Martin Daly calls public dental service 'a poor law service'
Martin Daly sharply criticised the public dental service, calling it 'a poor law service' and warning the system is regressing. He argued the Department of Health failed on capacity planning, dentist training and reform of hygienists' scope, and highlighted gaps in school screening and services for children with special needs.
Dental service assessment
Martin Daly described the dental service as the worst of the 'Cinderella' services in the health system and said it is slipping back to a poor-law model. He criticised the lack of capacity planning given population growth of 90,000 a year - year on year - amounting to 1.2 million in the last 20 years.
Workforce and training
He said dentist training is insufficient, noting about 100 dentists qualify each year and roughly 2,400 dentists are in the country, many in private practice. Daly argued that cuts under FEMPE encouraged clinicians to exit public service and that reform of dental hygienists' scope of practice has not happened despite clear need.
Registration and retention anecdote
Daly recounted a Pakistani registrar in GP training whose wife, a dentist, is moving to Enniskillen because of barriers to getting on the dental register in the South compared to the six counties in the UK. He used this personal example to illustrate how registration and regulatory barriers affect retention of dental professionals in public care.
Prevention, school screening and fluoridation
He emphasised preventative dental care as the most cost-effective approach and criticised the decline of the school screening programme compared with when he was a child. Daly also dismissed contemporary excuses around water fluoridation and urged reform to prevent future problems in children's oral health.
Services for children with special and additional needs
Daly described meetings with six families of children with complex needs in Roscommon and said local planning failures force some families to travel 45 miles to Galway for care. He highlighted a postcode lottery in access, a lack of protected emergency spaces for neurosensory disorders, poor local admission planning, and a broader failure of communication and common sense in services for children with special needs.
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You've drawn the short straw because, to be honest with you, I don't have any questions. I'm going to make some reflections on what's in the document because I think what's in this document and what we've heard from the IDA is indefensible. And we are talking about a dental service that is a poor law service. We are going backwards. We are going back before 1972. We're going back to poor law where it is almost a charity to get decent dental services if you don't have your personal resources. And it is interesting that in the health service, there are three services that are the Cinderella services of the health service. There's the mental health services. There's community services, even though there's some investment going in there. But it's not proportionate to what's happening in the hospitals, and that was pointed out by one of the previous deputies. And there's the dental service. And the dental service is by far the worst. So, I mean, capacity planning, that's a basic function of the Department of Health. How could we not plan for a growth of population of 90,000 a year, year on year, 1.2 million in the last 20 years? Training of dentists. We're not training enough. You talked about 100 dentists coming out on a year. Compare that to your medical schools. Compare it to veterinary colleges. It's just not enough. So if you have the number of dentists in the country, I think it's 2,400. Many of them are in private practice. And that leads on to the next thing. They dropped out of giving public service because under FEMPE, where there were very significant cuts, right across all sectors, had to be done, country had to be saved. But there is no doubt that there was a targeting of professions. And that might have been popular at the time because dentists were seen as a well-paid profession. Doctors were seen as a well-paid profession. But we are reaping the harvest of pandering to the lowest-hanging fruit. You get on then to, I had a Pakistani registrar, he's naturalised here in GP training. His wife's a dentist. They're moving to Enniskillen. He's a really, really good general practitioner because of the barriers to get on the dental register here in the South compared to the six counties in the UK. So that is a personal story. So that needs to be. I mean, the idea that there hasn't been reform of dental hygienists and their scope of practice in a time of famine doesn't make any sense. For the school screening programme. My God, we were doing better in the school screening programme when I was a child. And I don't want to tell you how long ago it was that, but that was 50 years ago. The dentist came to the school. It wasn't always the most humane service, but it was a service in screening children. And to give excuses around fluoridation of water in this day and age is just a joke. Preventative medicine, preventative dental care is the most cost-effective care that we can give. It closes off problems in the future for developing children. And I'm going to come to the service for disability. For children with additional and special needs. I had a meeting in my office in Roscommon last Friday where I met six families who have children with complex additional and special needs. And not only are they being let down by the health service, you know, I mean, simple things like having protected spaces in emergency rooms for children with neurosensory disorders. Protected spaces for children and plans in local hospitals to get admissions through so they don't have to go to the ER when everyone knows what needs to be done because these are repeated admissions. A lack of planning, a lack of common sense, a lack of communication. And, you know, when you get then the situation with the service for children with additional and special needs. For example, those six families in my office sitting there, Roscommon town, 10 miles from the border. Roscommon is a narrow county, as you know, Tony. So people who are 10 miles from a service in Roscommon town with children with special and additional needs, complex, are being asked to go to Galway. 45 miles away, and as you know, 30 miles is the easy part. It's an hour to get across the city. Thanks, Deputy. It's a postcode service for the care of children with special and additional needs. And it is simply unacceptable. Thanks, Deputy.
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