Brian Stanley: Three public dental schemes are in chaos
Brian Stanley raised the crisis in Ireland's three public dental schemes in the Dáil, citing fresh waiting-list figures from County Laois and demanding action from the Taoiseach and the Minister for Health. He set out failures across the school dental scheme, the Dental Treatment Services scheme and the PRSI-based Dental Treatment Benefit scheme and warned of serious health harm from long waits.
Immediate facts: The Deputy gave new statistics for Leash showing 6,618 children on the waiting list for a first school dental examination, including 818 who are seven years overdue. He described medically card patients having no local provision under the Dental Treatment Services scheme and criticised the limited scope of the Dental Treatment Benefit scheme.
Problems in Leash and beyond: Stanley singled out County Laois as a particular black spot where public provision is effectively collapsed, with only a single dentist from a neighbouring county providing limited services. He said private practices are not taking on medically card patients and that recruitment and training numbers must increase to address the gap.
Patient harm and special-needs case: The Deputy warned of serious consequences from delays - advanced tooth decay, gum disease, stomach problems and even cases requiring hospital anaesthetic. He referenced a special-needs child who waited six years in severe pain and only now has a consultation scheduled.
Government response and next steps: The Taoiseach acknowledged significant difficulties, referred to ongoing funding and recruitment efforts, and said he would ask the Minister to engage with the Deputy about County Leash. Stanley pressed for a fundamental re-examination of how dental services are provided, more training places and active HSE engagement with local dentists.
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Taoiseach, I'm raising with you again the three dental public schemes. You'll recall me raising these with leaders' questions last year with you. The three public dental schemes, the Dental Treatment Services scheme, the Dental Treatment Benefits scheme and the school dental scheme are in chaos. They're not functioning and I'll give you the example of Leash. It's worse now than last year when I raised it with you. It's in the dark ages. The school dental scheme currently, the figures have 6,618 on the waiting list for the first examination. That's an increase of 175 from when I raised it on you last year. And there's 818 of those who are seven years overdue. Some are not getting their first examination until they're in fifth year in secondary school. The harm, there's huge harm done in the meantime with serious tooth decay and other problems. 818 who should be seen in fourth class, but the HSE have it that they're changing their tune on it, that they're marking them from sixth year, but they've accepted that it's fourth year, third and fourth year should be seen. That's 818 are seven full years over time. 1,504 are six years over time and 1,520 are five years over time. They're adults before they're seen for their first examination and that exam should happen in fourth class. You're failing the children of Leish and other counties as well, but I know Leish is a particular black spot. The dental treatment services scheme, which is for medically carried patients, I told you last year that this scheme has collapsed in Leish. It's still flat on the floor. It's nonexistent in almost all of the county. There's still just one dentist from Carlow who provides a service in a community centre in on the borders of Leish and Carlow. Not one, not one other practice in the county is taking medically carried patients under the dental treatment service scheme and that's an absolute scandal. Medically carried holders are without a service in Leish. Meanwhile, eight are being recruited, eight are doing it in Offaly and I welcome that fact. You know if they're 16 that's good because they didn't raise Offaly before when it was in the constituency. And what's the government doing to address this? The dental treatment benefit scheme, which is a PRSI based one, that scheme has little or no substance. Just one, just an examination and polish. That's all you get. And low and middle income workers and their families are being failed despite the fact that they're paying thousands of euros in tax, PRSI and USC every year. They can't even get an extraction or a fill-in. These workers and their families are better. We're way behind other countries and we have failed them. As I said, you're in the dark ages. There are other health problems caused by this such as such as stomach ulcers, gum disease, even blood poisoning has been caused causing much more. Will you now take action to address this? You as Taoiseach and the Minister for Health. First of all Deputy, thank you for raising the issue and I would acknowledge that there are very significant difficulties and challenges with the dental treatment medical scheme more generally or with dental health in terms of the poor capacity in the public sector and the public sector's side of dental treatment and the preponderance has been of people are towards the private and the difficulty in terms of recruitment and establishing a comprehensive structure when in a dental public health service has proven problematic for quite some time. Now there has been negotiations with the IDA and between the Department of Health. There has been additional funding allocated. You've instanced perhaps some of the impact of that in Offaly. I don't have the specifics of Leash County per se but that the seems to me that the and I will speak to the Minister about this but that we need a more fundamental re-examination of how we provide dental services into the future in the most efficient and effective way that meets the needs of those who require such treatment and what's the best mechanism for doing that because I think existing approaches and the more traditional approach of the past has not borne fruit in terms of where dentists choose to operate or tend to do their practice and so on. I think that is a difficulty but I will ask the Minister to engage with you in respect of the situation in County Leash more specifically because you raised that on the school dental scheme. Overall by the way dental health has improved fairly significantly for broader because the public health side of dental health has been has been positive in terms of the basics that people need to adhere to but those requiring treatment many are waiting too long and particularly for orthodontics as well. You're accepting patients in Taoiseach and you don't have the specifics of Leash but I'm actually giving to you. They're only a week old most of them statistics that I gave you in relation to Leash and what I'm saying to you is that the three public schemes are in crisis. I didn't get to mention the special needs boy that I raised with you and Jennifer Carmack-Neal and previous Ministers before. After six years of waiting in severe pain with periodontal disease, severe inflammation and bone loss he has to be treated under anaesthetic in hospitals and I've raised it here a number of times. Only now is he getting an appointment to be actually for a consultation and that gives you the scale of it. So three dental schemes need to be fixed that's key. So will you now step up recruitment in Leash? There's a particular problem in Leash, the number of people in training places in dentistry has to be increased. What we have to do is is that will you now ensure that there's an active engagement, there needs to be an active engagement between HSE management and dentists in Leash to ascertain why the private dentists are not taking them on. Thank you Deputy, Taoiseach will respond now Deputy, your time is up, Taoiseach please. The people are moving more into the private sector, I mean that's the reality but I take your point and there are ongoing reviews and discussions on this between the Minister and representative organisations and in terms of the recruitment has been ongoing and additional funding has been allocated over the last two to three years. Well I don't have the specifics on Leash but I will, I know you do, and I'll ask the Minister to engage with you in respect of County Leash specifically and in terms of the prioritisation in my view those with special needs should get first priority in terms of interventions. Thank you.
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