Dr. Dympna Kavanagh:

On policy, the EU recognises two specialties, namely, oral surgery and orthodontics, and we have conformed with that. In the UK in particular, there is a plethora of specialties. There is much debate, particularly among my chief dental officer colleagues, about the merits of having multiple specialties in smaller countries such as ours with a population of 4.5 million. A dentist practising in a specialist limited area needs a body of work to maintain his or her skills and that is a dilemma for us. Many people first look to the practice in Scandinavian countries, where they have developed a concept of specialist generalist training and are moving away from limited specialties. Although I do not wish to pre-empt what will be in the policy, practitioners could combine several specialties, which would be of particular benefit to us in respect of rural areas, which are a challenge for us. It would be difficult for us to appoint a paediatric specialist, a special care specialist and several other specialists to such areas as there would be a shortage of applicants for such posts.

To come back to the policy, the advanced care centres provide credentials in this regard. On a national level, we need a broad range of specialties available to us. However, if we are looking into the community, we would have to consider that workforce planning in a certain way. It is important that practitioners maintain their skills. One of the important concerns raised in the consultation with dentists on the ground was that they are primary care dentists with a broad scope of practice, but feel squeezed by the specialties and auxiliaries coming in and want a clear definition of their scope of practice. The view of the Dental Council of Ireland is that primary care covers all eventualities unless, as Dr. Dougall rightly pointed out, it is an advanced part of care and this network is required to provide it. It is a mutual relationship. We currently only have two specialties and are conforming to EU standards in that regard. We recognise that more specialties are needed in key areas, but I am unsure whether having 13 specialties would be appropriate for us as we do not have a population of 78 million. The four key pillars, involving primary care, special care, looking at public health and looking at the advanced centres, such as in the areas of restorative and, perhaps, periodontal care, are key in considering the needs of our communities. That is our first port of call.