Dáil Éireann díospóireacht -
Thursday, 12 Feb 1998

Vol. 487 No. 2

Dental Services.

Mr. U. Burke

For the last two years 2,500 children in 32 national schools in east Galway, with Loughrea at the centre, have been without a dental service due to the retirement of the former dental surgeon last year and, prior to his retirement, his ill health. This is not good enough. When children in fifth and sixth class move to second level in June they will no longer be eligible for inclusion in the scheme unless the Minister uses his discretion and asks the health board to extend the period of eligibility when the position has been filled. That should be done immediately.

The health board is seeking to fill the position by offering six month contracts. No professionally trained dentist will accept such an offer which is neither attractive nor lucrative. If there is an embargo, it should be lifted immediately.

Will the Minister consider providing a fully staffed and equipped mobile dental unit on a pilot basis in County Galway? A similar service is provided in other countries. We could probably save money by providing the service on that basis, although I accept dental nurses visit schools on an occasional basis. As the children in fifth and sixth class have not been screened through no fault of their own, will the Minister give a commitment that they will remain eligible for orthodontic treatment?

A parent who sought access to the orthodontic service for her daughter received the following reply from the Western Health Board:

Following your visit to Portumna Health Centre with your daughter Amanda last Friday, I contacted the Orthodontic Department at Merlin Park Hospital. They have informed me that before a patient's name can be put on the waiting list for a brace all fillings must be done.

The letter went on to state that she would have to have the fillings done privately in this instance. A footnote to the letter stated: "You must take Amanda to be seen by a health board dentist before referral is made." The current position in the Loughrea area is impossible without the services of a health board dental surgeon. I ask the Minister to use his influence to ensure that a dentist is appointed permanently to the Loughrea centre serving Portumna, Loughrea and its environs, 32 schools in all, as a matter of urgency. The problems with which parents have had to cope over the past two years are unacceptable and the dental health of some students is being damaged. Will the health board take responsibility for that damage? I thank the Minister for taking this matter this evening.

Mr. Cowen

I thank Deputy Burke for his contribution on a problem in his own area. The problems being experienced by the Western Health Board in providing dental services to children in east Galway are not due to inadequate funding. They are due to difficulties being experienced by the board in the recruitment of dentists to fill approved posts for which funding has been provided by my Department.

For the past number of years the Western Health Board, in common with other health boards, has been progressively adopting a planned targeted approach to the delivery of dental services to national school children and phasing out a demand led system. This is to ensure the optimum use of dental resources and equal access for all national school children to the same level of dental care.

The school-based approach puts an important emphasis on dental health education and prevention. Dental health education programmes are now available to all national schools. Children in specific classes are targeted for preventive measures under the school-based approach. The children in these classes are screened and referred for treatment as necessary. The provision of fissure sealants for vulnerable teeth is an important element of the preventive programme. The programme has been specifically designed to ensure that children are dentally fit before they leave national school. It is the policy of the Western Health Board to provide dental treatment to children in second, fourth and sixth class subject to available resources.

The biggest obstacle being experienced by the board in providing a comprehensive public dental service to children is its difficulty, as Deputy Burke pointed out, in recruiting dentists to fill permanent posts in the region. The seriousness of this problem varies throughout the board's area, but it is most pronounced in the outlying rural areas which he mentioned.

In the Galway area the board prioritises second and sixth class for dental assessment and the provision of treatment as necessary. This year, for the first time, the assessment programme is being extended to children in fourth class. In practice, this target is only achievable where the dental services are well established and have not been interrupted due to loss of staff. This is most likely to be the position in Galway city and other large towns. In most other areas children in second and sixth class only are being assessed.

However, the position is that in a number of outlying rural areas in Galway, dental services are interrupted on a regular basis due to unfilled dental posts as a result of retirement, maternity leave or simply temporary staff seeking permanent employment elsewhere. In these areas children in second and sixth class are not being assessed on time. This creates a backlog of children requiring assessment and even when temporary dental staff are eventually recruited they are unable to clear this backlog for some time. In some situations this can result in children leaving national school and not having had their sixth class assessment.

I understand from the Western Health Board that the current position regarding the filling of vacancies for dental surgeons in the east Galway region is as follows. In Ballinasloe there has been an interrupted service but a permanent appointment has been made as from 2 January of this year. In Loughrea and Portumna the holder of the post retired last summer, as Deputy Burke pointed out, and I am informed the board has been unable to secure an appointment. In the adjoining Tuam area, a dentist is currently acting in a temporary capacity and she will take up a permanent appointment from 2 March 1998.

The board has made strenuous efforts regionally, nationally and to the extent of seeking recruitment abroad to fill existing vacancies for dental surgeons throughout its area. It will continue to maintain these efforts. It has had some success for east Galway and is hopeful of further success.

I sympathise with the position Deputy Burke has outlined. I emphasise again that this is not happening as a result of lack of funds from central Government but because of the great difficulty in getting dentists into the public dental system. I take the point that the people in the area he is referring to are at a disadvantage because of that. I will take up the matter personally with the chief executive officer of the Western Health Board and with the dental section in my Department to see what more can be done to ensure people in his or any other constituency are not at a disadvantage compared to other children.