Eugene Murphy (Fianna Fail)
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Go raibh maith agat, a Leas-Chathaoirleach agus céad míle fáilte roimh na múinteoirí agus na daltaí. I hope they have a wonderful day here. I acknowledge the Minister of State, Deputy Feighan, who is a Rossie like myself. I know he has been dealing with this issue and that people have been coming to him in relation to the dental treatment service scheme. I am getting a lot of representations about it as well.

We all have to acknowledge the importance of oral health and dental care. Dental and oral health is an essential part of one's overall health and well-being. Poor oral hygiene can lead to dental cavities and gum disease and other diseases as well. It is, therefore, important that we have an excellent dental service.It really is important that we have an excellent dental service. Unfortunately, at the moment, we have many difficulties under the medical card scheme that applies to 16-year-olds and over. Like many Oireachtas Members, this representation is made to me an ongoing basis by people not able to get the service.

In fairness to the Minister, Deputy Donnelly, the Minister of State, Deputy Feighan, and the other Ministers of State in the Department, an additional €10 million in budget 2022 was put in place. I understand €16 million that was not spent in 2021 is also being used to try to improve the situation.

One of the big problems we have is a lack of dentists to do the work. I am afraid that if we cannot bring those people back into the system, we will have an ongoing problem. This is not just unique to Ireland. I read that thousands of dentists have left the free dental scheme under the National Health Service, NHS, in England. It is happening here. Many dentists do not want that work and do not want to do that business anymore. They are not buying into the scheme. It is time for new ideas and new ways forward. I do not have any magic solution. I do not know whether the Minister of State has any magic solution this morning. We must realise and understand that dental healthcare is extremely important, particularly for young people.

It is not good enough that people have to wait and suffer. As we all know, some of those dental healthcare problems can become lifelong problems for people if they are not handled at an early age. Most politicians, irrespective of what side of the House they are on, whether they are in government or in opposition, know we have a massive problem here. It is not really a political problem as such but we must try to try to solve it. It is up to us to solve it. We have a problem within the system of getting dentists to serve all over the country and to do that work.

I will not detain the Minister of State any longer on this. I await his reply. It is not going to be a simple problem to solve. I am very concerned about people having to wait long periods for dental care, however. As I said, it is something that really needs to be looked after from an early age for people and it is a problem that the political system will have to tackle.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Senator for the opportunity to address the issue of dental services for medical card holders. I am taking this debate on behalf of the Minister for Health, Deputy Donnelly.

Dental services for children up to 16 years of age are provided by the public dental service of the HSE through its dental clinics. These services are provided to eligible children and do not depend on medical card status. HSE dental clinics provide a screening and fissure sealant programme for children at key stages of development, that is, children aged six to eight, children aged 11 to 16, and, where resources are available, children aged nine to 11. The service includes referral for further treatment, including orthodontic treatment, where necessary. Emergency care for children up to 16 years of age is also provided.

The Minister is aware that since the emergence of Covid-19, there has been a significant increase in delays accessing dental care for those in target school classes. This has resulted in backlogs emerging in the targeted schools programme. The Minister has been assured by the HSE that it is continuing to restore dental screening and treatment to children up to 16 years of age through recruitment initiatives to fill vacancies that have arisen or may arise, prioritising clinical treatment and patient groups and reallocating clinical resources according to greatest need.

Dental treatment for medical card holders aged 16 and over is provided under the dental treatment services scheme. Services available annually have included an examination, two fillings and emergency extractions. More complex care and a broader range of treatments for patients with special needs and high-risk patients is also provided, some of which requires prior approval.

Both the Minister and the Government have been concerned for some time that medical card patients in some parts of the country have been experiencing problems in accessing dental services. To help address this issue, the Minister secured an additional €10 million in budget 2022 to provide for expanded dental health care for medical card holders, including the reintroduction of scale and polish.To address the concerns of contractors about the sustainability of the scheme, the Minister is using an estimated €16 million of an underspend in this year's Estimate allocation of €56 million to award fee increases across a number of items, including fillings and restorations. The combination of these two measures represents an estimated total additional investment of €26 million in the scheme this year over and above what was spent on the scheme in 2021, which was €40 million.

Following consultation with the Irish Dental Association, these new measures came into effect on 1 May. The Minister hopes that this significant additional investment in the scheme will attract more dentists to treat medical card patients. The Minister has been assured by the HSE that its local services on the ground will assist any persons who are still experiencing problems in accessing a service.

These measures are designed to address immediate concerns with the scheme, pending a more substantive reform of dental services to align with the national oral health policy. As part of this work, the Minister has given a commitment that there will be a substantive review of dental services, and work on this has already commenced.

Eugene Murphy (Fianna Fail)
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Cuirim fáilte roimh an múinteoir agus na daltaí. They are very welcome to Seanad Éireann. I say that on behalf of the Leas-Chathaoirleach, the Minister of State and on my own behalf. It is great to see people here.

I acknowledge that the Minister of State, Deputy Feighan, the Minister, Deputy Stephen Donnelly, and the other Ministers of State in the Department are trying to sort out this matter. As the Minister of State has pointed out, extra money has been invested to try to deal with the service in parts of the country where dentists are not available to carry out this work. I know that the HSE is doing its best as well. It has advised that it is doing everything it can to expedite the processing of applications from dentists who wish to be reinstated on the DTSS. I hope those dentists who have left the system can now come back into it and assist people who need assistance.

To return to the point I made initially, oral healthcare is so important to the population, in particular at a young age, but also as people progress through life. Dental care is important. I hope that by highlighting the matter here and following some of the changes made by the Department and the HSE, that we can get more people back into the system and solve some of the problems that exist.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I have listened to Senator Murphy and his colleagues across the Chamber, and I assure him that the Minister appreciates the difficulties experienced by people accessing healthcare and is providing solutions.

As mentioned, additional funding has been provided to resolve current problems with access to the dental treatment services scheme. The HSE has also been taking action to resolve the problems in children's dental services. However, the Minister and the Government recognise that the current model of provision of oral healthcare is in need of fundamental reform. Smile agus Sláinte, the national oral health policy, provides the guiding principles aligned with Sláintecare to transform the current oral healthcare service over the next eight years. It will support provision of all levels of care by appropriate healthcare professional and in the most suitable settings. It will also support patient choice and access, and will replace the current service, which is based on the dental health action plan 1994, which was informed by data from the 1980s.