Seanad debates

Thursday, 26 January 2012

1:00 pm

Photo of Trevor Ó ClochartaighTrevor Ó Clochartaigh (Sinn Fein)
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Cuirim fáilte roimh an Aire Stáit. Gabhaim buíochas léi as ucht teacht isteach chun an cheist seo a phlé. Tá an fhadhb seo beag, b'fhéidir, i gcomhthéacs na tíre, ach tá sí mór dóibh iad siúd ar a bhfuil sí ag cur isteach. The major cutbacks that have been made to dental services throughout the country since budget 2011 have had a big impact in smaller rural areas. These problems have come to the fore in the Connemara area in recent weeks. The chief executive of the Irish Dental Association, Fintan Hourihan, said last year that Irish dental care is in a state of emergency and requires urgent assistance as a result of a mixture of official neglect and ongoing cutbacks. He continued:

Two thirds of dentists say they are now referring more patients to hospitals while 73% are referring more patients to HSE dental clinics. We predicted this would happen when the cutbacks were announced. We now fear that patients are in for a lot more pain and delays because the system is buckling under the pressure.

Early last year, subsidies for dental care under social insurance were slashed, as were entitlements to routine dental care for medical card patients. Some 88% of the dentists who were polled did not believe the public is aware of its remaining entitlements under two dental health schemes. This is having a particular effect on small rural communities, such as those in Árainn and Connemara. Local people in Carna were not given any news on the ending of the dentistry service that had been provided by the HSE and the health services for many years. They only heard about it in the last couple of days. The dental services provided in Connemara will be reorganised from next month. Alternative arrangements are being made to replace the service that is currently provided from the health centre in Carna one day a week.

This decision was made on account of staff shortages and the HSE being unable to replace staff who leave the service due to the public service moratorium on recruitment.

Currently, a limited service is provided by a dental hygienist in Carraroe and from February a dental team will be in Carraroe for one day per week to provide an elective and emergency service to the area. Patients who currently attend the one day per week clinic in Carna will be asked to attend clinics in Clifden or Carraroe. We are told the dental team will contact patients to rearrange appointments in Clifden or Carraroe. This will affect students in nine national schools that are served by the clinic in Carna.

The children of the area are being unfairly targeted due to the harsh cutbacks and the moratorium on recruitment in the HSE. This is inequitable, unfair and unacceptable. It is also very unfair to expect people to bear the extra travel costs pertaining to attending the basic services, as outlined, which could have a detrimental long-term effect on their health. I urge the Minister to use his influence to ensure that these services remain in Carna where they are accessible to the community, rather than take them out of the community.

The children in Carna are having their one day per week taken away and it is being given to the community in Carraroe, where we have already had a bad service. There is quite a distance between the two places and there is no direct bus service between Carna and Carraroe or between Carna and Clifden. Anyone who does not have a car cannot get to the clinic. Travelling also means taking children out of school for half a day and parents having to take time off work. The move strikes me as being very unfair.

I urge the Minister to see if there is any way the moratorium on recruitment can be addressed in this situation. I know that exceptions have been made in some cases and this is an area where an exception should be made. It would be for the benefit of those children. This is a very important service.

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
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I thank Senator Ó Clochartaigh for raising this issue. No matter where a service is provided parents will have to take time off work to take their children to dentists.

Photo of Trevor Ó ClochartaighTrevor Ó Clochartaigh (Sinn Fein)
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They might not have to spend half a day travelling.

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
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I understand that and I understand the distances. I say this because I am not certain anything I have in my reply is any different from what Senator Ó Clochartaigh has already said. I hope he accepts that. I accept that there are huge distances involved. I understand that the distances and the nature of the terrain mean this case is different. That is accepted.

I wish to address the provision of public dental services, in particular for children in Connemara and the Aran Islands. The public dental service provides emergency, routine and preventive oral health services to children under 16 and to people of all ages with special needs. The services are delivered by dentists, dental nurses and dental hygienists employed by the HSE. Galway local health office area provides dental and other health services to Galway city and county. It has a population of approximately 254,000 and is served by nine dental teams. Services provided by the dental teams include services for those with special needs; general anaesthetic services for both those with special needs and children requiring same; emergency services; screening and treatment for all 6th class children before entering secondary school; and orthodontic assessments.

Where resources permit, additional school classes are screened and preventive care and treatment provided. Staffing for dental teams in Galway is expected to reduce after February 2012 due to early retirements. Galway local health office area teams will be further reorganised at that time to include realignment of staff to ensure that equity of services is maintained across the area. The vast majority of children from the Aran Islands avail of services provided in Galway city.

The HSE is to consider the possibility of providing a school screening service on the Aran Islands so as to reduce the need for children to travel to the mainland. From next month, the dental services provided in Connemara will be reorganised. Alternative arrangements are being made to replace the one day a week service currently provided from the health centre in Carna. Patients who currently attend the one day a week clinic in Carna will be asked to attend clinics in Clifden or Carraroe, as the Senator has already outlined. The dental team will contact patients from the nine primary schools served by Carna to rearrange appointments for them in Clifden or Carraroe clinics. This centralisation of the service is necessary to ensure that standards for infection control are maintained at all of the clinics within the Clifden Primary Care Network. Refocusing services to fewer clinics ensures maintenance of standards. Centralisation is necessary also to ensure that sufficient staff are available regularly to service all of the clinics.

The clinic in Carraroe has been upgraded recently. It currently has a limited service provided by a dental hygienist. From February a dental team will provide an elective and an emergency service to the area for one day a week from the Carraroe clinic. Works on the clinic in Clifden are currently underway to ensure that it meets the national standards on infection control. The Clifden Primary Care Network area which includes the dental clinics at Clifden and Carraroe and also a clinic in Oughterard, serves a population of approximately 34,000. A total of six days of dental services is provided per week from this Primary Care Network.

Photo of Trevor Ó ClochartaighTrevor Ó Clochartaigh (Sinn Fein)
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The Minister of State mentioned that the Carraroe clinic was recently upgraded for reasons of safety and standards. Does that mean the clinic in Carna which was upgraded only in the last year or so is not up to a sufficient standard? It is my understanding that the clinic was only set up in the last year or so. If so, how did that happen?

The Minister of State has not addressed the issue. These cutbacks are very unfair. I ask the Minister to discuss this matter again with the HSE. The new arrangement will place a huge burden on the children and parents in that area. It is very unfair.

Photo of Kathleen LynchKathleen Lynch (Cork North Central, Labour)
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The issue is not merely one of standards. There is also the issue of staff, as Senator Ó Clochartaigh mentioned in his contribution. We will have a huge difficulty with early retirements and it will affect all areas.

I will, most definitely, take the Senator's remarks back to the Minister.