§ 7.4 p.m.
§ Lord LYELL
My Lords, I beg to move that the Dental Qualifications (EEC Recognition) Order 1980, a draft of which was laid before the House on 22nd April 1980, be approved. This Order-in-Council is intended to make those changes in existing legislation which are necessary to implement the directives of the Council 646 of the European Communities concerning the mutual recognition of dental qualifications. The statutory power for making the order is contained in Section 2 (2) of the European Communities Act 1972, and the Affirmative Resolution procedure is adopted in anticipation of the continuing desire of Parliament to debate matters relating to the manner in which Community obligations involving substantial changes in United Kingdom legislation are proposed to be met.
The Treaty of Rome, among other things, provides for the issue to member states of directives covering the mutual recognition of qualifications and the granting of the right of establishment to various professional groups. The directives relating to doctors and nurses have already been implemented in the United Kingdom. The dental directives are similar in form and content to those already implemented. The recognition directive has the general effect of requiring member States to permit the practice of dentistry by nationals of other member states if their qualifications and experience meet the specified standards. The Dental Training Directive specifies in broad outline the training which students must in future undergo before they obtain qualifications which will be recognised elsewhere in the European Community.
My Lords, we are concerned tonight with the draft order for the implementation of the directives in so far as implementation involves changes which require legislation, and I turn now to the content of the draft. Article I cites the title of the order and specifies 1st June 1980 as the date on which it comes into operation. Article 2 identifies the two dental directives and contains other definitions. Article 3 provides for a substantial insertion in the Dentists Act 1957. The new Section 2A provides entitlement to registration in the dentists register, and thereby entitlement to practise dentistry in the United Kingdom, to EEC nationals who hold one of the European diplomas in dentistry listed in the new Schedule 1A if the diploma was obtained in accordance with the requirements of the training directive. It also provides entitlement to registration to those holding earlier diplomas if the syllabus complied with the training directive, or if the holder has lawfully and recently practised dentistry for at least 647 three consecutive years. In Section 2B there is set out the same requirement as to linguistic knowledge as is found in The Medical Qualifications (EEC Recognition) Order 1977 and in The Nursing Qualifications (EEC Recognition) Order 1979.
It is, I think, common knowledge that this requirement that registration shall lapse after six months unless the practitioner satisfies the registrar that he has the necessary knowledge of English, has been challenged by the European Communities' Commission as being contrary to the Treaty of Rome and that there is the possibility that the Commission's view may be supported by the European Court. The Government have argued that it accords with the EEC directives because the provision in the directive which is common to those for a number of professions, is that,Member states shall see to it that, where appropriate, the persons concerned acquire, in their interest and in that of their patients, the linguistic knowledge necessary for the exercise of their profession in the host member state ".Whether the objectives of this requirement might eventually be achieved in some other way has been under discussion with the interested bodies, including the Commission, for some months but there is an understandable reluctance among the professional bodies involved in the United Kingdom to depart from the principle already established in the doctors' and nurses' orders that registration should be linked to the acquisition of the necessary linguistic competence. It is therefore expedient meanwhile to establish the same basis as regards linguistic competence for dentists as has already been established for doctors and nurses. Thus while consultation continues on the language question the other non-controversial measures contained in the draft order can be implemented so that the registration and establishment in practice of dentists who have an adequate command of the language will no longer be impeded.
Paragraphs (2) and (3) of Article 3 make some minor amendments to the Dentists Act. Section 16 (1) of the Act is amended so that the qualified European practitioner may have his name registered in the same list of the dentists register as those of dentists with United Kingdom qualifications, and in Section 50 (1) is 648 added a necessary definition of "recognised European diploma". There then follows the insertion of the new Schedule 1A listing the scheduled European diplomas to which I referred earlier. Article 4 of the draft order provides that a dentist who has been disqualified in a member State from practising dentistry because of some criminal offence or professional misconduct shall not, while so disqualified, be entitled to registration under the provisions of the proposed new Section 2A.
Article 4 (2) (a) of the order emphasises that a disqualifying decision in this respect is limited to one expressed to be made on the grounds that the dentist has committed a criminal offence or has misconducted himself in a professional respect and not on any other grounds. Article 4 (2) (b) emphasises that the effect of a disqualifying decision is that the dentist is prohibited from practising in his own state.
The Joint Committee on Statutory Instruments have expressed concern that this provision might be the cause of injustice in that it would allow a person disqualified in his own State for a criminal offence of a trivial nature to be debarred from his entitlement to registration in this country. The Joint Committee asked why, in Article 4 (2) (a) of the order, the reference was to a criminal offence simpliciter and that the article contained no qualification that it should not be of a trivial nature. The reason is that it is for each member state to decide what its disciplinary legislation shall be. There is no need to assume that in framing and operating disciplinary legislation, controlling bodies of the dental profession in respective member states will not be responsible or fair minded.
Article 4 (4) of the order provides that a person refused registration in the United Kingdom on the grounds of a disqualifying decision in his own state may appeal to the General Dental Council. Any such appeal is to be decided by the disciplinary committee of the General Dental Council and is to be noted that the issue before the disciplinary committee in such an appeal is the issue whether or not the disqualifying decision was a disqualifying decision within the meaning of Article 4 (2). It is not for the disciplinary committee to go into the merits of whether or not it would have disqualified the dentist 649 concerned had it been seized of the matter. Article 5 makes the General Dental Council the authority competent to issue certificates in relation to specialist training or practice which they would not otherwise issue.
I come to Article 6. The dental directives, like those relating to doctors and nurses, require member states to permit fully qualified and established nationals of other states, subject to the rights and obligations which apply to their own professionals, to render services temporarily without first securing normal registration. Because in the United Kingdom the practice of dentistry is permitted only to those who are registered, it is necessary to make special arrangements to control and legalise such temporary provision of service. This is done in Article 6. The principal control measure is by means of a written notification to be provided by the practitioner to the registrar of the General Dental Council giving particulars of the services to be rendered and the periods in which the practitioner expects to render them. Certification must also be provided of the possession of qualifications and the lawful practice of dentistry in his own country. Sections 34 (1) and 35 (1) of the Dentists Act 1957 are amended to permit such persons to practise dentistry and to use dental practitioners' titles. In the Medicines Act 1968, the Misuse of Drugs Act 1971 and the Poisons Act 1972 the definition of dentist is amended to place these persons on a par with registered dentists in relation to the handling and use of drugs.
As persons rendering dental services temporarily while visiting the United Kingdom will not be registered in the dentists' register, the disciplinary procedures provided in the Dentists Act for use against registered dentists could not be applied. Article 7 provides a parallel procedure which might be operated by the disciplinary committee of the General Dental Council to impose a prohibition on the person concerned in respect of the rendering of dental services in the United Kingdom in the future.
The recognition directive requires that in the temporary provision of services, the visiting dentist shall be subject to the same rules of conduct which apply in the host state. The wording of Article 7 therefore follows closely that used in 650 Section 25 of the Dentists Act 1957 which relates to the erasure of a name from the dentists' register kept by the General Dental Council in the United Kingdom. In particular, the disciplinary committee of the General Dental Council, under Section 25 of the Act, may not cause erasure of a person's name on account of a conviction for an offence which does not, either from the trivial nature of the offence or from the circumstances under which it was committed, disqualify a person from practising dentistry. Consequently, article 7 (2) of the draft order excludes consideration of criminal offences of a trivial nature when the disciplinary committee is considering imposing a prohibition on a visiting dentist providing services temporarily.
The provisions of this draft order constitute no departure in principle from those contained in the existing orders relating to doctors and nurses. Furthermore, the drafting of the EEC directives in 1978 and, more recently, the means of implementing them in the United Kingdom have been the subject of the closest consultation and agreement both with the General Dental Council, on which will fall the duty of registering EEC dentists who wish to work here, and with the British Dental Association representing the profession itself.
This order is not directly concerned with the recognition and acceptance of our own dentists in other member states, which is of course the other side of the coin which was minted by the Council of Ministers when the dental directives were adopted. Nevertheless, our own dentists are assured of corresponding benefits as other states implement similar measures, which the directives require them to do. The amendment of United Kingdom legislation by means of the Dental Qualifications (EEC Recognition) Order 1980 is an aspect of this mutual co-operation. I beg to move.
Moved, That the draft order laid before the House on 22nd April be approved.— (LordLyell.)
§ Baroness DAVID
My Lords, I thank the Minister for the very full account he has given of the order and for answering the points which were raised by the Joint Committee about the disciplinary provisions. I have no comments to make, 651 except to say that we are very glad about the requirement of linguistic knowledge, because it is obviously extremely important when foreigners come to practise in this country that patients can understand them; there must be full communication. We therefore support and approve the order.
§ On Question, Motion agreed to.
§ Lord SANDYS
My Lords, I beg to move that the House do now adjourn during pleasure until 8 o'clock.
Moved, accordingly and, on Question, Motion agreed to.
§ [The Sitting was suspended from 7.19 until 8 p.m.]