Dr. Jacinta McLoughlin:

I worked in the then health board dental services for 21 years, for seven of which I was a principal dental surgeon in County Meath. I understand the Deputy’s question and concern for the staff in place. I was a principal dental surgeon when the last policy was launched and implemented. Part of that was that the Department kindly offered us more dentist posts and it coincided with the introduction of dental hygienists. We had great difficulty in County Meath filling those positions, however. I had to go to Stockholm to recruit some dentists to fill those posts.

The problem is that, as currently set up, the HSE dental service is not attractive, particularly to new graduate dentists who would be young and enthusiastic. Unlike in medicine, dentists graduate with a wide range of clinical skills. In Dublin, they start treating patients doing irreversible procedures on patients in year two of a five-year programme. They come out with an accomplished range of skills. If one works in the salaried dental service, it does not allow one to use those skills. In the past, there were more opportunities to use them. When I was in the health board dental service, there were opportunities to treat adults. For example, I did some of that kind of treatment in psychiatric hospitals.

Having extra positions does not necessarily solve the problem if the posts are not attractive. Salary cuts, changes in the pension arrangements and so forth have an impact on the attractiveness. The model of care needs to change. This has been clearly outlined in the policy. As Dr. Green said, there will be much support for that as people understand that if one goes to reorientate a service, one must give people the skills to deliver it. Just offering extra posts is not going to work with the current model. The policy proposal, accordingly, is to change the model.