WRITTEN QUESTION E-3672/02

by Antonio Di Pietro (ELDR) to the Commission

(18 December 2002)

Subject: The practice of stomatology

In Italy, access for doctors to the practice of stomatology is subject to inclusion on the register of dental practitioners, who are not physicians, for the simple reason that the professional associations want to regulate medical practice in the field of stomatology via the dentist directives, thereby obliging doctors who want to practice stomatology to be included on a professional register alien to their actual profession, in blatant contravention of Community Directive 93/16/EEC(1).

This misguided requirement has been causing serious prejudice, not least in the legal sphere, to those doctors who have relied on the provisions of Directive 93/16 in order to treat mouths and teeth in their role as doctors on the medical register, a right recognised by Directive 93/16 for holders of a degree in medicine.

This attitude, which has already been censured twice in infringement proceedings brought against Italy (cases C-40/93 and C-202/99), both of which resulted in a guilty verdict on the grounds that Italy had treated as identical two different professions regulated by different directives which treat them separately (cf. the Commission's answers to written questions E-1522/96(2), E-1649/97(3), E-2698/98, E-2699/98 and E-2700/98(4)).

Can the Commission say whether the degree in medicine and surgery awarded in Italy to people who started their medical training in the 1980/81 academic year or later have the minimum training requirements allowing them to practice medicine in Italy in the field of odontostomatology or whether the exercise of this activity is subject to possession of a specialised qualification or inclusion on the register of dental practitioners, who are not physicians?

(1) OJ L 165, 7.7.1993, p. 1.

(2) OJ C 356, 25.11.1996, p. 52.

(3) OJ C 391, 23.12.1997, p. 113.

(4) OJ C 135, 14.5.1999, p. 99.

Answer given by Mr Bolkestein on behalf of the Commission

(20 January 2003)

Except where provided for by specific derogations, the Member States have been prohibited from authorising non-specialist doctors to practice dentistry or odontostomatology since the entry into force of Council Directives 78/686/EEC and 78/687/EEC of 25 July 1978(1) concerning the mutual recognition of dental practitioners' diplomas and the coordination of their professional training. This situation was confirmed by the Court of Justice in its judgment of 1 June 1995 in Case C-40/93 (Commission v Italian Republic(2)), which stated that Member States may not, under any circumstances, create categories of dental practitioners that are not provided for by the aforementioned Directives.

The only derogation affecting Italy appears in Article 19 of Directive 78/686/EEC, which expressly allows Italian doctors who began their university and medical training before 28 January 1980 to continue to practice dentistry in Italy and to move to any other Member State for that purpose. Because there was no specific dental training and profession which were separate from those open to medical practitioners in Italy at the time of the adoption of Directives 78/686/EEC and 78/687/EEC, the rights of the doctors in question had to be preserved whilst the new profession was being established.

Nevertheless, since Italy had unilaterally deferred the Article 19 deadline (28 January 1980) for the start of medical studies to the 1984-1985 academic year, the Court in its above-mentioned judgment found that it had failed to fulfil its obligations under Directives 78/686/EEC and 78/687/EEC. As Italy could not implement this judgment on its own (except by revoking the authorisation of the roughly 4 000 doctors concerned to practice the activities in question), Directive 2001/19/EEC(3) introduced specific measures designed to regularise the status of these practitioners (an aptitude test to be organised by the Italian authorities).

In conclusion, non-specialist doctors may not practice dentistry or odontostomatology unless the derogation conditions laid down in Article 19(1) or (2) of Directive 78/686/EEC, as amended by Directive 2001/19/EC, are satisfied. This state of affairs is not contrary to Directive 93/16/EEEC(4).

(1) OJ L 233, 24.7.1978.

(2) ECR 1995 I-1319.

(3) Directive 2001/19/EC of the European Parliament and of the Council of 14 May 2001 amending Council Directives 89/48/EEC and 92/51/EEC on the general system for the recognition of professional qualifications and Council Directives 77/452/EEC, 77/453/EEC, 78/686/EEC, 78/687/EEC, 78/1026/EEC, 78/1027/EEC, 80/154/EEC, 80/155/EEC, 85/384/EEC, 85/432/EEC, 85/433/EEC and 93/16/EEC concerning the professions of nurse responsible for general care, dental practitioner, veterinary surgeon, midwife, architect, pharmacist and doctor (Text with EEA relevance), OJ L 206, 31.7.2001.

(4) Council Directive 93/16/EEC of 5 April 1993 to facilitate the free movement of doctors and the mutual recognition of their diplomas, certificates and other evidence of formal qualifications, OJ L 165, 7.7.1993.