Colm Burke (Cork North-Central, Fine Gael)
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The issue I wish to raise, which I am aware was raised in the House recently, relates to the number of places for dental students in Ireland. In UCC in 2023, 61 students qualified as dentists. Of these, 25 were European, including Irish, and 36 were from outside Europe.

In Trinity the same year, 41 students qualified. Of these, 25 were Irish or European and 21 were non-Europeans. We have a huge shortage of dentists who are prepared to provide a service for public patients, yet they are providing treatment if you attend as a private patient. The number providing public care has dropped from 1,450 to 810. The latter is the most recent figure available and relates to 2023. The number has, in fact, fallen below 810 at this stage. The number receiving treatment who are public patients dropped from 393,000 in 2012 to 283,000 in 2023. That is a decrease of 110,000.

There is also a substantial problem with regard to people who have intellectual disabilities in that access to care is not there for them. I had one case recently where the family involved had to pay out for private care that cost more than €10,000. Care is available but there is a substantial waiting time of anything up to 12 months, even for the most urgent case. This issue needs to be dealt with, first in the context of engagement with the Irish Dental Association and trying to get more dentists to take on public patients or people with medical cards. The second issue is training. We have got to dramatically increase the number of students who qualify each year who are more likely to stay in Ireland.

I fully accept that the Royal College of Surgeons in Ireland intends to start a new training programme, which will involve at least 20 Irish students. I do not think that is sufficient for the demand that exists. For instance, within a mile radius of my constituency office in Cork, two dental practices have closed because the owners could not get anyone to take them over. They wanted to retire. We will have a huge number of dentists retiring out over the next five years. We have got to deal with this challenge now. The other figure given to me by the Irish Dental Association is that 75% of dental practices that wanted to recruit someone in 2023 failed to fill the vacancies that were there. We have got to deal with this as a matter of urgency.

It is not a case that universities have to take on extra staff. It is a case of reducing the number of non-European students taken in and increasing the number of Irish students taken in. This will really help. Even if we do that in the morning, we are still five years off having those qualified dentists available. This now needs to be given priority by the Department. It has to be done in the next three or four weeks before the universities make final decisions about admissions of students for 2025. That is why I am raising it a second time in a very short period.

Marian Harkin (Sligo-Leitrim, Independent)
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I sincerely thank Deputy Burke for raising this important issue. This is his second time to raise it in a number of weeks. It relates to the availability of dental training places in Ireland.

The Government is committed to ensuring that our healthcare system is supported by a steady and sustainable pipeline of highly skilled graduates. In fact, my Department has just progressed an immediate expansion of 461 places in key health and social care professions. I know dentistry is not included, but it does show the commitment of Government to ensuring that we expand the health and social care workforce.

To come back to the issue at hand, my Department, in collaboration with the Department of Health, the HEA and higher education institutions, plays a central role in delivering the education and training infrastructure needed to meet the evolving demands of the healthcare workforce, including critical areas such as oral healthcare and dentistry. Ensuring adequate capacity to train future dentists is part of our broader commitment to workforce planning that will support the health and well-being of our population.

Until this year, 60 places, as the Deputy said, were available each year to Irish and EU students on dentistry courses. My Department recognises that this represents a limited training pipeline at a time when the demand for oral healthcare, both clinical and preventative, is increasing nationally. The number of places offered is a matter for the higher education institutions in line with their autonomy. I acknowledge, however, that due to a high level of practical work, there can be material constraints on the number of students that can be accepted into dentistry courses.

While my Department does not set quotas for student places, we work closely with the Department of Health and the HEA to explore how capacity can be sustainably expanded in key health disciplines, including dentistry. In 2023, the HEA carried out a targeted capacity expansion exercise across priority healthcare areas. One key outcome was the establishment of new dentistry programmes, including a new bachelor of dental surgery at the Royal College of Surgeons in Ireland, commencing in 2025, as the Deputy mentioned. This new programme will provide at least 20 new dentistry places per annum for Irish-EEA students, significantly enhancing national training capacity. This expansion represents a landmark 33% increase in student intake and clearly demonstrates my Department’s and this Government’s firm commitment to strengthening the oral healthcare workforce and supplying the graduates needed for a modern, accessible health service.

My Department and the HEA are currently liaising with RCSI as they develop capacity for further expansion of 15 additional places from 2027, subject to approvals. I reaffirm the Department’s commitment to working with all of the relevant stakeholders to ensure that any future expansion of dental education is grounded in evidence, responds to national needs and is delivered in a sustainable manner.

It is also my understanding that the Department of Health is currently conducting a scoping exercise to support a skills assessment workforce census across oral healthcare services. This will be the foundation of future policy development.

Colm Burke (Cork North-Central, Fine Gael)
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I fully accept that the Minister of State and her Department are working very hard on this issue, but there is a crisis here. We have got to deal with it before the college places are awarded in UCC and Trinity. That is the reason why I am asking the Department to engage with them.

The other issue that needs to be dealt with - and this is a case where both the Department of Health and the Department of higher education need to work - is that there needs to be a clear plan put in place to deal with the number of dentists retiring over the next five years. Even if we increase the number of student places, we will still not deal with that issue. There are figures available. I am surprised that the Department of Health did not look at far earlier. I am concerned by what the Minister of State said about its engagement in a process. Engaging in a process may take two years. This is a priority. The figures are clear. Some 110,000 fewer people are being seen under the public scheme for dental care. In addition, there are 30,000 fewer students in our primary schools being reviewed by dentists. That figure is from 2017.

The other issue that has come to my attention is training for dental hygienists. For instance, I understand that in Trinity last year, there were 12 people taken in on the dental hygienists' programme. There were more than 200 applicants. Again, dental practices are not able to recruit people because there are not enough people available. People are going abroad to train in that area. Likewise, students who cannot get into the Irish system for dental training are going to places like Poland for training.

It is an absolute disgrace that Irish leaving certificate students who are competent and want to go into this area have to go abroad while 44% of all dental students in Irish colleges are from outside the European Union. That has to be addressed.

Marian Harkin (Sligo-Leitrim, Independent)
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I assure the Deputy, on behalf of the Minister, Deputy Lawless, that we are committed to responding proactively to future workforce requirements, including dentists and all other professionals required within the oral healthcare sector. We are working in strong partnership with the Department of Health, the HEA and the higher education providers to ensure our education and training system supports the delivery of a modern, sustainable and people-centred health service.

The Deputy mentioned UCC. The Department of Health has received a strong proposal from University College Cork, requesting €4.7 million in capital funding to establish a dental outreach centre that would enable the training of an additional ten undergraduate dental students annually, particularly benefiting Irish and EU students. This initiative will offer students earlier clinical exposure in real-world primary care settings, which enhances their skills and readiness upon graduation. Discussions are currently ongoing between the Department of Health and my Department to try to progress this proposal with a view to maximising Irish and EU places to obtain value for money for this proposal. Officials from my Department, the Department of Health and the HEA are meeting UCC next week to discuss the proposal. I expect to have more information and can give a further update to the Deputy after that date.

The Minister, Deputy Lawless, is visiting UCC next week for a separate engagement, and he looks forward to discussing this proposal and other important future developments with the UCC president.

Pádraig O'Sullivan (Cork North-Central, Fianna Fail)
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I am sorry. We have to move on.

Colm Burke (Cork North-Central, Fine Gael)
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May I just mention-----

Pádraig O'Sullivan (Cork North-Central, Fianna Fail)
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We have to move on, sorry.