one observation in reply to the noble Marquess, who said that what he was mainly concerned with—and, of course, it is what we are all mainly concerned with—is the welfare of the patients. As noble Lords have truly said, dental practice in this country leaves much to be desired, and I submit that this Bill as it stands is designed in the best, manner to give effect to what we all desire to see—namely, dental practice improved. The main object of the Bill is to bring all those who are practising dentistry under control and discipline. It also seeks to ensure that only persons with a certain amount of skill shall be engaged in the practice of dentistry. The noble Marquess said that five years of practice and of earning a living in a particular trade is no particular criterion of a man's skill, but I say that if a man has been practising dentistry for five years, and has been earning his livelihood in that profession for that number of years, he obviously must possess a certain degree of skill; otherwise, his patients would not have confidence in him, and he would not be able to continue the practice of his profession for so many years. Therefore, I contend that the qualifications which are introduced into this Bill do safeguard the public, and ensure that they shall be able to obtain men of skill and knowledge of their profession.

One other point with which I should like to deal is this. Even if you have two registers you do not alter the fact that the men who will be admitted to the register will practise in the way provided for in the Bill, and the Dental Board will see that they practise under proper conditions, and that those who are put on the register possess certain qualifications. The noble Marquess said that people will not consult the register, and will not look at the qualifications of dentists placed on that register, but I would point out that those who wish to be treated by dentists who have a degree in dentistry will easily be able to ascertain which persons have that degree, for everyone who has a doctor's degree in dentistry will call himself a surgeon-dentist or a dental-surgeon, while others who have not such a degree in dentistry will not be allowed to call themselves surgeon-dentists.

On Question, Amendment negatived.

THE EARL OF ONSLOW moved, in subsection (3) (a), to leave out "duly qualified." The noble Earl said: This is consequential on an Amendment inserted by the House of Commons.

Amendment moved— Page 1, line 16, leave out ("duly qualified").— (The Earl of Onslow.)

On Question, Amendment agreed to.

Clause 1, as amended, agreed to.

Clause 2 agreed to.

Clause 3:

Rigid of certain persons lo be admitted to register.

3.—(1) The Hoard shall admit to the dentists register kept under the principal Act—

  1. (a) any person who makes an application in that behalf within the interim period and satisfies the Board that he—
    1. (i) is of good personal character; and
    2. (ii) was for any five of the seven years immediately preceding the commencement of this Act engaged as his principal means of livelihood in the practice of dentistry in the British Islands, or was admitted to membership of the incorporated Dental Society not less than one year before the commencement of this Act; and
    3. (iii) had attained the age of twenty-three years before the commencement of this Act; and
  2. (b) any person who makes an application in that behalf within the interim period and satisfies the Board that he—
    1. (i) is of good personal character; and
    2. (ii) was for any five of the seven years immediately preceding the commencement of this Act engaged as his principal means of livelihood in the occupation of a dental mechanic in the British Islands; and
    3. (iii) had attained the age of twenty-three years before the commencement of this Act;
and who within ten years from that dato passes the prescribed examination in dentistry.

(2) Any person who satisfies the Board that he was at the commencement of this Act engaged as his principal means of livelihood in the practice of dentistry in the British Islands, and within two years from the commencement of this Act passes the prescribed examination in dentistry, shall, for the purposes of the regulations under this section, he treated as having been engaged for five of the seven years immediately preceding the commencement of this Act in the practice of dentistry in the British Islands as his principal means of livelihood.

(3)Any person who is a duly registered pharmaceutical chemist or duly registered chemist and druggist shall, if he proves to the satisfaction of the Board that he had immediately before the commencement of this Act a substantial practice as a dentist and that his practice included all usual dental operations, be treated for the purposes of the regulations under this section as having boon engaged for any live of the seven years immediately preceding the commencement of this Act in the practice of dentistry in the British Islands as his principal means of livelihood.

(4) The Hoard may on such conditions as they may consider proper dispense in the ease of any person with any of the requirements prescribed by the regulations made under this section if they are satisfied that that person is unable to satisfy those requirements by reason of having served in His Majesty's forces, or of having been engaged during the war in some work of national importance, and that it will not be prejudicial to the public interest to dispense with those requirements.

(5) A person entitled to be registered under the principal Act under or by virtue of the provisions of this section shall not by reason only of being so registered be entitled to take or use any description other than the description of dentist or dental practitioner.

No such person as aforesaid shall affix to or use in connection with his premises any title or description reasonably calculated, to suggest that the person practising dentistry in those premises possesses any professional status or qualification other than that which he in fact possesses, and if any person acts in contravention of this provision he shall, in respect of each offence, be liable on summary conviction to a. tine not exceeding one hundred pounds.


All the Amendments in my name down to subsection (5) are consequential on House of Commons Amendments.

Amendments moved—

Page 3, line 43, leave out from ("of") to (" this ") in line 1 of page 4.

Page 4, line 11, leave out ("the regulations under")

Page 4, lines 18 and 19, leave out (" the regulations made under")

Page 4, line 19, after (" section") insert (" other than requirements as to character or age ").—(The Karl of Onslow.)

On Question, Amendments agreed to.

THE EARL OF ONSLOW moved to leave out subsection (5) and insert the following new subsection:— (5) Regulations may be made, under this Act for prescribing the manner in which applications under this section are to be made, and generally for carrying this section into effect.

The noble Earl said: This Amendment is necessary because the Government have inserted a new clause dealing with the title and description of persons registered under the new provisions. The new subsection (5) is proposed in order to give the Dental Board power to make regulations prescribing the manner in which application for registration should be made. It is obviously for the convenience of all that the procedure to be adopted should be laid down.

Amendment moved— Page 4, lines 25 to 38, leave out subsection (5) and insert the said new subsection.—(The Earl of Onslow.)

On Question, Amendment agreed to.

Clause 3, as amended, agreed to.

THE EARL OF ONSLOW moved, after Clause 3, to insert the following new clause:—

Use of titles and descriptions.

(".A person registered under the principal j Act—

  1. (a) shall by virtue of being so registered be entitled to take and use the description of dentist or dental practitioner;
  2. (b) shall not take or use, or affix to or use in connection with his premises, any title or description reasonably calculated to suggest that he possesses any profession status or qualification other than a professional status or qualification which he in fact possesses and which is indicated by particulars entered in the register in respect of him.")

The noble Earl said: I have already referred to this Amendment, and I do not think it is necessary for me to say anything more upon it.

Amendment moved— After Clause 3, insert the said new clause.— (The Earl of Onslow.)

On Question, Amendment agreed to.

Clause 4:

Dental companies,

4.—(1) A body corporate may carry on the business of dentistry if—

  1. (a) it carries on no business other than dentistry or some business ancillary to the business of dentistry; and
  2. (b) a majority of the directors and all the operating staff thereof are registered dentists:

Provided that—

  1. (a) a body corporate which was carrying on the business of dentistry before the passing of this Act shall not be dis- 744 qualified for carrying on the business of dentistry under this section by reason only that it carries on some business other than dentistry or a business ancillary to that business if that other business is a business which the body was lawfully entitled at the. commencement of this Act to carry on; and
  2. (b) where any director or manager of any body corporate which is carrying on the business of dentistry at the commencement of this Act satisfies the Board within the interim period that he has for any five of the seven years immediately preceding the commencement of this Act been acting as director or manager of any such body corporate, he shall be entitled to be entered as such a director or manager, in a list to be kept by the registrar for the purposes of this section, and if so entered shall lie entitled, notwithstanding that he is not a registered dentist, to act as a director or manager, but shall not by virtue of being so entered be entitled to practise dentistry.

(2) Save as aforesaid it shall not be lawful after the date on which the provisions of this Act prohibiting the practice of dentistry by an unregistered person come into operation for any body corporate to carry on the business of dentistry, and if any body corporate carries on the business of dentistry in contravention of the provisions of this section, it shall for each offence be liable on summary conviction to a fine not exceeding one hundred pounds.

Where a body corporate is convicted of an offence under this section every director and manager thereof shall, unless he proves that the offence was committed without his knowledge, be guilty of the like offence, and the court may in addition to a fine order that the name of any director or manager convicted under this provision shall be removed from the list aforesaid.

(3) Every body corporate carrying on the business of dentistry shall in every year transmit to the registrar a statement in the prescribed form containing the names and addresses of all persons who are directors or managers of the company, or who perform dental operations in connection with the business of the company, and if any such body corporate fails so to do it shall be deemed to be carrying on the business of dentistry in contravention of the provisions of this section.

(4) The list to be kept under this section shall be published in the prescribed manner.

(5) Nothing in this section shall operate to prevent the carrying on of the business of dentistry by any hospital of any description (including an institution for out-patients only), or any dental school, which is approved for the purposes of this section by the Minister of Health after consultation with the Board.


The Amendments to this clause are drafting.

Amendments moved—

Page 5, line 11, leave out (" or manager")

Page 5, line 17, leave out (" or manager")

Page 5, line 19, leave out (" or manager")

Page 5, line 24, leave out (; or manager")

Page 5, line 40, leave out (" or manager").— (The Earl of Onslow.)

On Question, Amendments agreed to.

Clause 4, as amended, agreed to.

Clauses 5 to 12, agreed to.

Clause 13:


13.—(1) In this Act, unless the context otherwise requires—

The expression "prescribed" means prescribed by regulations made under this Act:

The expression ''registered dentist" means a person registered under the principal Act:

The expression "interim period" means the I period between the commencement of this Act and the date on which the provisions of this Act prohibiting the practice of dentistry by unregistered persons comes into operation, or such longer period as the Board may on an application made at any time within two years after the date aforesaid allow in the case of any person as respects whom the Board are satisfied that there were valid reasons for the failure to make an application before that date.

(2) For the purposes of this Act the practice of dentistry shall be deemed to include the performance of any such operation and the giving of any such treatment, advice, or attendance as is usually performed or given by dentists.


The Amendment I have put down to this clause is also consequential. Its object is to guard against the possibility of evasion.

Amendment moved— Page 11, line 22, at end insert (" and any person who performs any operation or gives any treatment, advice, or attendance on or to any person as preparatory to or for the purpose of or in connection with the fitting, insertion, or fixing of artificial teeth shall be deemed to hare practised dentistry within the meaning of this Act").— (The Earl of Onslow.)

On Question, Amendment agreed to.

Clause 13, as amended, agreed to.

Remaining clauses agreed to.

First Schedule: