2026-04-21

125. Deputy Pádraig Rice asked the Minister for Health if she has considered the Oireachtas Joint Committee on Health's Report on Dental Services in the Healthcare System; if she will commit to implementing its recommendations; and if she will make a statement on the matter. [28361/26]

There is a deepening crisis in dental services. Last week, the Committee on Health produced a report setting out 19 recommendations as to how this crisis can be tackled. Has the Minister had a chance to consider the report? Will she implement the recommendations?

I thank the Deputy and the Committee on Health for their work on oral health and I welcome their report. I have read it and it aligns with many of the frustrations being brought to me. I understand the frustrations of families and individuals who are experiencing this with the current service. To be really clear, the current position on dental services is not good enough. Too many people cannot get timely care and too many of those are children. We have to do two things at the same time. We have to take practical steps to improve access now and we also have to deliver lasting reform. The model of services we operate is largely rooted in the 1990s and it really needs to be modernised to meet today's needs. While that reform is being progressed, however, I am determined to ease the pressure people are facing now. What that means is improving access through the public system, especially for children and adult medical card holders. My Department and the HSE are finalising a more focused two-year programme to attempt to do just that. The plan is going to be delivered by a dedicated governance group with progress monitored closely and aligned to wider HSE and departmental priorities. It will aim to respond to sustained service pressures, workforce constraints and long waiting lists. It will focus on a small number of very clear priorities: cut waiting lists in the school dental programme and orthodontics, strengthen and expand the special access programme, review and improve the dental treatment services scheme, support recruitment, education and training, and then really lean into whatever innovations are appropriate for different ways to deliver care. Over the next two years, our aim is to stabilise services, reduce waiting times and make access measurably better while at the same time laying the groundwork for longer term reform. This will be achieved by initiatives such as utilising the newly available capacity with the new surgical hubs. A small proportion of cases, but not all, will be suitable because some will require general anaesthetic. My Department and HSE officials have already initiated engagements on this with many of the stakeholders, but it is important that they brief the committee as well when the plan is better finalised.

I thank the Minister. It is welcome that progress is being made because it is now seven years since the national oral health policy, Smile agus Sláinte, was published and we still do not have that implementation plan. I was not impressed by some of the excuses we received from officials at the committee, one of which was to blame Covid-19 for the failure to do this over the last number of years. We have been here before. Previous Ministers have promised an implementation plan, but it was never delivered. I hope that the current Minister does so, with clear actions, targets and timelines. Crucially, we need a new dental Act. The Dental Council is currently toothless. It needs powers to investigate, inspect and regulate. We have heard of cases of an unregistered person convicted of a sexual assault who may be practising as a dentist, as well as an unregistered dentist offering dental treatments, including X-rays, from a sitting room in an apartment in Dublin. We have also heard about three unregistered dentists offering pop-up clinics in Munster. We want to see a new dental Act and for the Dental Council to be given the real powers that it needs and has been calling for since 2008.

We are committed to updating the Dentists Act 1985, but we have spoken separately about the practicalities of some of those individual cases, some of which relate to legislative reform and some of which relate to completely different things. The Deputy is correct in relation to the need for a new dentists Act, but there is also a lot of policy development needed to underpin that. A recognition of the length of time that it would take in real terms has led to an agreement with the Dental Council to bring forward interim amendments such as continuous professional development, CPD, for dentists so that reforms can commence sooner. However, we need to make measurable and meaningful progress. I would like to have the opportunity to finalise that two-year plan, to present it and to have an implementation plan for it. This is not about planning for something in perpetuity. Rather, this is in recognition of very meaningful problems for a number of individuals who need a very specified intervention.

Children in particular are being failed here. Too many children are leaving primary school without receiving a screening. We know that children should be screened in second, fourth and sixth classes. Some of them are not being screened until fourth year in secondary school or later. We know that, in 2023, only 104,000 out of an eligible 208,000 children were screened, so half of them were not screened that year. There are real issues with workforce planning and having adequate staff in place to do that. It is a real failure by the State that we are not providing those services to children. Equally, the medical card scheme is not working. Dentists are leaving it. The number of dentists in the scheme has halved over a decade, which is a real signal that there are failures in this scheme. It is too limited, with a limit on the number of fillings but no limit on the number of extractions. There needs to be engagement with the Irish Dental Association to develop a scheme that works for patients, dentists and the public purse.

I will point out that the fees were increased by an order of 40% in that scheme. While I appreciate what the Deputy is saying, the fees were also increased by 40% and there is more complexity. I attended the dental association's conference. There is more complexity to the full range of practice that many dentists are engaged in and the other routes of practice, including aesthetics. I do not just mean aesthetic dentistry, which is important and was well defended at the dental association conference by its president. I just needed to make that point as well. The Deputy highlighted schoolchildren, who are a particular concern of mine. We have engaged with the dental association, the Irish Dental Hygienists' Association and the Dental Council to look at how we are going to deliver near-term improvements in the school programme in particular, how we can use the complete workforce, including hygienists and dental nurses, and how we can broaden the ways in which they are trained. We are engaging with the Department of further and higher education on that so that we can get the best out of our complete dental workforce.