Chuaigh níos mó ná 100,000 páiste bunscoile gan choinne scagthástála fiaclóireachta anuraidh. Tá sé soiléir ó Fheidhmeannacht na Seirbhíse Sláinte gur tharla seo mar gheall nach bhfuil an fheidhmeannacht ábalta níos mó baill foirne fiaclóireachta poiblí a earcú mar gheall ar an gcosc earcaíochta atá i bhfeidhm ag an Rialtas agus mar gheall ar mhíbhainistíocht ár seirbhísí sláinte. Gan dabht, tá níos fearr tuillte ag ár bpáistí. More than 100,000 primary school children went without dental screening appointments last year. That is according to the Irish Dental Association's analysis of the HSE data. More than 200,000 children were eligible for school dental screening appointments with public dentists, but only half of them received appointments. The other half were left without what they were entitled to. Children should be seen in second, fourth and sixth classes, because those are the years that correspond with dental milestones. Screening at these points is essential. It is necessary to identify early signs of disease or a need for more serious orthodontic intervention. Delays in these assessments reduce the chance of preventative measures when the disease is not caught early. Without preventative care, children face poor oral health.

The HSE corresponded with my colleague Deputy Cullinane and expressed concern at the extent of the backlog in preventative intervention and treatment, which the public health service has not been able to manage. The HSE has been clear about why this happened. It stated that the ability to offer services to children in each of the school years has been limited due to the availability of dental staff. No surprises there. The Irish Dental Association has stated that compared with 15 years ago, there are 74 fewer public dentists. That is a drop of 23%. The burden of missed care falls disproportionately on lower income households in rural and urban communities. At the same time as the collapse of the school screening programme, the number of dentists providing care to medical card holders has also collapsed. In 2016 - eight years ago - there were 1,600 dentists on that scheme; now there are only 800. Every year, the numbers decline. That means that if their parents do not have deep pockets and cannot afford private healthcare, ranging from hundreds to thousands of euro for fillings, crowns and implants, these children face dental decay, poor oral health and even tooth loss. They are more likely to suffer pain and to miss school, and it impacts their education and their social life. The Irish Dental Association has estimated a dentist shortage of about 500 across the public and private systems.

When asked about plans the HSE had to hire more public dentists, the response was devastating. The HSE informed my colleague David Cullinane that the embargo does not allow it currently to appoint any dental staff not at consultant level. It also stated that while the embargo is in place, no additional staff will be appointed. That is the nub of the problem. The Government is preventing our health service from recruiting staff to treat our children while one in two of them goes without what they are entitled to. The HSE cannot recruit public dental staff, other than consultants, because of the Government's decision and because of the Government recruitment embargo that is still in place. The Government is driving the privatisation of basic dental services, despite the fact that the vast majority of private dentists strongly support this essential service, particularly for children in school. It is one of the most basic forms of cost-effective, preventative healthcare. The Government is punishing ordinary families who cannot afford private healthcare as a result of its own incompetence and mismanagement of the health budget.

Our children deserve better. They do not deserve to be waiting and waiting. Access to care needs to be on the basis of need, not the ability to pay. Will the Government now, finally, lift its ludicrous recruitment embargo and launch a serious catch-up programme for these children? Will the Minister tell us what the Government's plans are to recruit and train more dentists?

I thank Deputy Doherty for raising this matter. This is a really important service and a really important issue. It is important we get the dental service children need at a young age. That is why it is in the school system. It is also a key priority for the Government. We have been investing over €200 million annually in the provision of oral healthcare, targeting, in particular, those most in need of support to access that care. This includes, importantly and in the context of the issue the Deputy raises, an additional €15 million in core funding since 2019-20 to support the national oral health policy, Smile agus Sláinte, and an additional €17 million in one-off funding to address service backlogs. The HSE is progressing the development of oral healthcare packages for children from birth to seven years of age. That is being supported by an additional funding package in the most recent budget of €4.75 million to facilitate the development of that service. We are also seeing additional investment being provided to target orthodontic waiting lists, prioritising those who have been waiting the longest to access treatment. In 2023, more than 2,000 patients were removed from the HSE's orthodontic treatment waiting list as a result of that funding. There was a reduction of 47% in the number of patients waiting to commence orthodontic treatment between the end of March 2020 and the end of June of last year. In addition, a new orthognathic, or jaw surgery, waiting list initiative commenced in September of last year, providing complex surgeries to patients. These surgeries require lengthy hospital stays. In addition, a further €3.35 million is being invested this year on a one-off basis to support the continuation of measures to reduce orthodontic waiting lists, prioritising those most in need.

We absolutely accept the importance of dental services to young people, particularly those who are of school age, the early advice intervention as regards good oral care and, particularly, treatments where they are necessary. We accept that there are pressures on the system. As a Government, we are significantly increasing the funding to help to address that, and I know the Minister, Deputy Donnelly, is particularly focused on that. We will continue that work because, as regards the two biyearly assessments that young children get when they go through primary school, it is really important we ensure that the resources are in place and that they get them when they need them. This certainly prevents many challenges down the line and ensures that children get the treatment when they need it.

The one thing on which I can agree with the Minister is that there is serious pressure on the system. Where we differ, however, is that the Government is putting the pressure on the system. The clinical lead tells us in correspondence we have from the HSE that it is a Government decision that is preventing these children from being treated. We have a serious problem. One in two children who are entitled to these appointments are not getting them. That is 100,000 young children. We all know the impact that delayed diagnosis and delayed treatment can have on the child and on oral health but also on self-confidence and all the issues in that regard. The HSE could not be clearer. The Taoiseach stood here yesterday and said there is no recruitment embargo. The HSE tells us the recruitment embargo is still in place at this point. It states that while the embargo is in place, no additional staff will be appointed.

I put it to the Minister again that there are 100 children being failed by his Government and by a Government decision to implement a recruitment embargo that makes sure that there will be no additional dental staff employed outside of consultants. What is the Government going to do about it? We have told the Government what needs to be done. It needs to lift the ludicrous recruitment embargo that is failing our children so badly and it needs to train more dentists.

Hear, hear.

We are recruiting staff.

Read your own memo.

Obviously, we have to work within the budgetary envelope-----

The Government has an embargo in place.

-----that is provided. However, a record number of staff have been employed across the health service during the lifetime of this Government.

The HSE states that no additional staff will be appointed.

Please, let the Minister respond.

An additional 28,000 staff have been employed across the health service. It is particularly important to ensure that we resource the provision of dental services. We accept the importance of early intervention.

No, you do not.

We absolutely do. As already outlined, we are putting additional funding in place to address backlogs. We want the backlogs to be addressed and the service improved.

What about the embargo?

Across the board-----

Lift the embargo.

-----there has been a significant increase of 50% in funding for the health service-----

Lift the embargo.

Would you stop heckling please?

-----generally over the past four or five years under this Government. We want to ensure the health service is as strong as possible.

Then lift the embargo.

This is laughable stuff.

In the context of dental healthcare services, we are putting additional investment in place. Some 900 additional staff were employed within the service as recently as last December in order to improve the service further.