Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this important issue. There is nobody in this Chamber who has not been contacted in our constituency offices on this issue. I am taking this debate on behalf of the Minister for Health, Deputy Stephen Donnelly. The Minister is acutely aware that access to dental services for medical card holders under the DTSS has become an ever-increasing problem during the pandemic. The problem is that a significant number of dentists who were contracted by the HSE to treat medical card patients have chosen to leave the scheme, which has led to difficulties for medical card patients in accessing dental care. Some parts of the country have been particularly affected, an issue which is of particular concern to the Minister. The latest figures we have from the HSE suggest that 1,150 dentists are contracted to the HSE to treat medical card patients, which is approximately 300 down on the figure before the pandemic.

I understand that the reasons given by dentists for leaving the scheme are numerous, including issues around the sustainability of the scheme and the need to align it with best international practice. The Minister has listened to the concerns raised by the dentists directly, and to the Irish Dental Association, and has heard their frustrations with the scheme. They are firmly of the view that the range of services available to patients under the scheme and the fees payable to contracted dentists are out of kilter with today's environment. The Minister is keen that all of these issues are addressed as a matter of urgency. He fully accepts that there is a need to align the scheme with best international evidence and practice, as outlined in Smile agus Sláinte, the current national oral health policy that was published in 2019. Regrettably the Covid-19 pandemic caused the roll-out of the policy to be delayed and the proposed review of the scheme to be deferred. However, the Minister has given a commitment that there will be a root-and-branch review of the scheme, and his officials and the HSE expect to be in a position to begin that work by the second quarter of this year. In the meantime, he his seeking that the contracted dentists, and their representative association, the Irish Dental Association, work with him and his officials to address the immediate issues of concern and to ensure that we have a sufficient number of dentists available to provide services to medical card patients.

The Minister has also heard what the dentists have had to say about the viability of the scheme and he wants that addressed as well. The Minister secured an additional €10 million in budget 2022 to address this very problem. He hopes that agreement can be reached very quickly on how the money can be used to address some of the immediate problems with the scheme, pending the full root-and-branch review.

Officials from the Department and the HSE last met with the Irish Dental Association on 17 December. Certain proposals were put to the association and the responses to those proposals are now being actively considered by the Department and the HSE. The Minister hopes that through dialogue some interim solutions can be found as quickly as possible, for the benefit of patients and the dental community. As the Deputy quite rightly said, anyone who has ever experienced a toothache knows they cannot hang around.

In the meantime, officials are engaging with the HSE public dental service, the in-house salaried service, which is seeking to provide cover for any medical card patients who are experiencing problems in accessing a service from their local dentist.

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