I thank the Ceann Comhairle for allowing me to raise this particular matter again. I thank the Minister of State for coming to the House to reply.
Saincheisteanna Tráthúla - Topical Issue Debate
School Enrolments
In north Kildare we have a particular problem. We have a rapidly growing population. This population growth continues year after year but particularly in the last couple of years. We at local level, Oireachtas Members and members of local authorities et al., have put forward proposals ourselves to ensure catchment areas were regularly defined and that they were logical in terms of travel distances from the point of view of the parents. The problem is that most or all of the parents are at work so they have a difficulty if they cannot travel to the nearest school. The problem that now exists, unfortunately, is that for ordinary mainstream education there are difficulties in virtually all schools. There is a difficulty in gaining access for children and their parents and grandparents went to those schools. However, because of some changes that took place in the planning department it is found that they cannot attend the school of their choice which happens to be maybe a school their siblings are also attending. As a result, there is total confusion in the community. In trying to be helpful, possible solutions have been put forward by the Department of Education to the effect the children could go to another school that beyond the existing school and have transport provided and so on. That is all very fine but would not be necessary if adequate provision was made with regard how the management of the catchment areas was done and how much regard it had for the parents.
This is also a particular problem with regard to children with special needs. In some cases there is more than one child in the one house. In many of these cases there is no place available at all. We had a meeting some time ago and the Minister kindly arranged for a meeting in her Department with the interested parties. It transpired during the course of the meeting that the planning department had done its own sums and made its own plan but it did not measure up to the needs of the community. This causes very considerable difficulties. For example, there are some cases where children are already being deprived from joining the school that is nearest to them and to which their parents went and where they already have siblings in the school and they cannot join them. That is impossible for parents to handle if they have to do a school run in the morning and in the middle of the day. It cannot be done. It is a tough enough challenge for the parents to be able to handle a child or more than one child with special needs and depending on the degree of special needs. It is very important at this stage to try to resolve the problem by identifying how that can be dealt with in the shortest time possible and in the quickest way with the minimum of disturbance to both the parents and the children. I ask that at this stage an urgent review of the catchment areas and the plan that is obviously not working be done forthwith with a view to bringing some kind of resolution to the problem.
I would like to thank the Deputy for raising this matter. It gives me the opportunity to set out for the House the position with regard to school places including special education in north Kildare for September 2024 and onwards.
I can assure the Deputy that the provision of school places to meet the needs of children and young people at primary and post-primary level, including children and young people with special educational needs is an absolute priority for the Department of Education and the Government.
The Department has invested significantly in schools in County Kildare over recent years. Under the national development plan, a total of almost €250 million has been invested in schools in County Kildare over the past five years. This investment has focused on provision of additional capacity to cater for its increasing population and there are further significant projects in our pipeline including for the north Kildare area. In line with the Department's demographic projections of post-primary school place requirements, there has been a continued growth in enrolments throughout many school planning areas in North Kildare.
In response, the Department is progressing a number of building projects in north Kildare under the national development plan. This includes projects at primary and post-primary schools and provision for mainstream accommodation as well as for children with special educational needs. These projects include recently completed new school buildings for Maynooth Community College, Maynooth Post Primary School, Naas Community College and Maynooth Educate Together National School. Additionally, a number of further new school buildings and extensions are at construction or planned, including: St. Farnan’s Post Primary School, Prosperous; Scoil Dara and Scoil Uí Riada, Kilcock; Maynooth Boys National School; Celbridge Community School; Scoil Naomh Padraig, Celbridge; St. Raphael’s Special School, Celbridge; Leixlip Educate Together National School; Gaelscoil Ruairí, Maynooth; Mercy Convent Primary School, Naas; Hewetson National School, Clane; and St. Patrick's Boys National School, Clane.
The Department is aware of pressure for school places in north Kildare. As part of planning for September 2024, data on applications for admission has been received by the Department from post-primary schools across areas of known enrolment pressure, including the school planning areas of Maynooth, Naas, Celbridge, Newbridge, Kildare, Prosperous and Clane. The sharing of this data has been very effective in the identification of school place requirements across the areas. In the majority of areas across Kildare, through the work of schools, patrons, management bodies and the Department, there are sufficient school places available to meet the needs of children in the area. The Department is working with schools and patrons to make additional places available in a small number of areas where a need has been identified. As part of this engagement with patrons, the Department is also collaboratively planning towards 2025-26 and future years, as part of forward planning generally.
I also wish to acknowledge the invaluable work being done by school principals and wider school authorities in expanding the educational provision for pupils with special educational needs. The Department has close engagement with the National Council for Special Education, NCSE, which has responsibility for co-ordinating and advising on the education provision for children nationwide. The NCSE is working actively with the Department and other key stakeholders, including school patrons and management bodies, to provide additional special classes and special school places for the 2024-25 school year, including across north Kildare.
The Deputy will be aware that a new special school is being established in Kildare for the 2024-25 school year, under the patronage of Kildare and Wicklow Education and Training Board. It will provide additional special school places to meet the needs of families in the area. With respect to special classes, I can assure the Deputy that the Department is working to ensure that there is appropriate provision in place to meet the school place needs of all children. In the first instance, it is focused on ensuring that the use of existing school accommodation capacity is fully optimised. Where additional capacity is required, this can be provided by means of modular accommodation where accelerated delivery is required or by means of traditional construction projects. The Department will continue to plan for future school place needs using most up-to-date information, including child benefit data, enrolments, census data and information on current and planned residential development activity.
I thank the Minister of State for a comprehensive reply. In it, he identified all of the pinch points that are already visible and causing problems. The Minister of State is correct. There has been huge investment. However, even new schools that have been built recently are now overflowing and there is difficulty for pupils in catchment areas in gaining access to those schools. In some cases, decisions have been made by the planning section to move a child to a different school, thereby creating a further catchment area that will disrupt the entire system if it is allowed to continue.
At this stage, there is evidence to show that schools are overflowing. St. Farnan's Post Primary school and new post primary schools in Maynooth are facing difficulties. There are difficulties in Straffan and Clane, as well as in all the other places Minister of State mentioned. In Naas, the Mercy Convent School has sat half-finished and idle for the past couple of years. It is vital that work is ongoing in order to meet the challenge. If we do not meet that challenge between now and next September, we will fall further back because the population is growing more rapidly than we are able to build for it.
The Minister of State identified all of the crucial areas. I ask that the planning and development section goes to work immediately to meet the challenges that are there now for mainstream pupils, as well as children with special needs who need attention more quickly because parents are under pressure to ensure that, as far as they can, they get a reasonably good education.
I thank the Deputy. I also wish to point out that the Department will continue to liaise with local authorities in respect of their county development plans and any associated local area plans, with a view to identifying any potential long-term school accommodation requirements across school planning areas. I can assure the Deputy that Department of Education officials will continue to work to ensure there is sufficient school place of provision for all children throughout north Kildare for the 2024-25 school year and into the future.
I thank the Minister of State.
Disability Services
I want to raise the issue of children receiving substandard services in children's disability network teams, CDNTs, in Carlow. I was disappointed to read in a response to a parliamentary question I submitted that the HSE has delayed a new children's service facility in Carlow which was to be the new home for the CDNT. Part of that was to include the Holy Angels centre.
A funding allocation of approximately €7.1 million was identified for the project, and a design team was engaged and proceeded with the design process last year. My understanding is that the stage 1 report from the design team in December 2023 estimated that the cost of the project would significantly exceed the funding allocation. We welcomed the funding allocation, which is in the capital plan, but we have been told there is not enough money. The HSE disability service estate is arranging stakeholder engagement to review the project and provide a revised scheme of the works and funding. I ask that funding be put together urgently because it is needed.
We need investment, innovation and reform. If we cannot future-proof a development such as this, how will we prioritise our disability services? When we began implementing disability services in CHO 5, the core focus of the change was to ensure the children with complex needs, and their families, would receive an appropriate and accessible family-centred service. However, I am hearing every day that this is not the case.
There is only one CDNT led by the HSE in Carlow, which is located in Bethany House, on Barrack Street. Across that team, there are 294 children with complex disabilities registered for clinical services, 50 of whom have active individual family support plans. Some 230 children are waiting on initial contact. I have been told that filling vacant clinical posts across these teams is the HSE's top priority in order to address the needs of children, deal with waiting lists and provide clinical services to new applicants.
I believe there is a proposal to move to an alternative model of enhanced disability services in the community by way of increased support hours in a home setting, increasing capacity in current respite services and offering alternative models of delivering respite services. We are not adequately serving the needs of the children, however. My office makes at least one representation a day for a child waiting on speech and language therapy, occupational therapy or autism assessments. I know of families who are going into debt in order to get vital interventions for their children.
What priority is being put on recruitment? There is no embargo on recruitment for these posts. When I spoke to Bernard Gloster recently, he assured me that interviews were taking place for staff for South East Community Healthcare services for all vacant clinical posts.
It is my understanding these interviews were completed on Friday, 16 February 2024 and that job offers from the recruitment campaign are in train. Is there any way we can speed up this process because it is so important? In Carlow, family forums have commenced to provide information to families on the services the CDNTs are providing and resources available to them, but families are telling me these are not working the way they would like. They feel they are just a box-ticking exercise. The next family forum meeting was scheduled for today and I will be contacting the families to see how it went. The CDNT in Carlow continues to receive referrals and many end up in the family forums. We need to see real action. Staff growth in this area is very important.
I am taking this matter on behalf of the Minister of State at the Department of Health, Deputy Rabbitte, who thanks the Deputy for raising this matter. The Minister is fully committed to the continued development and enhancement of our children’s disability services through the CDNTs, as they seek to ensure equitable access to services for all children with complex needs. The Minister of State acknowledges the difficulties faced by children and their families seeking to access the services of CDNTs in CHO 5 and takes this opportunity to reiterate her unhappiness at this situation and her commitment to addressing the underlying issues.
Presently, there are significant challenges both nationally and globally regarding the recruitment and retention of health and social care professionals, particularly for children’s disability services. While funding has been allocated, vacancy rates in CDNTs unfortunately remain high. In CHO 5, the HSE advises that the vacancy rate of the teams stands at 41% which equates to around 92.05 whole-time equivalent posts out of the approved 223.78 posts. This is based on the 2022 CDNT census. However, the HSE advises that the latest census is expected to be available in the very near future.
The Minister of State can assure the Deputy there is ongoing recruitment for vacant posts in CHO 5, both through the HSE’s national recruitment services and the HSE HR section at a local level. The HSE launched the first nationwide CDNT recruitment campaign in January 2024 with the theme "Be part of our team, be part of their lives". The Minister of State has been advised by the HSE that, at this time,and without prejudging the final outcome of the recruitment and selection process, CHO 5 is anticipated to significantly benefit from job offers arising from this campaign. If those offers were to be accepted by the applicants, it would represent an approximate 25% increase in staffing across CHO 5. However, to sound a note of caution, the applicants concerned may have other offers from the competition, so the Minister of State will await the finalisation of the process and a more detailed report from the HSE.
The Minister of State welcomes additional measures being progressed under the progressing disability services roadmap to increase capacity on CDNTs, including student sponsorship programmes for health and social care professionals; a target of 175 therapy assistants to support health and social care professionals in delivering the most effective and efficient services in environments appropriate to each child’s needs; and dedicated work on marketing CDNTs as workplaces of choice. While recruitment measures are ongoing, the Minister of State can advise that the HSE is driving forward several initiatives to reduce waiting times and strengthen services for children waiting. These include sourcing assessments and interventions from private service providers and the imminent launch of the children’s disability service grant fund. The launch of this fund called for applications from disability service providers and community groups who can provide additional and innovative services, including, but not limited to, recognised sensory programmes; evidence-based therapies; respite services, including clubs, evening and weekend sessions; Saturday clubs; sports sessions; and additional therapy sessions for service users such as managing challenging behaviours. There was a huge response from voluntary and community groups and private agencies, with around 495 applications for funding. The HSE intends to issue letters to applicants in the very near future and commence the process of engagement around the drawdown of funds.
I thank the Minister of State. I was made aware the Minister of State, Deputy Rabbitte, would not be able to take this Topical Issue tonight but, in fairness to her, I have worked very closely with her and can say she is totally committed to trying to recruit for disability services. One of the biggest issues I have been talking to her about recently is the inclusion of assessments and intervention from private service providers, which I welcomed. That made a difference but we still have a long road to go. As I always say to the Minister of State, early intervention is the only way forward. It is important that children are assessed early. That is the most important issue going forward.
I welcome the information on recruitment and await the final numbers for CHO 5. The Minister of State, Deputy Collins, is probably not aware we have a huge HSE site in Carlow and we will be getting a new CDNT building there which also includes the Holy Angels day care centre. I ask him to raise the funding for that project with the Minister of State, Deputy Rabbitte. While I welcome the €7.1 million that has already been provided, the cost of construction materials now means we may need extra funding for that new building. It is important we get that new building. It will make a huge difference to the children in County Carlow.
I referred to a lot of figures tonight but I have families coming in to me daily who are borrowing to get their children assessed because of the long waiting times. Timing is crucial and we do not want any family to have to borrow money from grandparents or other family members. We need to provide these services urgently. I know Minister of State, Deputy Rabbitte, is committed but I ask that she would get back to me directly with regard to the recruitment and what is happening there.
While recruitment and retention of staff to CDNTs remains a considerable challenge, the Minister of State wishes to reaffirm her commitment as well as that of the HSE and her Department to exploring all avenues to improve access to CDNTs for children and their families in CHO 5. I will make the Minister of State aware of all of the issues the Deputy raised here this evening.
Sports Events
Cork's heroic victory over Limerick last weekend will go down in history as one of the most exciting games of the modern time but thousands, if not tens of thousands, of people were not able to watch it, including diehard GAA people and hurling people who love the game. So far, not one of Cork's hurling championship matches have been on television. The games against Clare and Waterford were also crackers but people did not get an opportunity to see them. This decision by the GAA and by RTÉ is a disgrace and flies in the face of all the volunteers who have given their time and commitment to the association. It costs €12 to watch a match which, for people on limited incomes or budgets, for young people whose parents might not be interested and for other people who are struggling to pay their bills, is a lot. A lot people cannot afford this. There were three Cork hurling games and the Cork versus Kerry football match so people in Cork would have had to pay €48 to watch them all.
In today's edition of The Echo, the elderly rights campaigner, Mr. Paddy O'Brien, condemned the GAA for what it is doing to older people and to volunteers who have given their lives to the association. I spoke to a former Cork hurler in Blackpool on Saturday. This man has limited mobility and is on crutches. He played in an All-Ireland with Cork in 1984 and he has senior all-Ireland medals with his club, Glen Rovers. He was going to a pub to watch the match. This is a man who has graced Croke Park. He was going to the pub because he could not watch the game on television. Money was not the issue for him. The issue was that he does not have a computer or a smartphone to watch it so his friends had to bring him out. I spoke to another man on the northside who played hurling all his life. He listened to the game on 103 FM. I thank and commend 103 FM for providing proper public service broadcasting, unlike RTÉ. If it were not for 103 FM, people in Cork would not have been able to listen to live coverage of the match.
Last year, 1 million people watched the all-Ireland hurling final. That is the level of love for hurling in this country. Instead of fostering the game, as the GAA, especially, and also RTÉ, the public sector broadcaster, should be doing, they are putting it behind a paywall to make money. The question is whether the GAA is more worried about making money or promoting hurling.
The number of GAA players is decreasing. In 2019, 22,514 club teams were signed up to the association. Between October 2021 and September 2022, that number fell to 20,994, which was a decrease of 1,520 teams. It is no wonder clubs are not fielding teams. Last weekend, the under-15s hurling féile took place in Cork. It is the most prestigious underage hurling competition on the island. I know of two clubs that did not field teams last weekend because players were playing other codes. Instead of the GAA promoting hurling and getting more young people to play the game, it is putting matches behind a paywall for money. It is a scandal.
I love the GAA. I am a lifelong member and my family is steeped in the association. I love hurling and I love the GAA. It is an unbelievably good sporting organisation. However, too many people in Croke Park are living in a bubble. GAA members are not professionals. We are volunteers. We are based in the parish and the community. That is what the GAA should represent; not big business, not big money but the love of hurling.
I thank the Deputy for raising this issue, to which I am replying on behalf of the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media. It is important to note that the GAA, like all national governing bodies, NGBs, in sport, is an independent, autonomous body. The management of broadcasting and commercial rights is entirely a matter for the association. The GAA, like all NGBs, is free to enter into commercial agreements to generate revenue to support the continued development of its sport from grassroots to elite levels.
A challenge for all sports bodies, including the GAA, is to strike a balance between generating revenue through broadcasting rights and ensuring accessibility to as wide an audience as possible, particularly those who might not have the technical know-how to engage with a streaming service. There is a vital need to promote sport generally, and active participation in sport in particular. One way to do so is to give access to live sporting events. There is also a need to ensure there are sufficient levels of coverage of our national games. In this regard, there has been much discussion about the need to promote hurling, in particular. Widespread free-to-air availability is a part of this.
I appreciate that fans will want to see more games but it is important to consider the practicalities of broadcasting those games. Public service broadcasters are not dedicated sports channels. They have a statutory obligation to meet the expectations of all people and to provide a broad schedule that caters for the interests of the whole population, on all subject matters and via all programme types, not just sport. In saying that, there is, rightly, still a significant amount of sport available to view on free-to-air television. In the case of Gaelic games, I understand there was no reduction in the number of games shown free to air by RTÉ in 2023. It is worth considering that if GAAGO did not exist, a number of matches would not be aired at all.
I understand that between Friday and Sunday last, there were 12 GAA matches played from under-20s to senior level. Six of those matches were available on free-to-air television, with a further three available on GAAGO. More than 300 Gaelic games matches will be shown live on free-to-air television this year. They include matches shown on TG4, which has expanded its Gaelic games broadcasting over the years and now shows national league, club, intervarsity and underage championship games, as well as women's football. A quick look at the television schedule shows there will be Gaelic games coverage on TG4 every day this week, including three live matches. In addition, two live matches will be shown on RTÉ next weekend, as well as highlights shows.
Obviously, sports fans would like to have more games available free to air, especially those involving their own counties. However, it simply may not be possible to broadcast all matches. The number and frequency of games, and the potential for clashes, are issues of the sporting calendar, not the television schedule. Recent changes in championship structure and season duration are bound to result in fixture congestion. The scheduling is a matter for the GAA to address. It must work with its broadcast partner, RTÉ, to decide which games are broadcast. This is not something in which the Government can or should be involved.
With regard to the broadcasting policy element of guaranteeing free-to-air availability of sporting events, there is provision in national and European legislation to designate major events as free to air if they are deemed to be in line with statutory criteria. The legislation also provides for regular reviews of the list of events that are designated as free to air. A review is currently under way. It included a public and stakeholder consultation, which was launched by the Minister, Deputy Catherine Martin, last January to invite feedback on a number of new events being considered for free-to-air designation. While the consultation phase is closed, there is now an independent analysis and assessment of the outcome of the consultation.
I do not accept the Minister of State's assertion that there is no role for the Government in this matter. Hurling is not just another sport. It is our national game. It is part of our culture and tradition. It is what Irish people from the island of Ireland and all across the world associate with being Irish. To say the Government has no part to play in it, while other sports are on every television channel, is not acceptable. We must protect our game.
Hurling is a minority sport. Fewer and fewer people are playing it, especially at a higher level. For the past two weekends, there has been no senior Munster or Leinster championship game shown on television. That is the truth of it. RTÉ is a public broadcaster. Its job is, or should be, to show hurling. If it does not want to do that, other organisations should be allowed to do so. The Minister of State said there has been no decrease in the number of games shown. There was uproar last year when this happened. The review should have been finished earlier and the results should have been published.
There are solutions to be found. Will the Government increase funding to the GAA to ensure it does not have to sell its soul, and the souls of GAA members, for money? GAAGO will probably bring in approximately €4 million. Are we interested in promoting our national game or are we interested in profit? That is the question. I am really disappointed by what is happening. In every city, town, village and parish, the GAA was the mainstay of communities. It needs to go back to its grassroots and back to basics.
There is so much the Government should be doing. The Taoiseach, the Tánaiste and the Minister have made comments on this issue. We need less talk now and more action. I spoke on this matter last year, I raised it again this year and I speak on it once more tonight. What has happened is a disgrace and a scandal. I am thinking not of myself but about every person out there who ever played the game, ran a team, washed a set of jerseys or lined a field. I am talking about the people who are at the heart of our great association. I am really disappointed in the new president's comments. I believe, as a lot of people do, that he is a great man to bring about change in the association. However, he seems to be listening too much to the money men in Croke Park. We have to get back to where we came from and to what made the association so great. What has happened is wrong and it is time to reverse it.
I referred to the independent analysis of the consultation that took place.
This will inform which events will be brought to the EU for approval, as required. Already, all-Ireland football, hurling and camogie finals are designated for free-to-air coverage. The current review involves an examination of the possibility of designating a number of additional GAA events, such as the quarter- and semi-finals of the All-Ireland series and provincial finals. A number of these are traditionally broadcast free to air already, but we are right to examine the merit of protecting or possibly extending this free-to-air status.
Upon detailed consideration of this report, the final list of events to be designated will be laid before the Houses and will then be submitted to the European Commission for its consideration and approval. What is very important to bear in mind with the designation process is that it is not intended to designate an entire competition or all of one particular sport's events. Rather, the intention is to ensure free-to-air coverage of major national events and events involving national teams. In addition, it is important to remember that designation does not guarantee coverage. It does not and cannot oblige a broadcaster to purchase rights to an event. It is designed to protect certain significant events and ensure they are available free to air.
There are many strong views on this issue and, as such, the debate is to be welcomed. What is important is that the concerns raised by Members of this House, and the sporting public, need to be considered by the GAA and responded to accordingly.
Dental Services
I thank the Minister of State, Deputy Colm Burke, for being here tonight. I am raising the long waiting list for dentures, specifically for people over 70. I want to go back to a newspaper article in January 2009, which appeared under the subheading: "Dentures will be rationed for medical card holders as part of a wave of Health Service Executive ... cutbacks, dentists representatives warned." The article states:
The Irish Dental Association ... chief executive ... said dentures are the most expensive discretionary item provided for under the general medical card scheme.
Because of that we are getting strong indications they will be the first thing to go,” he said.
Currently, dentists can perform routine dental work, such as examinations, fillings and extractions on medical card patients without receiving authorisation from a HSE principal dental surgeon. More expensive treatment items, such as advanced gum treatment, large x-rays and dentures, must be authorised by the HSE.
In July 2023, the same chief executive said that nearly 500 more dentists were needed in order to meet demand. An article in the Irish Independent on 19 March last stated, "More than 13,000 people now on waiting lists for dental surgery".
The issue of dental services was recently raised in the Seanad by Senator Tim Lombard. The information he received is that in the Cork and Kerry region, as of last June, while 860 patients had their orthodontic needs assessed in the first six months of the year, a whopping 2,900 patients were still waiting for an assessment. While 1,937 patients were in active treatment at the time, there were 2,600 patients waiting to start treatment at the end of June. That is slightly different in that it probably relates to the younger generation, but it is still indicative of the crisis that the dental service is in. It was also stated that the HSE says that the problem is a lack of participation by private dentists in the scheme, because there is an embargo on the recruitment of its staff.
A number of people have been in contact with my office in recent months in respect of this matter. I also spoke to a very good friend of mine about it at the weekend, which prompted me to table a parliamentary question on it but I have not received a response to it yet. We will call my friend Dave from Midleton. About 15 months ago, he had problems with his dentures. He brought them to the local dentist and paid to get them fixed. The Minister of State should bear in mind that he is a pensioner. When he went on a waiting list more than a year ago he asked how long he would be waiting. They said it would be about two years. Nearly four weeks ago he again had a problem with his dentures. He went back to the dentist and paid to get them repaired. When he asked where he was on the list, he was told he would probably be waiting for two years. He said he was told that last year, so now it is three years.
There are other costs involved. I went on the patient information page on the UCC website. What this gentleman needs is a full upper and lower denture replacement. The quote I have is for €1,100. As a pensioner, there is no way he can afford that. One of the necessities in life is that we are able to eat. We can imagine what it would be like at that stage in life if we could not even put in dentures to chew food. It is absolutely ridiculous that the basic rights of the most vulnerable are being ignored and excused by waiting lists, but if a person has cash, he or she would only be waiting a couple of weeks. What will the Minister of State do for the likes of this man, and the others who have come to me? They are in fear of their life. They are afraid to ask. They are ashamed to say they cannot afford it, so they just sit there in pain.
I thank Deputy Buckley for raising this matter. I am dealing with this reply on behalf of the Minister. Dentures and denture repairs for medical card holders are provided by contractors through the dental treatment services scheme, DTSS, which provides dental care, free of charge, to medical card holders aged 16 and over. Denture-related items are available from both dentists who hold a DTSS contract and contracted clinical dental technicians who only provide dentures on the scheme. Services available annually and on demand through the DTSS include an examination including preventative advice, two fillings, emergency extractions, and a scale and polish. More complex care, such as dentures, and a broader range of treatments for patients with additional needs and high-risk patients, are available subject to the approval of the local HSE principal dental surgeon.
The DTSS contract enables patients to have a new denture provided every five years, and to have denture repairs undertaken as required. Medical card holders may choose to attend any contracted dentist or clinical dental technician to access repair or replacement dentures. In response to contractor concerns regarding the scheme, the Minister approved measures from May 2022 providing for increased preventative care and increased the fees paid to dentists for most treatment items, including dentures and denture repairs, by 40% to 60%. This has increased both the number of patients seen and the treatments provided in the DTSS.
The HSE is unaware of any waiting lists in contracted practices. However, the Minister is aware that medical card holders in some areas continue to have difficulty accessing care. While there are a significant number of contract holders, appointment availability fluctuates daily according to practice demands. The local HSE principal dental surgeon may be able to provide assistance in accessing DTSS care. The HSE is required to support the provision of emergency care to adult medical card holders who have difficulty accessing a local dentist. In the longer term, the Government is committed to fundamentally reforming dental services, including the DTSS, through implementation of the national oral health policy, Smile agus Sláinte. The policy sets out a complete transformation of oral healthcare services and expansion of the care available for both children and adults. The HSE has appointed a strategic reform lead to drive policy implementation across the organisation and to move forward in 2024 with developing new services in line with the policy. This will include work on planning new services for medical card holders. The HSE is currently developing the clinical aspects of new packages of preventative care for DTSS patients, as the first phase of reform of the medical card scheme. An implementation plan for the first phase of roll-out is being developed between the Department of Health and the HSE, for consultation and then publication in the third quarter of this year. This report will be set out by the third quarter of 2024.
I thank the Minister of State. I respect the response outlined. I am well aware that new dentures can be provided every five years, but that is if a patient can access a dentist.
That is the issue here. Then there is the medical stuff that goes with it. Oral health is vital. The Minister of State's written statement reads, "The HSE is required to support the provision of emergency care to adult medical card holders who have difficulty accessing a local dentist." In the case I am talking about, the gentleman was told a year and three months ago he would be waiting two years. Three weeks ago, he was told he would be waiting another two years. That is not a very proactive way to provide emergency care for adults.
When I was speaking to the gentleman, he laughed. The older generation always have a good sense of humour and a bit of fun. He said he would be like the elderly couple in the burger restaurant. The husband was sitting across from the wife and they had the burger cut in half. She was chewing her half but he had not touched his. A young couple spotted them and did not know what was going on but assumed they were sharing the burger. The young gentlemen went up, purchased another burger and dropped it at the table of the older couple. He told the man to have that burger and let his wife have the other burger. The other man said he was missing the point, that there was nothing wrong with the cost of the burger and that he was waiting for her to finish eating her half of the burger so he could use her dentures to chew his half. That is the story that gentleman told me.
The Minister of State mentioned the HSE assisting people. It assists people by telling them it is tough luck, to go away and get things fixed again and come back in two years. That has to be revisited. The written statement reads, "The HSE is required to support the provision of emergency care to adult medical card holders who have difficulty accessing a local dentist." That is where the problem is. They cannot access them and the HSE is not helping them to do it. It is just giving them the hard luck story. I do not know where we will go from here. I do not know what I will do or what I will tell this gentleman and others when I go back to my constituency at the weekend.
I fully understand where the Deputy is coming from in relation to any person having difficulty accessing dental care. It is clearly set out in the statement, "The HSE is required to support the provision of emergency care to adult medical card holders who have difficulty accessing a local dentist."
Access to dental care, including for adult medical card holders, is a top priority for the Minister and Government. The Minister has made substantial additional investment in oral healthcare services in recent years. In addition to more than €200 million the Government invests in public oral healthcare services annually, €17 million in one-off funding has been invested since 2019-2020 to address service backlogs.
The national oral health policy, Smile agus Sláinte, 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. Maximising the contribution of all our oral healthcare professionals and allowing them work at the top of their licence is central to Smile agus Sláinte and to increasing services.
It is heartening to note we have more registered dentists in Ireland than ever before. There are 3,652 registered dentists, which is an additional 177 since March 2023. This reflects positive trends, with the comparative figure being 3,217 in 2018. That is an increase of more than 400 dentists.
The Minister supports the creation of additional capacity in higher education, including in oral healthcare. The Higher Education Authority is undertaking a process to identity a set of options to achieve this important step towards health workforce sustainability for Ireland. I am confident that, working with the dental profession and other stakeholders in line with their respective roles and responsibilities, the goals of this policy will be met.
I accept there is a need to increase the output of dentists from third-level colleges. It is not only dentists but also dental hygienists and all of that area that needs to increase because we have an increasing population. It is important to note there has been an increase in the number of dentists available to provide a service in this country. Let us keep working towards increasing it further.
Cuireadh an Dáil ar athló ar 10.25 p.m. go dtí 9.10 a.m., Dé Céadaoin, an 1 Bealtaine 2024.
The Dáil adjourned at 10.25 p.m. until 9.10 a.m. on Wednesday, 15 May 2024.