David Cullinane (Waterford, Sinn Fein)
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3. To ask the Minister for Health her plans to bring forward legislation to enhance the powers of the Dental Council; and if she will make a statement on the matter. [17628/26]

David Cullinane (Waterford, Sinn Fein)
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The Dental Council of Ireland does not have sufficient powers to protect the public from unregistered dentists. It has been unable to act in 80% of cases of credible concern of unregistered dentists in the past three years. I have met council representatives on a number of occasions. I assume the Minister has as well. It has been raising this matter for some considerable time. I also know compulsory continuing professional development, CPD, is important and the Minister is working on it and has supported it. Regulation and powers for the Dental Council of Ireland are what is at play. Will she set out her intentions are in this regard?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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There is no question but that the regulatory framework requires updating and modernisation. It is closely linked to the wider implementation of the national oral health policy. Ahead of comprehensive reform, several priority interim amendments have been identified particularly to strengthen the powers of the Dental Council of Ireland. The first amendment addresses the lack of a statutory basis for continuing professional development, as the Deputy highlighted. While dentists are currently required to meet ethical CPD standards of course, that is not enough and they must be underpinned by legislation. A policy has been developed to introduce CPD on a statutory footing, which will enhance the Dental Council of Ireland’s ability to ensure dentists undertake adequate and appropriate ongoing professional development. I have received Government approval for that policy along with consent to draft the general scheme of the Bill. My Department is now preparing the heads and associated regulatory assessments. We will deal with that in the Oireachtas in due course.

With regard to unregistered dentists, powers to address the illegal practice of dentistry by unregistered individuals exist under the Dentists Act 1985 and other legislation. Under the Dentists Act it is an offence for unregistered persons to use the title of dentist to provide dental treatment or present themselves as dentists and the council may prosecute such cases. In addition, under the Consumer Protection Act 2007, the council can also seek court orders to stop dental practices from operating if they enable unregistered individuals to practice illegally. All suspected cases of illegal dental practice should be reported to An Garda Síochána. Unregistered individuals who treat patients while masquerading as dentists may also have committed assault under the Non-Fatal Offences Against the Person Act 1997 or have breached the Criminal Justice (Theft and Fraud Offences) Act 2001. Those offences carry significant penalties including imprisonment.

David Cullinane (Waterford, Sinn Fein)
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I welcome the wider work but the Dentists Act, an issue I have been over several times, does not provide the Dental Council of Ireland with sufficient powers to deal with unregistered dentists. In fact, it has been saying recently that it has not been able to take action against a total of 37 unregistered dentists over the past eight years, including one who was practising unregistered with a sexual assault conviction. I met a locum dentists recently who spoke to me about some horror stories of him being placed in unregistered dental practices. Some of the stuff would make the hairs stand on the back of your head. He was very concerned. There needs to be a review of that Act. I agree with Minister about the wider issues, a new oral health policy and stronger regulation and so on but if it is a case of right here, right now, the Dental Council of Ireland tells us it does not have sufficient powers. It may have some powers and there are other powers but these dentists are going undetected, are not properly sanctioned and I am hearing of these horror stories. I think this was reported in The Irish Times last week as well. They are serious issues that need urgent intervention.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I agree with the Deputy. While the broad legislative suite is in place and there are existing powers are under the Dentists Act, I have no difficulty with a review and strengthening them where needed. I recognise the suite of legislative powers I outlined so we need to be very specific as to the additional powers necessary. I have no difficulty in strengthening the powers of the Dental Council of Ireland to do just that. We are talking about potentially unremediable assault on a person in their mouth or on their face. It is an appalling thing to happen to any person. We need to make sure the powers are as robust as necessary. There is simply no question on that. I signal a change I want to make to the Act to enable direct access for dental hygienists. That would require an amendment to section 54. Direct access refers to the ability of a dental hygienist to initiate treatment within their scope of practice based on assessments of patients' needs without the specific authorisation of a dentist. That is a change I want to make to enable the workforce but that is for dental hygiene work not necessarily dental work. There is distinction, of course.

David Cullinane (Waterford, Sinn Fein)
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I welcome that as well. It will add real value. The Minister spoke about oral health generally. The are issues with screening in schools. Enough simply is not being done. There is a need for more publicly hired dentists. I have made the same argument in relation to GPs. I would like to see a public GP contract but for dentists we need to look at that space. Dentists are not engaging with the dental treatment services scheme. There are rights and wrongs on both sides. I have said to dentists and the representative body that there is an obligation on dentists to ensure the most vulnerable patients have access to services. We need to beef up the public system particularly in terms of screening and orthodontists because of the waiting times.

This is particularly the case in the south east where I live, where children are waiting four, five, six or in some cases even eight years. They are listed as urgent cases and the most urgent cases are when children are in pain. There is a lot of work to be done in this area. I acknowledge what the Minister has said but there are so many issues to be addressed.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I agree with the Deputy. At the moment I am trying to develop a programme with Pat Healy in the HSE, who is doing excellent work on a very targeted programme of intervention to get on top of screening in schools and make sure we can address the backlog, particularly in relation to orthodontic work and specialised orthodontic work. I have given a direction to all of the various regions that I expect our new surgical hubs to have a measure of dental capacity in them, whether it is once a month or whatever it happens to be, so that access to theatres is there equally for dentistry in the community and to ensure we have pathways. I acknowledge there is a considerable work to be done and I will bring forward a plan and proposals on this.

I welcome the Deputy's engagement with the dental associations. We do need to hire more public dentists. They have suggested to me that part of the graduation programme could be that qualifying dentists spend a period of time in the public system, something I would greatly welcome. It would give dentists who do not have an opportunity to train in public practice the opportunity to be in public practice. It is too private, too remote and too disconnected from the public health system. If part of the training was that we got the benefit of a graduate spending a year in the public system, I certainly would be very much in favour of that proposal.