The Dentists Act, the underpinning legislation for regulating the dental profession, is now almost forty years old. While many of its provisions remain robust, some elements of the Act are no longer fit for purpose. There are also some significant gaps that pose a substantial risk to patient safety. The Dental Council has been calling for a new Dental Act for almost fifteen years to allow the system of regulation to adapt to the systemic changes in dentistry since 1985.
Dentistry has evolved, and a fundamentally different profession now exists. The way the profession delivers dental healthcare and the range and complexity of treatments routinely available in general practice has changed significantly and continues to do so. This evolution has challenged the regulatory framework, exposing risks to patient safety and potentially undermining public confidence in the profession. Dentistry, like many other healthcare professions, is now a global and very mobile profession; this mobility is not well supported by the Act. The present Act is also not sufficient to support the implementation of many elements of ‘Smile agus Sláinte’, the new National Oral Health Policy (NOHP).
There are two gaps in the present Act that pose a significant risk to public safety:
- the failure to oblige registrants to maintain their competence on an ongoing basis in line with a statutory scheme, and
- the failure to regulate dental practices.
These are important because the majority of registrants are in private practices. Best practice in comparable professional regulation in Ireland is that the regulator has the appropriate powers to regulate in both these areas.
These gaps were of limited concern when the Act was first introduced as the range of treatments available, by today’s standards, were minor and mostly confined to simple procedures or preventative work. As practices were comparably smaller and less complex, a proportionate regulatory balance between professional autonomy and patient protection was achieved by registering and advising dentists.
Because of the significant changes in the structure of dentistry over the intervening period, the Dental Council’s ability to ensure that patients are properly protected can no longer be adequately assured.
The Dental Council made this submission to the Minister for Health under the provisions of Section 66(1) of the Dentists Act, 1985. Under this section the council is obliged to advise the minister on all matters relating to the functions assigned to it under the Act.