Thursday, 19 January 2023
Public Dental Services: Motion [Private Members]
Dara Calleary (Mayo, Fianna Fail)
Gabhaim buíochas le gach Teachta sa Teach a bhí páirteach sa díospóireacht seo. I thank every Deputy, on behalf of the team at the Department of Health. The Minister, Deputy Stephen Donnelly, was here until just a few minutes ago and I assure the House that the Minister appreciates the serious difficulties that are being outlined this evening. I thank the Regional Group for bringing this issue forward.
The Minister has noted that the Government is committed to addressing the issue by easing current access issues through a range of interim measures, which still include a 40% to 60% increase in payment for treatments under the dental treatment service scheme, DTSS, last year, but ultimately through substantive service reform. In saying that I also want to acknowledge the truth of many Deputies’ feedback, including my own, on the inaccuracy on HSE lists on those participating in the DTSS. That needs to be improved. An additional allocation of €15 million has been invested in budget 2023 to support the work.
The national oral health policy, Smile agus Sláinte, sets out the vision for the future of oral healthcare services in Ireland. This is a body of wide-ranging and transformative reforms. While it will take a number of years to bring to complete fruition, there will be an early and continued emphasis on addressing the issues described this evening. The policy will support the provision of all levels of care by appropriate healthcare professionals and in the most suitable settings. It will support patient choice and access across the life course. The fundamental aspiration is that all Irish people will have their own dental home where they will build a lifelong relationship with a local dental practice or with practices of their choosing, for continuity of care from birth to old age. It will replace the current service approach, which is based on the dental health action plan 1994, which was informed by data from the 1980s. The policy has two goals, the first of which is to provide the supports to enable every individual to achieve his or her personal best oral health; the second goal is to improve access to dental care in an equitable and sustainable manner, therefore enabling vulnerable groups to improve their oral health. The policy reflects the WHO approach, grounded in primary healthcare, which is being informed by and aligned with other relevant Government and health policies, including the primary healthcare approach, Sláintecare and Healthy Ireland.
We know that oral health is linked with general health. Alcohol, tobacco use and poor diet are common risk factors that not only lead to poor oral health but to heart disease, stroke, diabetes, cancer and other non-communicable diseases. We know from Healthy Ireland surveys that the population highly rates the advice they receive from their dentists and from other oral healthcare professionals regarding these risk factors. Oral health promotion, based on a holistic approach, that acknowledges lifestyle-based risk factors common to oral and non-oral diseases, will be made available to all age groups under the policy. The Government has already taken the first steps towards this preventative approach in the measures introduced to the DTSS last May, which included the requirement for dentists to provide advice on diet, tobacco, alcohol and other lifestyle impacts as part of the oral health exam, and the reintroduction of the scale and polish treatment for all adult medical card holders. More than 93,000 additional people received scale and polish treatments under the scheme in 2022, versus 2021.
For children, the best evidence shows they should have access to oral healthcare services as young as possible to establish their dental home with their local dentist or oral healthcare professional of their choice. This ensures they can access support before they have problems. The Government is committed to starting the process of developing these new and more comprehensive services for children this year, starting with the zero to two years old age group and then moving to seven years. This change will increase the capacity of the HSE public dental service to reorient and develop oral health promotion programmes. There will also be greater capacity to provide care to those more vulnerable groups in our community, including adults and children with additional needs and adults living in residential settings.
All of this requires a sufficient number of appropriately trained dentists and oral healthcare professionals, including dental nurses and other grades. The Minister has said many times that we need a radical approach to increase the number of healthcare professionals available. At the end of December there were 3,442 dentists on the dental counter register. As Deputy McNamara has referred to, we need many more. The Department of Health is collaborating with the Higher Education Authority, HEA, to identify opportunities to build capacity in the higher education system for dentistry and for more oral healthcare graduates. Potential new and innovative models of dental education are also being considered, with a focus on primary care. The HEA initiative is aligned with a Department commitment in the national oral health policy to improve access to care.
The Department of Health is committed to the development of an oral healthcare workforce plan, as set out in the national oral health policy. Dedicated resources have been set aside to advance this work. This work and workforce plan will consider how other dental professionals, such as expanded roles for dental hygienists, can express support for the new model of oral healthcare services, and how they in turn can be supported with career pathways that support staff retention and development. The Department has asked the Health Research Board to review the type of work placements used in dental undergraduate education in other EU countries. All of this should help to ensure our higher education system provides enough oral healthcare professionals with the relevant skills to meet our population’s needs.
I want to assure the House that the Minister will continue the ongoing work to address the access issues, which are affecting current healthcare services and which have been described throughout this debate. He will also progress work on the implementation of the national oral health policy, which sets out the body of transformational response. I thank the Deputies who participated again and I thank the Regional Group again for bringing forward this motion. I assure them of the Government’s complete commitment to improving our oral healthcare services and the access issues raised this evening.