Paul Murphy (Dublin South West, Solidarity)

I thank Deputy Stanley for bringing forward this motion. It is striking that oral health is not much discussed in this House. This reflects a neglect that exists within our State whereby we know that oral health is so important for overall health and well-being but it is neglected and seriously under-resourced in our public health system. If your teeth and gums are healthy, you are less likely to suffer from heart disease, cancer, chronic respiratory diseases and diabetes. Dental care is a key part of preventative healthcare that can keep everyone healthier for longer and lower costs for the HSE. At least it should be. Unfortunately, in Ireland it has been treated as a luxury only accessible to those with the ability to pay to see a private dentist. Scandalously, that goes for children as well as adults. Public dental care is extremely limited. There are long waiting lists. Fewer private dentists accept medical cards. Children are meant to be seen in first or second class but often this does not happen until secondary school.

A mother of a child with additional needs recently contacted me in relation to this. She says they are currently paying a private orthodontist to help with their daughter's teeth because she urgently needs early intervention treatment and they cannot wait for the HSE. When the mother called the HSE, she was told that it could not help and that the child would not be seen in sixth class because the backlog is so big. She was also told that it would wait to see her for the first time in second year, most likely. If the family waits for this, their daughter will most likely need more intensive treatment and other treatments that would not be needed if she was seen when required. The mother tells me the HSE is currently only seeing kids for dental problems that are causing pain, so basically when it is too late. She says that all the waiting times are very frightening and the kids have been failed so badly right now, and that she just has to stand back and watch her daughter be failed in the context of multiple issues. She finds it absolutely heartbreaking that she cannot do anything else to help her. If this is not a common story, elements of it are definitely things I hear again and again. I refer, for example, to the complaint that people do not get prioritised in the public system until they are experiencing pain, that is, when it is too late. Kids have to wait to be seen and are then forced to go private, if their parents can afford to do so. In many cases, parents get loans in order to go private.

The cause of all this unnecessary suffering is deliberate underfunding and understaffing of our public dental service by successive Fianna Fáil and Fine Gael Governments. They have pursued a policy of privatisation by stealth. Public dental care in this country was never great, but it was decimated after the financial crash as a result of austerity cuts. That policy of starving the public system of resources continues today through the HSE pay and numbers strategy, which guarantees that there are never enough dental workers to staff the system properly. There are also nowhere near enough dental training places. In addition, inflexible working conditions force dentists to either go into private practice or emigrate. We still do not have any dental therapists. A dental therapist qualification is midway between those of dentist and dental hygienist. Dental therapists exist in many other countries and could help fill in the gaps here. The solution is to fund public dental services properly and to train and recruit hundreds of new public dentists and dental therapists. Public dental care should be available to all, free of charge, as part of a universal single-tier national health service. There should be no limits on care as proposed under Sláintecare, which has still not been implemented.

No one is going to the dentist for the craic, obviously. The right-wing argument that free healthcare will encourage overuse is even more wrong for dentistry than for other forms of healthcare. Free dental care - free healthcare - would encourage people to go early to ensure prevention rather than seeking a cure later. We know that prevention is always better than cure. Even from the point of view of cents and euros, it makes sense. Regular, free dental examinations, with treatment from an early age preventing more serious problems later, make obvious good sense. The only argument against it is an ideological preference for privatisation and private profit. For Fianna Fáil and Fine Gael, these will always take precedence over public health. We need a renewed mass movement for universal free public healthcare, including free oral healthcare. A left government is needed for this change to happen, together with the mass movement to which I refer.

See this speech in context