Dáil debates

Thursday, 19 January 2023

Public Dental Services: Motion [Private Members]


5:05 pm

Photo of Peter FitzpatrickPeter Fitzpatrick (Louth, Independent)

I welcome the opportunity to contribute to this debate. I thank my colleagues in the Regional Group for tabling the motion before the House. In recent years, I have lost count of the number of times I have heard of people going up to the North to Newry, or even abroad, for dental treatment due to the cost and availability of dental services in my constituency of Louth and East Meath.

In tabling this motion, we in the Regional Group want to highlight the problem while also offering real solutions to the Government. The bottom line is that dental services should be affordable and available. Unfortunately, it is neither. We must improve access to dental care in an equitable and sustainable manner for all, across all income groups. With an almost 25% fall in the number of dentists claiming reimbursement through the dental treatment services scheme since December 2020, the Minister for Health approved new measures to provide expanded dental healthcare for medical cardholders in the DTSS in April 2022. However, according to the Irish Dental Association, many dentists have withdrawn from the scheme, as it is not fit for purpose, which means that assess to dental care, despite having a medical card, is scarce. The number of dentists providing treatment to medical cardholders has more than halved. For this reason, the motion calls for the provision of additional undergraduate places for dental graduates in Irish universities, as well as extra training places for auxiliary workers and a renewed vocational training scheme.

The lack of dental services is having a knock-on effect on children, whereby some children who should have been seen by the HSE dental service three times before the age of 12 are only seeing a dentist for the first time when they are well into secondary school. To put this in context, children are between 15 and 16 years old before they receive the first of their three dental checks. There is a backlog of almost ten years in parts of the country to access the HSE school dental screening service. For this reason, we wish to push for reform of the dental tax relief scheme, the Med 2 form, to increase the tax relief to a minimum of 30%, and to expand access to treatments and the reliefs available. We are also calling on the Government to provide additional training to allow paediatric dental services to operate where a lack of paediatric nursing staff is currently preventing dental surgery under general aesthetic.

I have recently been contacted by numerous concerned constituents who have been refused dental care at their regular practice due to their medical card status. Additionally, constituents who are on the adult oral surgery list or who have a child on the paediatric special care waiting list for patients have also come to my clinics having been waiting an extraordinary amount of time for essential medical treatment.

In tabling this motion, we in the Regional Group want to highlight the potential dangers that can result from delayed dental care. Due to the effective collapse of the dental treatment services scheme, oral diseases are becoming more common and share common risk factors with chronic disease, such as heart disease, obesity and diabetes. Modifiable risk factors, such as the overconsumption of sugar, tobacco use, alcohol use, poor hygiene, and underlying social factors are often the primary cause of oral disease.

This should indicate that oral health conditions are largely preventable and can be treated in their early stages. However, the Government must step in. Out-of-pocket costs for oral healthcare can be major barriers to accessing care. Therefore, an integrated approach for the prevention and treatment of oral and general healthcare is required. When the oral health of the nation suffers, the people who suffer most are usually the people who have the greatest oral health needs and the least amount of income to afford dental care. That is what dentists report to us all the time.

In 2021, Dr. Joseph Green warned that unless the provision of basic dental services for adult medical card holders is addressed urgently at the highest level, the HSE Louth and Meath dental service may be forced to confine dental services to emergency treatment only, to the detriment of the oral health of children and adults and, in particular, those with special care needs.

I am shocked that, two years later, the scale of the problem in terms of waiting times for dental treatment and the impact of withdrawal of care for medical card patients have not been addressed. This flies in the face of the Government's promises under the national oral health policy to develop a model of care that will improve access and enable preventative approaches. The Minister for Health and the HSE urgently need to engage with providers and the representative body and put an effective plan and resourcing in place to ensure the people of Louth and east Meath have timely and full access to essential dental treatment.

Our motion highlights the urgent requirement of reform of the current DTSS contract model, in particular as it applies to medical card holders and children who urgently require dental care or orthodontic treatment. We call for the reform of the working permit scheme for dentists and dental nurses, a commitment to the training and recruitment of dentists and the immediate addressing of the uncertainty the public dental service has caused. My colleagues in the Regional Group and I are looking for cross-party support for this motion. I look forward to working with everyone to find a solution. We feel the review, reform and implementation of the DTSS, through the engagement of all stakeholders, is required immediately.

I meet a lot of children who come in with their parents and the condition of their teeth is dreadful. A child who is 15 or 16 years of age has been waiting nearly ten years to get their teeth seen. As Deputy Murphy said, 20 years ago the budget was perhaps €20 million more than it is today. That is wrong. I am a firm believer that prevention is the best cure. Older people in my constituency give up when they sit in a dentist's chair and tell the dentist to pull all of their teeth out because they cannot afford to come back again. We cannot afford that in this day and age.

Children who are six, seven or eight years of age come to my clinic with their parents and their teeth are all over the place. Having an examination or a brace could help them. They sit beside children in school and children say there is a smell off someone's breath. It is wrong. All organisations need to get together. Communication is the best way forward. Everybody wants the best for children, families and everyone else. I ask the Minister to renegotiate the contract and get the system up and running again.


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