Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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68. To ask the Minister for Health if there is a mandatory requirement for dental practices to accept patients with medical cards for treatment; and if not, the measures that are in place to ensure access to dental care for medical card holders. [10370/25]

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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I ask the Minister to clarify if there is a mandatory requirement for dental practices to accept patients with medical cards for treatment. What measures are in place to ensure access to dental care for medical card holders? What are the current procedures for emergency dental treatment for children under the age of 16 when dental clinics, such as the dental clinic in Cork city, are closed at weekends? What plans does she have to improve accessibility to urgent dental care for patients under the age of 16?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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Over €200 million is invested in public oral healthcare services annually. The dental treatment services scheme provides oral healthcare, free of charge, to medical card holders aged 16 and over, as the Deputy is aware. Services are provided by dentists and clinical dental technicians who hold a contract with the HSE.

It is not mandatory for a dental practitioner operating in the State to hold a contract to operate the DTSS. However, it is the Government’s continued intention to support and incentivise practitioners who choose to do so, in order that medical card holders can access vital oral healthcare.

In May 2022, the care available under the DTSS was expanded and the fees paid to contractors significantly increased by 40% to 60% to incentivise that across most treatment items.

Those measures did improve access to care and more than 44,000 extra patients were treated in 2024 compared with 2022. I know well, however, that there are some towns with no or limited DTSS dentists who have sufficient capacity to accept new patients. In those areas local HSE services can assist patients to access a dentist, and in exceptional circumstances where emergency treatment is required, the HSE can directly contact private providers or arrange treatment to be provided by HSE-employed dentists.

The Government is committed to reforming oral healthcare services through the implementation of the national oral health policy, which is particularly important for children. I might come back to that on the supplementary question. The programme for Government contains commitments to implement that policy and reform care for medical card holders. The first phase of implementation to end in 2027 is currently being finalised and it includes reform for services of medical card holders as one of several priority actions. Of course, the real differentiation relates to children and a model of prevention. Perhaps we will catch up on that in the supplementary question.

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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I appreciate the Minister's response and I understand the response but the DTSS programme just is not working. For instance, the working-class town of Mallow that I come from, which has 13,450 adults living there, has no medical card provided dentist practice. Nobody is accepting a medical card in Mallow. You must travel to Cork city or to Charleville, to Limerick or down to Kerry. Many practices have given up because the system is not working. Would the Minister agree that what we need to be doing now as a Government, or what the Minister needs to be doing as part of the Government - I am not in the Government yet-----

Peadar Tóibín (Meath West, Aontú)
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Soon.

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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Some day. Could we not start looking at a programme where medical cards are accepted in the same way as when a person goes to the GP and the dentist would be paid in the same way GPs are paid, so everyone is covered and there would be buy-in from everybody?

The other reality is that there are situations in Cork city where if a young child falls off their bike and breaks their teeth, they have no access to the dental clinic on the weekend and therefore it is either accident and emergency or the mercy of a dentist who might accept a medical card. The reality is that a lot of them do not so children are without teeth or parents are faced with bills of €4,000 or €5,000 to replace them.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I accept there has been an issue with the DTSS and the contractors numbers, notwithstanding the increase in fees and the increase of 44,000 in the number of patients being treated, which is something. Nevertheless, our figures for contractor numbers have gone down very considerably, from 1,500 in 2019 to 813 in 2024. In Cork and north Cork those numbers have gone from 35 to 26. I accept that. The new policy is designed to try to reflect this and reform that service delivery. The new policy sets out detailed descriptions of envisaged service reforms, which are about prevention, routine and emergency care, and oral health evaluation. That reform of the DTSS will be impacted by this new policy. It sets out for the first time that there will be comprehensive modern and clinical infrastructure supporting oral care. The child oral health examination programme, which is delivered by HSE-employed oral healthcare professionals, is to provide examinations and treatment identified as necessary from the age of seven up to when a child is in sixth class. Emergency care is also available from the HSE for children up to the age of 16.

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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I thank the Minister but, as I pointed out, emergency care is available but is not available all the time. What does a parent do when their child is suffering? Parents have to find the money somewhere and they will beg, borrow and steal to protect or save their children. In my constituency of Cork North-Central many people have come to me and said they had to borrow money from friends or family because they had no access to dental care for a child over the weekend due to an accident. That is €2,000 or €3,000. It is simply not good enough.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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No, it is not sustainable and that differential in money is not fair. This is why the emergency services are attempted to be covered by the HSE. We really do need to move to that new oral policy which provides fair and open access to people across every community and in a targeted way. That is about prevention as much as about emergency care. I appreciate what the Deputy has said about accidents, which is a slightly different thing, but this is about general oral healthcare. We need to focus on the implementation of that new policy, which is aligned with Sláintecare in providing care where it is needed and when it is needed at the right time.