Michael Moynihan (Cork North West, Fianna Fail)
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I thank the Acting Chairman and the Office of the Ceann Comhairle for giving me the opportunity to raise this issue. In the past year or so in particular, many of my constituents who have a medical card have contacted me regarding their inability to access dental care. It seems that dentists have moved away from medical card patients. Obviously, dentists are overwhelmed by the volume of work they are doing and all dental practices, which do great work, are overloaded with case work. However, an issue has arisen, which is that some dental practices do not have the capacity to take on medical card holders. Right through, people have been ringing my office to say they cannot get a dentist because the dentists no longer take medical cards. I thank the Minister of State for taking this issue. I want to understand why dental practices throughout the country, not just in my area, are moving away from taking on people with a medical card. Those with a medical card can access GP services through their card. The medical card is means-tested and, as such, holders may not have the funds to access serious dental treatment when in crisis or severe pain.

They also want routine dental treatment. This is not only for adults but for young people as well who have to get dental treatment. The Government needs to first of all acknowledge that there is an issue throughout the country with dental practices being unable to take on medical card holders and to understand the reason for this. I am always asking why treatment is not available for this group. The Government needs to forcefully look at this issue which is developing up and down the country. People are travelling long distances to dentists who accept the medical card. It is leading to major anxiety and challenges and storing up problems, even on the routine side of dental treatment. If that is not done properly, it will store up more problems down the line and the Government, through the Department and the HSE, will have to deal with it.

Will the Minister of State acknowledge the crisis and that something needs to be done? We need to understand why dentists have moved away from accepting the medical card. What does the Government or the HSE intend to do to resolve this issue? It is fundamental that everyone is able to access dental treatment whatever his or her income level. We are a republic and we should ensure everybody gets the treatment they deserve, be that acute or routine dental treatment. I ask the Minister of State to acknowledge this issue and see can be done to resolve it. It is a problem in my area and throughout the country.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Deputy for raising this important matter, which I am taking on behalf of the Minister for Health, Deputy Stephen Donnelly. The Minister is acutely aware that access to dental services for medical card holders under the dental treatment services scheme, DTSS, has become an ever-increasing problem during the pandemic. The problem is that too many dentists contracted by the HSE to treat medical card patients have chosen to leave the scheme. This has led to difficulties for medical card patients in accessing dental care. There is the added problem of medical card patients being displaced by the abundance of private work. I know some parts of the country have been particularly affected and the Minister is very concerned about this.

The Minister has listened to the dentists and the Irish Dental Association and has heard their frustrations with the scheme. They are firmly of the view that the range of services available to patients under the scheme and the fees payable to contracted dentists are out of kilter in today's environment. The Minister does not disagree with them. He fully accepts there is a need to align the scheme with best international evidence and practice, as outlined in Smile agus Sláinte, the new national oral health policy which was published in 2019. Regrettably, the Covid-19 pandemic caused the roll-out of the policy to be delayed and the proposed reviews of the DTSS to be deferred. However, the Minister has given a commitment that there will be a root-and-branch review of the scheme, and his officials and the HSE expect to be in a position to begin that work early in the new year. In the meantime, he wants the contracted dentists and their representative association, the Irish Dental Association, to work with him and his officials to address the immediate issues of concern and ensure we have an abundance of dentists available to provide services to medical card patients.

The Minister has also heard what the dentists had to say about the viability of the scheme, and he wants that addressed too. He secured an additional €10 million in budget 2022 to address that problem and he hopes an agreement can be reached very quickly on how that money can be used to address some of the immediate problems with the scheme, pending the full root-and-branch review.

I am aware that a preliminary engagement with the Irish Dental Association was held in June this year and that the Minister's officials and the HSE will invite the Irish Dental Association in for further talks in the coming weeks. The Minister hopes the association will respond positively to that invitation in order that we can put in place immediate solutions for the benefit of patients and the dental community. In the meantime, his officials are engaging with the HSE public dental service, the in-house salaried service, which is seeking to provide cover for any medical card patients who are experiencing problems in accessing a service from their local dentist.

Michael Moynihan (Cork North West, Fianna Fail)
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The issue here is that dentists have withdrawn from the scheme. I gather from the Minister of State's reply, for which I thank her, that an engagement was held in June. That is almost six months ago. This is a crisis. What has happened during those six months? Extra funding has been made available in the budget. What is the commitment? I fear the words "early in the new year". There are a number of weeks left in 2021. The urgency of this matter does not merit waiting until the new year or four, five or six weeks for serious engagement with the Irish Dental Association to take place. During the meetings held in June, the Department and HSE were obviously made aware of the issues on the dental side that were making the scheme unworkable. The dentists are only withdrawing because the scheme is unworkable. What are the issues that caused them to withdraw from it?

I implore the Minister of State to ask the Minister and the HSE to arrange immediate discussions with the Irish Dental Association, not in a number of weeks' time but this week and next, to try to find a solution for this. Deputies are being contacted by many people in acute pain who have been looking for help and support to get dental treatment. That is not acceptable in this day and age.

I ask the Minister of State to impress on the Minister the need to immediately start talks with the Irish Dental Association and to put a resolution in place that will bring dentists back into the scheme and ensure people with medical cards can access dental treatment. This is a matter of extreme urgency.

Anne Rabbitte (Galway East, Fianna Fail)
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I take on board everything the Deputy said and I will liaise directly with the Minister, Deputy Donnelly. It is important to say on his behalf that his officials have been engaging with the dental profession. He has secured funding. I will speak to the Minister about taking immediate action and engaging with the Irish Dental Association. All Deputies are contacted by constituents who are severely impacted by this, such as a 17-year-old who needs to have her teeth cleaned before she gets orthodontic treatment and cannot access treatment. It is creating delays and causing a crisis of confidence for young people. People are in extreme pain. The confidence issue has a huge impact on young people. In that regard, I will take the matter up with the Minister, probably tomorrow.