Dáil debates

Thursday, 19 January 2023

Public Dental Services: Motion [Private Members]


6:05 pm

Photo of Joan CollinsJoan Collins (Dublin South Central, Independents 4 Change)

I support the motion from the Regional Group. I thank the Deputies involved for putting it forward. The debate is badly needed in this Chamber. There is quite rightly deep anger at the moment over the trolley crisis in the HSE. However, the health crisis extends much further than what is taking place in our accident and emergency departments. The DTSS for people on medical cards is in a total state of collapse. The Irish Dental Association has called it unfit for purpose. Dentists are leaving the scheme in their droves. The Government slashed funding for the DTSS after the recession hit in 2008. The Irish Dental Association called these cuts savage. The Government has continued to cut funding since then. It cut funding by 36% between 2017 and 2020 alone. All of this has left many of those who need help the most with a severe lack of access to dental care. Many people simply cannot find a dentist who accepts medical cards. The Minister has acknowledged that the scheme is not fit for purpose, but he still failed to meet his own deadline for a review last year. The Irish Dental Association states the scheme has remained largely unchanged since it was implemented in 1994 at the same time as privatisation of dental care for medical card holders. We have seen the number of dentists enrolled in the scheme fall from 1,600 in 2019 to just 600 last year. That leaves more than 2,500 medical card holders for every dentist in the scheme. The Government has failed to lift a finger while a vital service for some of the most vulnerable people in this country has completely fallen apart.

As was said by previous speakers, we know that gum disease increases the risk of heart attack, stroke and other cardiovascular events by two to three times the average. In the middle of a cost-of-living and inflation crisis, retired, low-paid and unemployed people cannot always afford a healthy diet. They cannot afford the cost of private dental care and they certainly cannot afford the time and money it takes to actually find a dentist who accepts medical cards. To make things worse, in June last year I received a letter from a constituent whose son has a disability and who had been that told they could no longer attend the public clinic at Old County Road because it would only be serving those who could not physically attend a community dentist, sit to wait for the appointment or sit still in school. That was the reply I received. This was confirmed to me as being in line with HSE policy by the Minister when I raised the matter by means of a parliamentary question. This is a massive change for many with disabilities who have been attending public dental clinics their whole lives. It pushes more and more people into a rapidly shrinking system that cannot provide for them. The failure of the scheme leaves people who are largely struggling in serious physical pain. It puts the burden of dental care on those who can least afford it and the burden of a lack of preventative care on a health service that is already bursting at the seams.

Another matter was raised with me by families of autistic children. They were told that only autistic children who are in special needs schools or classes can access the special care programme. Children in mainstream schools who have autism are not entitled to access the special care programme. This is a failure for those people in our communities. It is yet another result of failing to implement the recommendations laid out in the Sláintecare report. Sláintecare lays out the need to return to pre-austerity levels of funding and highlighted the shocking situation where we have seen massive reductions in access to regular dental care and massive increases in emergency extractions. This situation is just not good enough. We need to look after people on medical cards. We need an emergency return to pre-recession funding for the DTSS. We need investment in and expansion of our dental schools. We need to implement the reforms of Sláintecare that were promised five years ago. We need to end the privatisation of the 1990s and ensure proper, public dental care for everyone in this country.

I support the motion. We need immediate intervention by the Government to implement the plan to help those on medical cards.


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