Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank the Deputy for raising the issue of access to dental treatment for medical card holders. She is right, and there is nothing she has said with which I could disagree. It is the same in every constituency office and the situation is difficult the length and breadth of the country, more so in some areas than others. Swords in north County Dublin has a large population.

I am taking this debate on behalf of the Minister for Health, Deputy Stephen Donnelly. Dental treatment for medical card holders aged 16 years and over is provided under the dental treatment services scheme, DTSS. Services available annually have included an examination, two fillings and emergency extractions. Deputy O'Reilly is right, in that some of us - it might be because of our age - find it difficult to face going to a dentist and we leave it too long whereas others are proactive and go every six months for scaling and polishing, at which point problems they might have show up. More complex care and a broader range of treatments for patients with special needs and high-risk patients is also provided, some of which requires prior approval.

The Government has been concerned for some time that medical card patients in some parts of the country have been experiencing problems in accessing dental services.To help address the issue, the Minister secured an additional €10 million in budget 2022 to provide for expanded dental health care for medical card holders, including the reintroduction of scale and polish. To address the concerns of contractors about the scheme, by whom I mean the dentists who deliver it, the Minister is using an estimated €16 million of an underspend in this year's Estimate allocation to award fee increases across a number of items, including fillings. The combination of these two measures represents an estimated total additional investment of €26 million in the scheme over and above its €40 million spend in 2021. Following consultation with the Irish Dental Association, these new measures came into effect on 1 May. The Minister hopes that this significant additional investment in the scheme will attract more dentists to treat medical card patients.

One of the questions that has to be addressed is that of why so many dentists do not want to participate in the scheme and are leaving it. I believe that 42% of people have a medical card or doctor-only card. That is two in every five people who may need to access a dentist using a medical card. This can cause difficulties if you are in pain and cannot access a dentist. The number of patients being seen and the numbers of treatments being provided under the DTSS have started to increase in recent months. Patients are also accessing the reintroduced preventative scale and polish, which is a positive development.

Reintroduction of the scale and polish is in line with the preventative ethos of the national oral health policy, Smile agus Sláinte. I have been assured by the HSE that the local services on the ground will assist any persons who are still experiencing problems in accessing a service. I take on board the experience of Deputy O'Reilly's constituent who we called "Mary". It can be quite difficult for some people who do not have transport.

The Minister is aware that contractors are looking for more substantive reform of the dental treatment services scheme in the longer term. This concern is recognised. It is the Minister's intention that this is addressed in the context of the implementation of the national oral health policy, Smile agus Sláinte, which sets out a body of substantial reforms of dental services. Work is under way within the Department of Health to design a Government framework to oversee and facilitate root and branch reform.

To answer the Deputy's question, an extra €26 million has been provided this year on top of the original budget spend. Slowly but surely, we are seeing increases in the number of people being treated. However, I accept that it is slow.

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