Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

It is understandably disappointing that the Minister is not here. I understand he has a family bereavement and funeral this morning but I hope he gets an opportunity to look back at this debate. I sincerely thank Deputy Shortall and her party for tabling this motion. Not only does it relate to a contemporary, urgent health crisis – one of many – but it is also one to which I feel attached, given my history of dental treatment through the State. From the age of six, I needed emergency dental treatment. In fact, my first-ever trip to the dentist necessitated a raid of my own Communion money to afford it. Not long after, I got captured by the primary school screening system and was looked after by the State dental services from then on, be it in locations from Millmount Health Centre to St. James’s Hospital, where I was discharged a month before my leaving certificate examinations. I received the most comprehensive and, dare I say, socialist treatment. It was the most fantastic dental care for complex dental issues that you could get anywhere, and my family did not have to put their hands in their pockets. There was nothing exceptional about my circumstances except the fact that I had a need. The problem now is that children are not getting the treatment I got as a child more than 35 years ago.

This motion is not calling for something new or aspirational that we have not had before; it is calling for something we used to do quite well but that we have allowed to be run into the ground. It is at a point of such crisis that it feels we are a million miles away from ever getting it back on track. The Government has totally ignored dentistry services. It has ignored the calls not only of the Irish Dental Association but also of the Irish Dental Hygienists' Association, another body that has a good contribution to make in improving dental services in this country.

Some 104,000 children are on a waiting list for the school screening dental service out of an eligible 208,000. This failure is a searing indictment of the Government. Just under four weeks ago, the Minister for Agriculture, Food and the Marine, Deputy Charlie McConalogue, stated the requirement for dental services for young people was a key priority for the Government; however, as with many so-called key Government priorities, it has not been backed up with funding, resources and, most important, action. The reality is that the numbers are going in the wrong direction. In the past five years, we have seen a 31% reduction in the number of children seen by HSE dentists, and, indeed, the number of HSE dentists has declined by 23% between 2006 and 2022. The number of medical card patients seen under the DTSS has reduced by 35% in the past ten years. We are all dealing as best we can, through our advice clinics and constituency offices, with the crisis that is the collapsed DTSS. In the past ten years, the number of dentists participating in the scheme has dropped greatly, almost by 50% or from 1,600 to just over 800. Even more concerning is that of the 810, only 600 are active. How is the Government going to arrest this slide? How is it going to reverse these numbers? It has absolutely no plan to do so. It is long past time for action in this sector.

For a number of years, the Dental Council of Ireland has called for the Government to amend the Dentists Act 1985 to expand the council’s powers to enforce the regulatory code, a call the Irish Dental Association has supported. The 1985 Act is so far out of date and unfit for purpose that its amendment needs to be prioritised by the Government. However, it does not seem like we will see this in the lifetime of the current Government. We need the Government to prioritise increasing the number of dentists and dental hygienists, and that means taking key decisions and reversing the decision to pause new dental schools in Cork and Dublin due to funding concerns. The pausing of these schools equals an acceleration of need and pain for those who need dental care, particularly children. A screening service and the catching of complex and non-complex dental needs early not only save the State money in the long run but also save children a great deal of pain and sometimes stigmatisation and considerable difficulty in what are their formative years.

Since budget day, on 10 October 2023, we have heard story after story about the impact of the Government’s underfunding on our health service and, indeed, our dentistry service. The services are treated as separate. When the Government talks about health service Bills, it wants to talk about acute hospitals and accident and emergency services, and other parts of our health service are seen as ancillary or not even part of the health service at all. Our dentistry service is as integral to our health service as any other aspect, and this is a message the Government needs to take on board.

As with access to GPs, no one should be put off going to the dentist because of the cost. We are in circumstances in which the most vulnerable in society, those with the lowest amount of discretionary funding or zero discretionary funding, are forced into a position in which they must pay out of pocket for emergency dental procedures. That means difficult trips to the credit union or, indeed, family members or friends, if indeed any of the required facilities are available. Many cannot or will not get the money and many will have to live with the pain of toothaches and more complex dental conditions.

It is all well and good for the Government to say it will support this motion; however, as previous Deputies have said, that is just a facility to get the debate over and done with and into the history books so it can move on without taking any action whatsoever on the substantive issue dealt with in this motion or any other motion the Government decides to support in name but not in deed. What we want to know is simple.

Will the Government follow through and guarantee that all primary schoolchildren will receive their three school-based appointments at the appropriate age by the target of 2027? We need the Government urgently to strengthen and expand the capacity of public dental services for children and special care patients and to commit to providing the required funding in budget 2025 to put the medical card scheme on a sustainable footing. We also require the Government to immediately begin engagement with the sector to reform the DTSS and to commit to publishing the heads of the long-promised dentists Bill by September 2024 to ensure patient safety. There are actions the Government can take but I have no faith that it will. I am certainly not taking the Government's so-called support and acceptance of this motion as any kind of shift from the inertia and inaction it has taken towards our dental services.

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