Kieran O'Donnell (Limerick City, Fine Gael)

I thank Deputies across the House for their contribution to the debate. I also thank Deputy Stanley for bringing forward the motion.

As the Minister of State, Deputy Butler, announced, the Minister for Health and the Government are not opposing the motion, which provides a chance to update the Dáil on developments in this sector and to outline the Government's priority to fundamentally reform dental services.

As the Minister of State noted, there was €4.85 million in additional HSE funding this year, building on an additional €15 million in core HSE funding from 2022 to 2024 and a further additional €17 million in one-off HSE funding in the same period, which is supporting the ongoing work to reduce waiting lists and address access to services through policy implementation. Further, expenditure on the dental element of the PRSI-based treatment benefit scheme administered by the Department of Social Protection increased by more than €11 million in 2024 compared to 2023, bringing it to €75.4 million. A total of 1.7 million dental claims were processed under the scheme in 2024.

I assure Members that the Minister for Health, Deputy Carroll MacNeill, and her Department appreciate the difficulties experienced by people seeking to access oral healthcare and we will continue our ongoing work to address this. We are easing current access issues through a range of measures, which include a 40% to 60% increase in payment for treatments under the dental treatment services scheme and additional staffing for the HSE oral healthcare service. Ultimately, implementation of the national oral health policy will achieve the substantive service reforms that are required to ensure that patients can access the care they need, as set out in international best evidence and practice. Collectively, these reforms will examine the scope of oral healthcare in Ireland to ensure a focus on basic and essential oral healthcare, provided in a reoriented community-based model of care so that our most vulnerable can access the care they need. The State has a responsibility to do this. In turn, we recognise that the oral healthcare sector must be enabled and supported to provide this evidence-based care through an appropriate framework of professional regulation, education and training and strategic workforce planning, as well as modernised contractual arrangements.

The national oral health policy, Smile agus Sláinte, sets out the vision for the future of oral healthcare services in Ireland. The policy was informed by considerable evidence inputs, including the support of an oral health policy academic reference group, consultations with key stakeholders, considerable feedback from a number of consultations with front-line workers, including dentists and auxiliary dental workers, and a comprehensive qualitative research project.

This policy constitutes a body of very wide-ranging and transformative reforms. The implementation plan for the 2025 to 2027 phase is being finalised by the Department of Health and the HSE. The lengthy phase of policy development was fully cognisant of two policies in particular, which have provided the framework for the vision of transformative change that Smile agus Sláinte sets out.

Smile agus Sláinte is based on technical concepts that the World Health Organization has endorsed for several decades, including the emphasis on preventative care, the provision of care in a primary, rather than acute, setting, and the integration of oral healthcare into general healthcare. Accordingly, Smile agus Sláinte reflects the ethos, practices and intentions of the WHO’s global oral health resolution, strategy and action plan.

Smile agus Sláinte also applies the Sláintecare vision of enabling patients to access the right oral healthcare in the right place at the right time, based on best international evidence and practice. The designing and development of oral healthcare packages for adults and children that is under way within the HSE represents a significant expansion of preventative care. The delivery of these packages by local dental practices under contract to the HSE will allow patients and families to attend a local practice of their own choosing for continuity of care and to prevent problems before they arise. This will also allow dental practices to build enduring relationships with their patients.

The Sláintecare approach also means that people should have sufficient access to care from birth and across the full life course to prevent problems before they arise. This is why starting with our zero– to two-year-olds, who can currently only access emergency care, is a priority.

The HSE oral healthcare service will continue to play a core role in oral healthcare provision. The changes envisaged will increase the capacity of the HSE 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. This a considerable change, based on the evidence identified. The Government will work with the sector to support these developments.

A key enabler of this transition towards the Sláintecare ethos is ensuring that we have a sufficient number of appropriately trained oral healthcare professionals. We need to consider educational models that enable students to experience care provision in community settings, including within our most vulnerable communities. We currently have more dentists on the Dental Council’s register than ever before, with 3,888 as of July 2025. There has been a steady increase in the number of registered dentists since April 2019, when Smile agus Sláinte was published, from 3,100 - an increase of more than 25% - but many more are needed.

The Department of Health is committed to the development of an oral healthcare workforce plan, as set out in the national oral health policy. This workforce plan will consider how dental professionals can best support the new model of oral healthcare services and how they, in turn, can be supported with career pathways that support staff retention. We will progress consideration of the role of the wider dental team and expand the scope of practice of oral health professionals where appropriate. This will support increased capacity and access and give patients greater choice.

To support this work, the Department is finalising the design of the first oral healthcare workforce census skills assessment. The workforce census will gather information, including the proportion of registered oral healthcare professionals who are practising in their registered profession, the services they provide and the skills they have. The census data will provide information to support the development of the sector and support workforce planning by identifying the skills that oral healthcare professionals need to provide the new model of service set out in the policy.

This Government is firmly committed to ensuring our healthcare services are supported by a steady, sustainable pipeline of highly skilled graduates, and one of the programme for Government commitments is to increase the number of healthcare college places, including in dentistry. The RCSI will commence a new bachelor of dental surgery this September, which will train students in a community-based model of dental education, significantly increasing the number of dentistry training places available nationally and expanding access to dental services. Last week, the Minister for Health officially opened the new Dental Education Centre in Sandyford. This is the first of three proposed facilities that the RCSI is developing to facilitate the delivery of its new bachelor of dental surgery. This new programme will significantly increase the number of dentistry places available in Ireland and provide 20 new dentistry places per annum for EU-EEA students from 2025 onwards. It will also have a focus on delivering a primary care-oriented model, in line with policy.

The Government remains committed to supporting oral healthcare and dental education. By enhancing our future workforce, we are taking important steps to ensuring that our national oral health policy, which supports greater access to care across the life course, is implemented.

The Minister for Health will continue the ongoing work to address the access issues that are affecting current healthcare services and will progress work on implementation of the national oral health policy, which sets out a body of transformational reforms. Along with the Minister of State, Deputy Butler, I thank Deputies across the House once again for their contributions and reiterate the Government's commitment to improving our oral healthcare services. I also thank Deputy Brian Stanley for tabling this motion.

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