Brian Stanley warns of dental care failures and long waits

Deputy Stanley. Just to chime with you and welcome visitors to the gallery, Fintan Hurrigan as well, the Irish Dental Association and indeed Pat. I met Pat a few times in his former role as a councillor. Let me say this at the outset, we are all elected here to be the vice of the people, chuck the dolly, doll delegates, and not to make any cheap shot, but the Government benches have been empty throughout this debate, and not one member of Government, apart from the Ministers that have spoken. Maybe they do not see there is any problem in dental health, but I just find that remarkable. Maybe they are not hearing it from constituents, but we have had a range of speakers from across the opposition benches, from Kerry, to Durney Gaul, to Dublin, across the Galway, and everywhere else in between. The problems have been outlined, and some suggestions have been outlined, and that has been welcome. I welcome the fact that the Minister is not supporting it. I know that you are sincere in what you are doing, and Minister Butler as well, but I want to frame this in the context of Solange of Care, and you mentioned that in your closing remarks, and we do have to set it in that context. That means that we must start providing the proper dental health services that are available to everybody. I know there is not. It is like a lot of other problems, like the housing thing. There is no one thing that is going to fix any of it. There are a number of parts, and a number of them have been focused in on fairness, and been identified by the speakers here this morning, and I have tried to do it in the motion, and in the proposals I have brought forward. You mentioned the overall budget, 230 million, yes, and that is the case. But we cannot have budgets without tracking the outcomes. Outcomes have to match any increase in budget. That needs to be clear, and I am saying that as an opposition TD. Throwing money at something will not solve it on its own. It has been mentioned about people going abroad, and there is even a term now, I heard it recently called turkey teeth, and we have seen good and bad examples of people coming back with treatment. But when they are going there, it is a failure. What brought this to my attention a number of years ago, and I have raised assistance to come in here, this is my 15th year here, is that an acquaintance of mine actually wound up nearly dying in hospital because of poor dental health and dental problems. It applies into a system, and you know, a fine hardy fellow almost killed him, and it really underlined for me the problem. The other issue is, is that, you know, my granddaughter is watching her going through primary school, and I remember seeing the dentist in third class, as far as I can remember, and that is a few years ago now, in the dispensary in Mount Trot, and everybody else saw the dentist at that time. And here we are now, but she did not see the dentist in primary school, and she came out of primary school, and her and her pals who I had known them, the kids she was running around with at the time, now they are all near the end of their teens, they went through secondary school, and they almost came out of secondary school, the other end of it, without seeing the dentist. They saw the dentist in the last year, that was her first examination, you know, and that is, it brought it all into sharp focus for me. But anyway, under Section 67 of the Public Health Act 1970, the HSE must provide dental treatment and appliances for those on medical cards. We must increase the number of places. 65% of dentists have been unable to recruit additional people. New dental school at UCC, there has been no progress in this since the then Minister, Simon Harris, turned this out in 2019. My understanding is the funding has been withdrawn. Only 10% of dentists work in the public dental health services, and that needs to be, including the private dentists are saying this, that figure needs to be doubled. We need to double the percentage, and double the numbers, in terms of having a representative number in the public dental system. I could have said this to you Minister, it is a bit like the GP situation, not all dentists can afford to open a private practice, or want to open a private practice, because, you know, you have to run a small business, and there is a lot of costs associated with that. And women then, as well, in particular, you know, the need to work, because of the reality of the world we live in, they need to work, you know, 35 or 40 a week, because of other responsibilities, and trying to manage family and everything like that. So they want to work in, you know, 9 to 5 job, and a lot of men do as well, you know, because men now are taking on a greater role in terms of parenting of children and that. So, you know, we must try and get more people into the public system, and in the private system. What has been proposed also is that for the dental treatment benefit scheme, the shortcomings and the limited number of services that are available under is being outlined very, very graphically here this morning. But Portugal, as I understand it, has a voucher scheme, and not to make this look cheaper, but the voucher scheme would allow people to access the services that they consider that they need, or that the dental surgeon considers that they need, under the dental treatment benefit scheme, and it is something maybe that you would consider. I mentioned the six-year wait on this for orthodontic services, and what is happening there is that nothing happens during school term, during primary, nothing happens during secondary, and to come out the other end, and of course that is it, it is all over at that stage. You know, the opportunity is gone, and that is really, really very, very disappointing. I want to read to you just a very short letter, one of the many letters that I get, but this came from somebody working in the public dental services, and she says, hi Brian, I am working within the HSE public dental services, and I want to outline to you the staffing issues. There have been jobs advertised, but no dentist have applied. There are currently two full-time dentists covering all of Leish. We are currently doing late evenings to try and get through the list, and I want to acknowledge here the efforts of one particular HSE manager in getting that in place, Joe Rowan. I want to just mention that, acknowledge that, because there are people trying to change things, and I welcome the fact that I want to recognise the efforts of those people working late in the evening to try and do that, to try and shorten the list, and get on top of this. They want to say there are very few dentists qualifying in Ireland, as college spaces are limited, and no nationalists tend to go back to their home country once they are qualified. Maybe you could speak to the dental hospitals in Dublin or Cork, and maybe they could come up with a scheme that once qualified you have to practice in Ireland for a year, and some have mentioned here this morning two years. I know two years ago 43 dentists qualified in Dublin, and only 10 stayed in the country. I'm going to finish at that point, and I want to read the rest of it, but that to me brings it home in terms of the problem that we are facing. It has been mentioned that the overall dependence on foreign students, and nothing against foreigners, they are welcome, particularly those who are working in our public health system, but you have governments of other countries paying them to come here to train. The funding from that is supporting the dental schools. This is something I put a lot of work into looking at this in recent months, and indeed over the years, but in the last few months I decided to give this a particular focus here, while I'm here in the Dáil representing Leish during this Dáil term. We can't have a situation where the dental schools are dependent on that. The spaces are taken up, we are not educating, we are not training enough dentists to work here in the system, either in public or in private, and we need to get on top of this. It is not a luxury, as has been outlined already, it is not a luxury. We do need a fix, and I outlined that the new dental plan and the Minister, when she spoke earlier on, referred to it, the timeline for it, but that needs to happen a lot quicker. We need that scheme as well for the under 7s, the dental schools, you know, TCD, UCC, you know what needs to be done there in terms of additional funding for that. The structured mentorship programme, and different forms of that have been spoken over here this morning, but that needs to be brought on stream so it can gain work experience. The HSE recruitment, and one, I think as Deputy Sherlock mentioned, a 14-month wait for one person who is recruited between actually being saying, yes, we are going to take you on, and actually starting on the job. They go elsewhere. They are not going to hang around. They can't hang around, because they have to bring in money to live in a very expensive economy and country. You know, the recruitment as well for the DTSS scheme, there is something still wrong there. I know the fees have been increased, I acknowledge that, and they are good for it here. You know, it is 40% increase, but it is not being taken up, so there needs to be a dynamic advertisement and recruitment campaign there for the DTSS scheme. The treatment benefit scheme, you know, expand the services there, look at the voucher system as well as being one option. I am not sure, you know, I am not going to audience and out of it, but it certainly should be considered. And for those people who have special needs, and I really plead with you on this because I have come across some terrible cases where somebody has to have treatment or anaesthetic because they are autistic or whatever, you know, they have some other condition. They really, you know, I have seen awful situations there. That really needs to be fixed, and that needs to be fixed in the hospitals that are providing that services. So, Minister, I welcome the opportunity. I know you are not opposing the motion, and I welcome that. But I am asking you, let us not just go here this morning and nothing happens. Let us use some of the suggestions that are put here this morning. They are being put forward genuinely, you know, from Kerry to Donegal, from Galway to Dublin, and from Leish, I am telling you, it is really, really serious in Leish. It needs to fix, and I am pleading with you, as ministers in this Government, to fix this issue. Thank you, Deputy. That concludes the debate on the motion. I know it is not being opposed. Is the motion agreed to? Agreed. Those in favour of the table? It is against St Neil. The motion is carried.