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Suuhygienisti/ Munhygienist (Finland)

  • Proportionality information

    1. Have you examined whether the requirements under your national legal system are
    directly or indirectly discriminatory on the basis of nationality or residence?
       In Finland dental hygienists practise as authorised registered dental professionals who help patients maintain their oral health by preventing and treating periodontal disease and promoting good oral health practice. They carry out treatment direct to patients or under prescription from a dentist. Dental hygienists from EU countries cannot be automatically registered as authorised professionals because the training in EU countries has not been harmonized.In Finland applications for registration from dental hygienists are accepted via three routes: applicants have received their training in Finland, another EU/EEA country or a country not in the EU/EEA. The difference in the procedures cannot be regarded as being discriminatory. The requirements relating to competence and qualifications are the same for all, although there are some differences in the procedures involved.Dental hygienists who have received their training in Finland are entitled to practise as such purely on the strength of the educational and training courses they have undertaken. The right to practise professionally gained through a course of training in another EU/EEA country is subject to the conditions described in the Professional Qualifications Directive. Those who received their training in a country other than an EU/EEA Member State must undertake additional studies, and/or take an examination, prescribed by Valvira, before they can practise professionally. Dental hygienists who have not been studying in Finnish or Swedish must also demonstrate adequate language skills before they can practise professionally.Automatic recognition as described in the Professional Qualifications Directive is possible if the dental hygienist training received in the country of origin has been established as being the equivalent of that available in Finland. This difference in requirements is not based directly on nationality or where someone lives.

    2. Which of the following overriding reasons relating to the general interest justifies the measure(s)?
    • Public health
    • Protection of consumers and recipients of services

    3. What specific risks or benefits have you identified that your measure(s) is designed to, respectively, minimise or maximise?

       Please try to be specific in describing the nature of the risks/benefits you have identified
       Where you have selected more than one overriding reason relating to the general interest in question 2 please be sure to address each of these in your response. Wherever possible please include evidence.

       In Finland the regulation for dental hygienists is designed to mitigate the risk of causing harm to patients, to avoid having unqualified practitioners treating patients. Dental hygienists promote good oral health practise and that way have a significant role in public health. The benefits of the regulation are clear standards for dental hygienist training and practice. People can trust that they get adequate dental services regardless of which dental hygienist they choose. It is also possible to remove the dental hygienist from the register if things go wrong and he does not meet the common standards. This is important for individual patient safety and for public health.

    4. How specifically do your measures operate to minimise the risk(s) or maximise the benefit(s) identified in question 3?

       When addressing this question please try to explain how the measures prevent the risks or guarantee the benefits.
       Where you have selected more than one overriding reason relating to the general interest in question 2 please be sure to address each of these in your response. Wherever possible please include evidence.

       In Finland, National Supervisory Authority for Welfare and Health (Valvira) grants dental hygienists entitlement to practise as a health care professional, and monitors procedures. No one can practise an authorised profession without proper authorisation. Dental hygienists are linked to a national register kept by Valvira. Part of the register is open to public scrutiny, and any citizen can check a single professional's entitlement to practise and any restrictions imposed on it. Valvira and the Regional State Administrative Agencies can intervene if a dental hygienist is acting improperly. The more serious cases are dealt with by Valvira. The Health Care Professionals Supervisory Board, which functions alongside Valvira, can prohibit a professional from practising either temporarily or indefinitely. There may also be partial restrictions placed on a certain function, task, operation or treatment. By these means, it is possible to intervene if the activities of dental hygienists are endangering patient safety or public health.

    5. In so far as you are able, please provide information that you have gathered regarding the concrete effects of the measure(s).

       For example, through impact assessments or information gathered during implementation or review of a measure. Member States who have recently undergone reforms may in particular be able to contribute helpfully to this field. Where you are able to provide cost-benefit analyses this would be particularly valuable.
       Information on whether the measures indeed successfully prevented risks from being realised (e.g. the number of sanctions imposed, a drop in transgressions since the measure was introduced or consequences from previous modifications of the regulation) would equally be helpful.
       Where you have selected more than one overriding reason relating to the general interest in question 2 please be sure to address each of these in your response. You may also wish to include evidence on consumer satisfaction or other measurements of the impact.

        In Finland it has not been carried out specific research related to the impact of regulating the dental hygienist profession. The number of surveillance cases with respect to health care professionals has risen in the past few years. This, however, cannot be regarded as being due to the inadequacy of the remedy chosen. Other contributory factors include the overall increase in the number of dental hygienist professionals there are, the lower threshold at which people complain about them, and a greater endeavour on the part of employers to monitor themselves and file reports. No cost-benefit analyses have been carried out, but we know that productivity in dental services usually improves when dental hygienists instead of dentists treat patients whenever they are qualified to do so. Regulation for dental hygienist profession is crucial to guarantee the safety of patients.

    6. Is the general interest objective you indicated in question 2 pursued in a consistent and systematic manner?.

       In approaching your response to this question please consider examples where you have addressed similar risks for comparable professions, not necessarily within the same sector. Is the approach you have adopted in this particular profession comparable or distinct from such similar cases and why?

       The approach adopted in the dental hygienist profession is comparable on several different healthcare professions. The register of professionals is considered to function reliably and systematically. The register makes it easier for Valvira to conduct its monitoring exercises and therefore reduces risks to patient safety and public health. It also boosts the confidence that the public has in the professionals themselves and the service system.

    7. Please explain in how far the degree of complexity or the nature of the activities
    which are reserved justify that these activities can be exclusively performed by professionals possessing a specific professional qualification?

       For example: when the tasks are essentially of a straightforward nature (such as preparing and printing pay slips etc.), or involve essentially the execution of instructions, specific professional aptitudes should not be required.

       Regulation for dental hygienist profession is needed because this occupation requires a great deal of competence and skill and there would be serious risks to the health of individual patients and the public if it was undertaken by unqualified individuals.

    8. Where you have indicated several measures in place in the screening tab,
    have you reviewed the cumulative effect of all these measures on professional activities?

       If not, why not?
       If yes, please outline for us how you approached assessing this issue as well as the results and conclusions or any learning you drew from this. Where possible please include evidence.

       In Finland, we have not reviewed the cumulative effects of the various measures, which have been outlined in the screening tab for each profession. We believe that they are proportionate for meeting our objective to protect the patients and are not prohibitive for the professionals concerned.

    9. Have you considered the use of alternative mechanisms to achieve your objective(s)?

       Please briefly explain. Where you have selected more than one option, please be sure to address each of these in your response.

       No, it has not been considered the use of alternative mechanisms to achieve the objectives in Finland.

    10. Conclusion

       Following your internal examination of this regulated profession, which of the following have you concluded?

    •    Maintain current system

       Explain where relevant:


    11. Any other comments?
       No further comments.
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