Charles Ward (Donegal, 100% Redress Party)

I thank my colleague, Deputy Stanley, for tabling this motion, which I fully support. Dental care is completely inaccessible, especially for people in rural areas. In Donegal, children are lucky if they have seen a dentist once by the time they are finished school. Many of them have not seen one at all. I know this from experience, as I have four children. Maybe one has seen a dentist but the rest have not, unless we go privately. The Irish Dental Association has outlined that just half of the children targeted for school dental screening were screened in 2022. Of those who are seen, many are seen late, with almost a ten-year backlog in accessing services in parts of the country.

It is very common for children in Donegal to receive their first appointments when they are nearly finished primary school or well into secondary school. The HSE threshold for children and teenagers to avail of essential dental treatment like extractions or orthodontic work is far too high. Many children in Donegal are forced to go across the Border to access essential dental treatment. This is not for cosmetic procedures; this is for essential treatments. The application process can be complex and confusing, with many constituents feeling misled or unclear about the eligibility requirements. Some of the requirements to ensure reimbursement are unnecessary and, frankly, ridiculous. When people go into the North to visit a dentist, they have to purchase an item from a shop in the North so as to have a receipt to show they are actually in the county of Derry or Tyrone. That receipt would then be proof instead of the dentist actually filling in the paper. Dentists do not take that. People must have the receipt. Some of the requirements to ensure reimbursement and some of the things people have had to do are bizarre.

Many people are unaware of these requirements, believing the application and confirmation from the clinic would be enough. This is not the case, and many people are misled and some are out of pocket for significant amounts of money. The Ombudsman himself, Ger Deering, has criticised the HSE for an unreasonable, inflexible approach to administrating the scheme. It funds treatment abroad for healthcare that the State is either unable to provide or unable to provide in a timely manner in Ireland. In his report, entitled "In Sickness and in Debt", the Ombudsman found that some patients faced a fight to be reimbursed for the legitimate costs they had incurred for necessary treatment they had received abroad. Many people were forced to borrow money, and some fell into debt as a result. In other cases, approval to have treatment abroad was unreasonably refused or delayed. This is completely unacceptable and it is clear that the application process needs to be far more accessible and the scheme needs to be flexible.

We also need to address the severe lack of dentists. This is what is causing such a backlog. Last year, there was only one dentist per 2,500 eligible medical card patients in Ireland. One in six patients on private dental care waiting lists is waiting over three months for an elective appointment, while half of patients are being forced to wait longer than three months for specialised care. The Irish Dental Association has outlined issues regarding staffing across the sector, which is limiting capacity and patient access. Our overreliance on non-EU students at our dental schools is growing, so we need to increase the number of places available to undergraduates in the country. We need to start taking necessary steps to address this.

I agree with this motion.

We need to provide a significant increase in dental school places in University College Cork, UCC, and Trinity College Dublin, but we also need to expand significantly beyond Dublin and Cork. It is clear that we need to establish a new dental school, and this should be established in the north west. I do not believe we can properly address issues in the public or private dental sectors, particularly in rural areas, without establishing a dental school in the north west. The Atlantic Technological University is steadily growing. It is developing its campus. There are new courses going on all the time. The university should be supported in establishing a dental school to address the staff shortages and clinic closures we are seeing across the country.

The HSE needs to step up its recruitment. There are dentists in County Donegal and beyond who would work and who would help. The Government needs to ensure significant investment to make sure this is addressed in this upcoming budget. Oral health has often been left behind in health budgets despite the fact that so many oral health issues are preventable. Early intervention is available to ensure issues are caught in time. However, like everything else, the Government sits on its hands and allows issues to grow and fester until we have a full-on crisis. It is time we break this vicious cycle.

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