Alan Dillon
Question:95. Deputy Alan Dillon asked the Minister for Health the steps being taken to alleviate the backlog for patients of all ages to access dental services; and if he will make a statement on the matter. [7725/23]
View answerThursday, 16 February 2023
Questions (95)
Oral answers (6 contributions)
The lack of dental services is causing severe problems for men, women, and children across the country. Numerous contracted dentists have withdrawn from the dental treatment services scheme, DTSS. Primary schoolchildren are not receiving dental treatment until they reach secondary school. What steps are being taken to alleviate the backlog for those on waiting lists to access dental treatment?
There are challenges in the provision of dental services and patients of all ages are waiting longer than they should to access care. This is not acceptable, but we are responding. This year, an additional €15 million was allocated in the budget to specifically deal with the issue. It is an unprecedented increase. Some €4 million of the allocation will target orthodontic care, prioritising those who have been waiting the longest to access treatment. Another €5 million is being invested to address backlogs in the public dental service, which invites children, usually in second and sixth classes, for a check-up with a HSE dentist, who will then provide further treatment if it is needed. The €5 million also supports the HSE to provide emergency care for adult medical card holders who are having difficulty accessing care under the DTSS.
Last May, I introduced additional preventative treatments to the DTSS and increased fees by between 40% and 60% per item across most items. This has led to an increase in the numbers of treatments provided and the number of patients being seen. We are pursuing fundamental reform of dental services, through investment in implementation of the national oral health policy, Smile agus Sláinte. As well as all that investment, my Department is supporting the HSE to put clinical leadership roles in place. These have not been in place so far. The chief dentist in the Department made a very strong case for it as part of his budget. We saw recent coverage of CAMHS, where the Minister of State, Deputy Butler, has agreed with the HSE that there will be both an administrative national lead and a clinical national lead. The national oral health policy is another national strategy were we are putting in place a similar approach to drive it on. I accept that the waiting lists in the children's service, orthodontics in particular, are too long. Significant money is being put in place and we must ensure that waiting lists reduce.
I thank the Minister for his response. On a weekly, if not daily, basis, we receive representations from people of all ages who are unable to access dental treatment. We must ask why contracted dentists are withdrawing from the DTSS. Dentists in Mayo say the DTSS is outdated in its scope and that it is so burdened with bureaucracy that most of them would not accept the contract regardless of the fees being offered. They need to be consulted when it comes to reforming the scheme. What engagement has the Minister had with dentists to see what can be done to encourage them back into the DTSS?
I will make two points specifically on the DTSS. The first is that the fee structure did not keep pace with inflation and we saw a lot of dentists leave the scheme as a result. There are issues related to the administrative burden of the scheme but they have been a factor for a long time. In response to that, we significantly increased the fees paid to dentists, by between 40% and 60% per item. We did that in a single year. Any dentist who chooses to leave the DTSS can do so, and dentists can also choose to rejoin it. When we discussed this recently in the Chamber, one Member of the House gave an example of a constituent whom a dentist refused to treat under the DTSS and when the person came back some time later in agony, the dentist agreed to do the treatment privately. I do not believe that is acceptable behaviour from the dentist. The State has a role to play. We are significantly increasing fees. There are two parties to this arrangement. It is not acceptable for dentists to pull out of the scheme and refuse to treat patients under a publicly funded scheme but then to be willing to take their money some time later as private patients.
I thank the Minister for his response. We have similar examples in Mayo where elderly people had to look for appointments in Sligo to fix their dentures, which is completely unacceptable.
On another point, the lack of access to dental treatment for young people is causing great difficulty for primary schoolchildren who are to be examined and treated by the HSE dental services in second, fourth and sixth class, before the age of 12. We are having significant problems with many checks coming after significant developmental milestones. It is a major issue. Additional supports must be put in place. There is a large backlog of 13,000 children who are waiting for orthodontic treatment for grades 4 and 5 on the HSE eligibility criteria. That must be addressed. We must also put in place supports for parents if they cannot get access to the HSE service and have to go privately for treatment. How can we support families in that regard?
There was an issue with regard to young people which was driven in part by Covid. The school-based schemes were affected by Covid. Money is being put in to catch up on those schemes. The Deputy will be aware that, critically, I funded a new scheme this year. That will be very important in years to come. Almost €5 million has been provided for a preventative scheme for children aged from birth to seven. We will see the benefits of that in years to come.
There are 30% more dentists in Ireland now than there were ten years ago, so the number is increasing.
The population is increasing, and the burden of care is increasing as well. I encourage dentists who have left, on the basis of a very significant increase in fees, to rejoin the scheme. Is it perfect? It is not. Does it need to be upgraded? It does. We are talking to the Department about a more streamlined and modern scheme but, right now, there are people with medical cards throughout the country who could and should be treated under the DTSS. I would love to see those healthcare professionals signing back up with an understanding that we will reform the scheme.
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