Health Professionals: EEA and Non-EEA Citizens

Lord Colwyn Excerpts

Thursday 8th September 2011 Lords Chamber

[Lord Colwyn]

My Lords, I am delighted to follow the noble Baroness, Lady Young. I spent many years on Sub-Committee G and I regret not being there while she was chairman.

Professionals holding specific qualifications and currently registered with a competent authority in one member state can register to practise in any other member state without having to satisfy further tests or formalities. Automatic recognition of qualifications under the directive 2005/36/EC is about granting access to professional registration, not about suitability to undertake a particular job. It is up to employers to ensure that the applicant has the necessary skills and competencies to perform the role for which they are applying. In the limited time available I will make some general remarks about issues that affect the dental profession. I declare an interest as a former dental practitioner.

Registration of non-UK dentists with the GDC is dependent both on the individual's nationality and the country in which they qualified. Dentists who are EU citizens with degrees obtained within the EU benefit from automatic registration based on the rules of free movement of EU citizens. Subject to proof of identity, degree and good standing in the home country, dentists are able to register with the GDC without further exams. A directive defines the minimum training standards required within the EU. All degrees of current EU countries comply with these requirements, although some member states require their dentists to undertake a period of clinical work experience in addition to the degree before they can work independently. In these cases, the requirement may apply also to registration with the GDC.

There are regulations for dentists who are EU citizens with degrees obtained outside the EU; regulations for dentists with a qualification gained before and after 01/01/01 from Hong Kong, Singapore, Malaysia, South Africa, New Zealand and Australia; and regulations for dentists who are not EU citizens but who have obtained degrees within the EU. I would like to have had the time to explain this more fully. The regulations are considered to work well, both with regard to the minimum training standards and the compensation measures for those countries that joined the EU more recently and did not at the beginning comply with the directive. A consultation is currently taking place with a view to modernising the directive.

The main concerns for dentistry have been the lack of language testing at registration points and the lack in some countries of practical training involving seeing patients. In the current review there is a welcome option for more formal language testing. I suggest that there is also a need to update the minimum training standards in accordance with the latest science.

Another concern that is not directly related to registration with the GDC is the fact that dentists from Europe are exempt from the requirement to undertake vocational training. UK-qualified dentists as well as non-EU dentists are required to undertake this training, while EU dentists are able to register without further training on a local performer list. All dentists should be required to undertake such training. However, to ensure fairness of the system all places would have to be funded. EU dentists are eligible to apply for foundation training but, if allocated a place, take it away from a UK graduate. There is high competition for these training places across the UK.

The overseas registration exam for non-UK dentists is designed as a competency test set at the level of a UK undergraduate. The pass rate is not high. Concerns over the exam remain with regard to appropriate provision of exam places, as there continues to be a waiting list. Dentists who are not EU citizens are required to undertake vocational training or foundation training through an equivalence route before they can become independent performers. My time is up: I look forward to hearing from the Minister.