For Discussion
on 13 September 1999

Purpose

This paper reports on the outcome of the recent consultation exercise on the registration of ancillary dental personnel (ADP).

Background

2. ADP refers to dental therapists (DTs), dental hygienists (DHs), dental technicians (DTechs) and Dental Surgery Assistants (DSAs). At present there are mechanisms for regulating ADP. DHs are regulated under the Dentists Registration Ordinance. The scope of work of the DHs is clearly laid out in the Ancillary Dental Workers (Dental Hygienists) Regulations made under the Ordinance (Cap 156). The scope of work of DTs is defined in the internal regulations of the Government. DSAs are under the direct supervision of dentists. The applicances fabricated by DTechs are subject to the dentists' scrutiny.

3. A Working Group formed under the Dental Subcommittee of Health and Medical Development Advisory Committee was tasked to study the proposal of introducing a statutory registration system for ADP. The Working Group recommends :-

1. the establishment of a statutory body comprising one Council for all categories of ADP;
   
   
2. mandatory registration for DHs and DTs;
   
   
3. mandatory registration for DTechs with three classes -
   
   
   1. "registered" for those practitioners with acceptable academic qualifications or ten years' experience;
      
      
   2. "enrolled" for those existing practitioners with less then ten years' experience; and
      
      
   3. "trainee" for new entrants to the occupation through apprenticeship;
   
   
4. voluntary registration for DSAs.

Consultation Exercise

4. We issued the consultation paper at Annex on 1 June 1999 and invited ADP, dental practitioners and other interested parties to express their views on the proposed registration of ADP. We have received a total of 13 submissions from concerned organizations and individuals.

5. Views from the ADP and the dental practitioners are entirely different. While the ADP unanimously supported the introduction of a statutory registration system for all four types of ADP, the dental profession maintained their objection to compulsory registration of ADP.

6. Despite the consensus among the ADP that statutory registration should be imposed on the four types of ADP, their views were divided regarding the detailed mechanisms. Specifically, there were different views on the registration system of DSA and DTech :-

1. whether registration of DSA should be voluntary or mandatory; and
   
   
2. whether registration based on apprenticeship should be allowed for DTechs.

7. We presented in the consultation paper three possible structures of the proposed regulatory body. Again feedback from the ADP respondents were diverse, with respondents of the same type of ADP indicating different preferences. However, no respondents have suggested other alternatives apart from commenting on the three options proposed.

8. Other concerns raised by some ADP respondents include :-

1. more training opportunities; and
   
   
2. the potentially high operating costs of the regulatory system;

Way Forward

9. Given the opposing stance of the ADP and the dental practitioners, we are still considering how best to take the matter forward. We shall continue to discuss and explore with the ADP as well as dental practitioners with a view to identifying mutually acceptable regulatory arrangements to improve the standard of service of ADP for the protection of public health.





Health and Welfare Bureau
September 1999

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