Dr. John Marley:

It is a good question. Replacing specialists and consultants at that level is about successional management.

Part of successional management is planning ahead, from the undergraduate through to the postgraduate continuum. If the system is not doing this, it cannot be a surprise that it is not generating the people who are needed at the top end of the pyramid to deliver the leadership and expertise required to treat the very sick patients with comorbidities, the elderly and those with special care dentistry needs. I shall defer to Professor Lynch who is a consultant and professor within one of the dental schools in Ireland who can perhaps comment on that issue also.