Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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My question relates to the lack of a school dental programme in County Monaghan. I submitted a parliamentary question on this and the response I got was very disturbing, to be honest. We all know that in all areas of health care, early intervention is crucial. Prevention is preferable to treatment. Issues identified early allow for less intensive or invasive treatment. It is positive to introduce and reinforce positive dental hygiene and care from an early age. Dental is among the most basic of health services, so the Minister of State will appreciate my shock to receive a response from the HSE to a parliamentary question which outlined that no children in County Monaghan received a dental check-up in the last academic year. Actually, shocked does not go far enough; I was disgusted, to be honest. The HSE informed me that the reason for this was staff retirements, maternity leaves and the paucity of dentists available nationally. It is not too much for the people of Monaghan to ask the Minister that this service would be put in place immediately. Retirements are generally foreseeable and should not lead to collapse in the services. Maternity leave is a fairly common life experience which should not leave to a collapse in the service. Will the Minister of State ensure that the people of County Monaghan get their routine dentistry requirements and check-ups in national school?

It is also a question of accountability for the HSE and the Government on this matter. This scandal that no children in County Monaghan are receiving dental check-ups has brought both me and the Minister of State into the House this morning. What has brought us to this point is a broader mismanagement and, given the latest revelation, I would say maladministration of our dental services. At the heart of the issue is Government's failure to train enough dentists and overreliance on private dentists who are under no obligation to deliver this critical public service. To go from 770 children in 2021 who did receive routine check-ups to zero children last year in County Monaghan who received a dental check-up, leaving 832 children on a waiting list, is undeniably a collapse of the service. Does the Minister of State accept that there has been another collapse in the HSE school-linked dental programme in County Monaghan? What is she going to do about it and when is she going to do it? How many children in Monaghan will receive a check-up in this academic year?

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank the Deputy. This is a very serious issue for children who are waiting for public dental assessment in the Deputy's county of Monaghan. The HSE oral healthcare service aims to provide an oral examination and necessary treatment for children between second and sixth class and, in some cases, fourth class. Emergency care is provided for children of all ages up to 16 and for those with complex and additional needs. Due to the nature of the oral health examination programme, it does not meet the usual definition of a formal waiting list. However, children are deemed eligible on 1 September when they commence the relevant academic year.

The Department of Health engages with the HSE on an ongoing basis to understand and address any challenges arising in the provision of public oral healthcare services. The Minister for Health is aware that there are backlogs in the HSE’s child oral health examination programme which has meant that sixth class groups are being prioritised. Currently, capacity in the Cavan-Monaghan area is impacted by maternity leave which is reducing service provision. I take into account what the Deputy has said about the children over the last year who have not had a check-up. She can be assured that it will go back to the Department and the Minister for Health, Deputy Carroll MacNeill. The public dental service in Monaghan is currently targeting children in the 2023-24 academic year, 65% of whom have received assessments. There are 832 consents received from parents for children in the 2024-25 academic year who are waiting for appointments. So far in 2025, 425 sixth class targeted assessments have been completed in the Cavan-Monaghan area.

The Government acknowledges that more needs to be done to ensure these children can access their examination appointment. Building on investment of over €230 million per year in public oral healthcare services, an additional €2 million was awarded in budget 2025 to recruit 15 additional oral healthcare WTEs nationally. The Deputy is right that one of the biggest issues is recruitment. As she said, there may be staff out on maternity leave or there could be vacancies. That is an issue and a challenge for us. The good news for us is that there was funding in budget 2025 to recruit 15 additional oral healthcare WTEs nationally.

In the longer term, the Minister recognises that oral healthcare needs to be modernised in line with best international evidence and practice, as set out in the national oral health policy, Smile agus Sláinte. The €2 million budget 2025 investment will increase to €4 million in 2026. This supports the delivery of a three-year implementation plan for the policy, which is currently being finalised for publication by the Department of Health and the HSE. Service reform is vital to improve access to services in the long term, to ensure care is accessible from birth and is prevention based. The policy also highlights the need for strategic workforce planning to ensure a sufficient number of appropriately trained oral healthcare professionals, to include dentists, dental hygienists, dental nurses and other auxiliary grades. The Department of Health will continue to work with the HSE to continue to address any challenges arising in the provision of oral healthcare services and ensure the implementation of necessary reforms.

Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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I want to reiterate that although 900 people were assessed in Cavan, in County Monaghan zero children were assessed. That needs to change and something needs to happen immediately. Sinn Féin outlined our proposals to address the crisis fostered by Fianna Fáil and Fine Gael in our dental services. A year ago, my party colleague and Sinn Féin spokesperson, Deputy Cullinane, published our health plan. It highlighted that between 2019 and 2024, nearly half of dentists providing publicly funded care to medical card holders had withdrawn from the dental treatment services scheme. Nearly 80% of those who remained were not taking on new patients. The Government's oversight of the denial of services has been seen in low-income households that have been denied the opportunity to save teeth and prevent oral disease. In the long term, it will cost households and the State more. The Government has not heeded the warnings from the Dental Council of Ireland, the Irish Dental Association or Sinn Féin and we are dealing with the consequences. We can now pay heed to Sinn Féin's plan. The Minister of State needs to do this. We need to hire more dentists and dental care teams to target school screening for children and medical card holders. Sinn Féin would expand dental training places by 32% from 185 to 245, develop a modern general dental services contract, crucially including a public-only contract, and make necessary reforms to the Dentists Act. A year ago, Sinn Féin said we needed to get dental screening programmes in schools back on track. In my county of Monaghan, the programme has come off the tracks entirely. Will the Government implement the necessary measures that I have outlined?

Will the Minister of State give a guarantee that the schools programme will be reinstated in County Monaghan this year?

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I have taken the Deputy's points on board. She also spoke about Cavan, which was the one over the one-year period. I will bring that back to the Minister. The Government is committed to addressing immediate difficulties patients are experiencing in accessing oral healthcare services as well as fundamentally reforming dental services through the implementation of the Smile agus Sláinte programme.

The two key goals of the policy are to provide supports to enable every individual to achieve their personal best oral healthcare and to reduce oral health inequalities across the population by enabling vulnerable groups to access oral healthcare and improve their oral health. I can assure the Deputy that these are priorities for the Government. I do see the frustration. I am a mother and now have grandchildren so I know how important early access to oral healthcare is. Dental services are so important for us. I am very mindful of that.

The implementation plan will be published and will set out intended milestones and timing for the first phase and reform of the service for adults and children will be among the initial priorities. I am confident that by working together across relevant Department agencies and other stakeholders in line with their respective roles and responsibilities, the goals of the policies will be met to benefit children nationally and in the county of Monaghan. I thank the Deputy for raising a really important issue. I can assure her that the Government is committed to working on this.