Dental assistants to register or stop working

New regulations from the Health Professions Council of South Africa (HPCSA) could result in an increase in dental costs for customers and dental assistant retrenchments. Under the new rules all dental assistants need to be registered with it by 31 March 2016. This follows amendments to the Health Professions Act.
 
However, there has been an outcry as the impact that this will have on the dental profession. The South African Dental Association (SADA) has revealed that there are an estimated 2500 dental assistants who are working but are not registered.
 
In order to register, the dental assistants will reportedly also have to complete one year of study.
 
Maretha Smit, CEO of SADA, revealed: “Some assistants who have not completed the formal year of study, would have been registered under the prior “grandfather clause”, and they are therefore not at risk to be adversely affected by the legislation at this stage. It will, however, impact on those dental assistants who have not been able to register under the grandfather clause and, thus, now need to find an accredited course of study for them to enrol in. There are currently only four institutions providing such courses, all of them with face-to-face training programmes, and with a total capacity of graduating only approximately 200 assistants per annum.”
 
SADA is concerned about the implications that the registration process could have. SADA highlighted that the proposed regulations would impose:

• A high level of compliance for dental assistants to uphold registration;
• Annual on-going, continuous professional development; and
• A minimum level of training at an official, accredited institution.

 
Smit emphasised: “SADA does not have any objection to the professional development of any group of people. Our only concern with the legislation, is purely around the practicality of implementation thereof, as we do not foresee that it will be possible in the near future to have a sustainable pool of qualified dental assistants available from which dentists can recruit.”
 
The impact of the registration requirement
 
As a result of the new regulatory requirements, the cost of dental procedures may be affected. Smit explained that regulation always has a cost element to it. “In this specific instance, the costs are associated with a minimum entry requirement of formal tertiary education, ongoing annual registration fees payable to the HPCSA and ongoing costs of attending continuous professional development programmes (both cost of attendance and time away from practice). Naturally, this impacts on the input costs in dentistry and may have an effect on the ultimate output pricing of dental procedures.”
 
There is an added concern that the new regulation requirements could see dental assistants who do not register being retrenched. In these instances, the dental practice will need to hire registered assistants, practice without an assistant, or consider closing down.
 
The HPCSA has highlighted that “failure to register will result in the criminal prosecution of the dental assistants and the HPCSA will prosecute dentists who continue to employ unregistered dental assistants.”
 
“SADA is very keen to engage with the HPCSA in order to find alternative mechanisms to enable this troubled environment. One proposed mechanisms could, for instance, be the availability of a further grandfather clause on less punitive measures than before (i.e. less than five years’ experience), with the simultaneous introduction of a distance learning training programme. Alternatively, dentists could be mandated to do “in-service” training, as is the case in some other international locations, with a requirement for the assistant to be able to indicate competence in a pre-defined set of outcomes, as assessed externally,” added Smit.
 
The HPCSA revealed on Friday: “In order to facilitate the registration of those dental assistants who, as a result of this moratorium, did not register with the HPCSA, the PBDOH (Professional Board for Dental Therapy and Oral Hygiene) is presently instituting measures that would enable unqualified yet experienced dental assistants to be provisionally registered for a period of two years, with the provision that within a period of two years they complete a Board examination. The Board will offer four examinations per annum over a period of two years, and candidates will be allowed three opportunities to undertake the examination. Successful completion of the Board examination will permit access to full registration, and not a qualification. Whilst being provisionally registered the dental assistant would need to comply with the continuous professional development (CPD) and annual fee payments as required for dental assistants.”