Brian Stanley: Ireland's Public Dental System Is Failing

Thanks Ceann Comhairle, and I welcome the fact that these proposals are before the Dáil here tonight. Indeed, I brought similar proposals to the floor of the Dáil here and to Micheál Martin only just a few short weeks ago, you'll recall, and set out a lot of what's in this motion already. But it's good that we're here and that parties are getting behind this. Minister, I've been raising this with successive Ministers for Health, from James O'Reilly, Leo Varadkar, Simon Harris, Stephen Donnelly, and to the current Minister. And we've had four Governments, and it's a major failing, a major failing of a relatively wealthy state that we don't have a good public dental system. We've actually gone backwards, and the figures in the case of Leash, for example, show that matters have deteriorated. We have a situation where students are not getting their first examination until they're, they should be getting their third or fourth in primary school, like I got, and you probably got, in Graycullen. I got it in Leash as well. But prevention is the key, but now they're not getting until third, fourth, and fifth year in secondary school. That's according to the HSE. There's 6,600 waiting for their first examination, Minister. 800 of them are overdue by six years, according to the recent figures I got from the HSE. 1,500 are overdue by five years. And if prevention is the key, you'll understand that untold damage is being done. I want to raise the position of special needs children and adults, and this is a really serious one. Those who can only have dental treatment under a general anaesthetic, they're really being neglected. And there's a number of cases I have dealt with where they've been waiting years for hospital access. In one case, not 100 miles from your own house in Leash, Minister, the boy has been waiting six years for to have treatment under general anaesthetic. The child is non-verbal, has serious inflammation, disease, and in constant pain. This is medical neglect and it's not good enough. Now recently, he received dental treatment in a hospital at last, after repeated representations. We had extractions, but the teeth that's remained are in very poor condition. There's advanced decay, according to what the family tell me, and infection still. And I'm informed that he will lose those teeth. But the child can't have dentures, and this is very regrettable. The school dental scheme has to be the foundation of a public scheme. We have to catch people when they're young. And when this fails, and it clearly is failing in Leash, the whole system fails. And it's been outlined how it's failing in other parts of the country. But the Taoiseach agreed with me that Leash is a black spot. He also gave a commitment to take this up with the Minister for Health, and I would like to see that followed through with. The dental treatment services scheme is 95% non-existent. Just one dentist, one dentist from Carlow provides a service in a community centre in Colesham on the Leash-Carlow border. It's impossible for 95% of medical card patients to get treatment under the DTSS, which is a scheme that's supposed to cater for them. But there's no dentist will do it. No dentist will take on new ones. Then there's the pre-RSI-based scheme, the dental treatment benefits scheme. But all that comes in under that for workers and their families is a cleaning and examination. No treatment. The Irish Dental Association estimate that we need at least 500 extra additional public dentists immediately, because as has been outlined here earlier on, we actually have less public dentists now than we had five years ago, and we need an extra 500 now, according to the Irish Dental Association, to begin to make a start in providing dental care. The facts are that as a state, we have failed, and successive governments have failed to get a public dental system in place. The failure of those with special needs, the failure of those with medical cards, the failures of workers and families under the dental treatment benefits scheme, but crucially, the failure to provide a proper school dental scheme. This is, you know, it shows that we are way back and that we have huge work to do here in terms of this. We're supposed to arrive at the full implementation of Sláinte Care, which is a public health system, in 18 months. But of course we're not near that. And this should form part of this. I acknowledge that extra dental training places are now in place, but recruitment of them as public dentists and retention, that is key, and there's work there to be done, and the government need to prioritise this with the HSE. We're putting money into the dental system. We probably need to increase it. I would always argue that money should go into frontline services as much as possible, reduce the bureaucracy, reduce the top layers, you know, make sure that the money isn't wasted before it actually gets to where it should provide the service. So it's time for a major shake-up of the dental services and the way how they're delivered. Other countries can do it, we should do it, and clearly, you know, we need action, we need an action plan, and we need to prioritise those areas they outlined, public dental scheme, the school scheme, and those people, children and adults with special needs, and particularly those that are non-verbal and have to have treatment under a general anaesthetic. So other countries can do it, other countries have done it years ago, we should do it, it needs political will, it's part of Sláinte care, we should get to work on it now, and waste no opportunity. As I said, four governments and five and possibly even six ministers have raised this with, and we're still not there, but we have grown to make up, and certainly as an opposition party, I would support government in that, so we need to do it.