Over recent years, I have lost count of the number of times I have heard of people going to Newry in the North or even abroad for dental treatment due to the cost and lack of availability of dental services in my constituency of Louth and east Meath. The lack of dental services is having a detrimental effect on children. For example, I spoke to a constituent last week about the orthodontic situation in Dundalk. Her daughter got braces two years ago. It was done publicly through the HSE. However, the orthodontist in question quit in February and the child has gone from being seen every seven weeks to not being seen for the past four months. She is looking after her braces herself. The mother inquired about the situation last week and was told there was nothing in the pipeline as regards interviews or potential replacements for the orthodontist in Louth, and even if one were appointed today, her daughter would not be seen for more than six months. At best, this child would be seen at the end of the year. Going private is not an option, as private orthodontists are either too busy or not taking referrals. This is one of many stories I have heard concerning children.

I have been contacted by numerous concerned constituents who have been refused dental care at their regular practices due to their medical card status. Constituents who are on the adult oral surgery list or who have a child on the paediatric special care waiting list have also come to my clinic, having waited an extraordinary length of time for their essential medical treatment. Some children who should have been seen by HSE dental care services three times before the age of 12 years are only being seen by dentists for the first time when they are well into secondary school. To put it in context, children are not being seen for the first of their three dental checks until they are 15 or 16 years of age. In parts of the country, there is a backlog of almost ten years in accessing the HSE’s school dental screening services.

Due to the effective collapse of the dental treatment services scheme, oral diseases are becoming more common. As they share common risk factors with chronic diseases like heart disease, obesity and diabetes, this highlights the potential dangers to which delayed dental care can lead.

Although the Minister for Health approved new measures to provide expanded dental care services for medical card holders under the dental treatment scheme in April 2022, the Irish Dental Association has stated that many dentists have withdrawn from the scheme and that it is not fit for purpose, meaning that access to dental care is scarce despite having a medical card. The number of dentists providing treatment to medical card holders more than halved.

All of this points to a grim picture for rural health services. This is a national health emergency and it is time the Government started treating it as such. This flies in the face of the Government’s promise under the national oral health policy to develop a model of care that would improve access and enable a preventative approach. The Minister for Health and the HSE urgently need to engage the providers and their representative bodies on putting an effective plan and resources in place to ensure that the people of Louth and east Meath have timely and effective access to essential dental treatment. Prevention is the best cure.

I thank the Deputy for raising this issue. Like him, I appreciate the frustration that families and, in particular, parents feel at not being able to access services in a timely way. We all see that in our constituencies when these queries are raised with us.

This is an area that has received significant investment in recent years, with more than €200 million allocated every year for oral healthcare. That investment is targeted at those who need it the most and those who cannot access services privately. There is a clear commitment. The funding is being used to treat more patients. Last year, more than 154,000 additional treatments were provided under the dental treatment services scheme, with over 26,700 extra patients, compared with the year prior. In 2022, the dental treatment services scheme was enhanced to reintroduce elements of preventative care, which is the best way to deal with this issue, and substantially increase the fees paid to dental contractors for most treatments by between 40% and 60%. Improvements in access to care and reductions in waiting lists in recent years have been supported by significant investment. An additional €15 million was provided in core funding to support the national oral health policy. A further €17 million was provided in one-off funding to improve access and try to reduce waiting lists. My understanding is that there has been a significant reduction in children’s waiting lists. In particular, the backlog in sixth class appointments has almost been cleared in all areas. The Minister for Health is working to ensure that we can address any further backlogs as they arise.

Regarding the current scheme, the Minister has increased the fees that are paid to contractors for most treatments by between 40% and 60%. They are now aligned with other European countries. Many countries, especially in Europe’s southern and eastern regions, do not have such a scheme, particularly for adults, which is free at point of access.

These developments are having an impact, with access to care increasing in 2023 and increasing further again in 2024. There are particular challenges in Louth, especially as regards orthodontic care. Work is being done to try to address those challenges. Where orthodontist positions have not been filled locally, the HSE is seeking other orthodontists within the CHO 8 area to take on patients where there is space within their practices. This has had a positive impact on reducing the waiting lists. There are full-time positions being sought, but other methods of recruitment are also under way, which will take a little longer. Every effort is being made to try to address what is probably one of the greatest challenges in Louth in terms of orthodontic care for young people and adults.

It is not working. The cost and availability of dental services need to be tackled, as does the orthodontic situation in Dundalk. Going private is not an option, as orthodontists are too busy or not taking referrals. Medical cards are being refused by regular practices. People are waiting extraordinary amounts of time for essential medical treatment. Children are 15 or 16 years of age before they receive the first of their three dental checks. I could go on. These stories highlight the urgent need to reform the current dental treatment services scheme model, particularly as it applies to medical card holders and children who require orthodontic or other dental treatment. Will the Minister please liaise with the Minister for Health to ensure the recruitment of an orthodontist in Louth as soon as possible while also ensuring adequate access to and funding of dental and aftercare services for children and medical card holders? My main fear is that children are seeing nothing but sparkling teeth on television programmes and they believe that they should have the same teeth. It is important that we get them services at an early age and that those who have problems with their teeth can get braces, but it is also important that aftercare be provided.

We are having problems. Will the Minister please liaise with the Minister, Deputy Stephen Donnelly, and see whether this can be tackled?

We are committed to improving services overall. On top of the €200 million budget for public oral health, there has been additional funding of €15 million for the Smile agus Sláinte policy and €17 million in one-off funding to improve waiting lists for orthodontic services. There was €10 million in 2023 to support a decrease in the number of patients waiting to commence that treatment. There has been another one-off investment this year of €3.35 million to reduce waiting lists further. That said, we want to improve services even more. We are committed to the comprehensive reform of oral healthcare services, as set out in the national oral health policy, Smile agus Sláinte. The Minister is working on an implementation plan for 2024 to 2026. It is being drafted by the Department of Health with the HSE and will be open for consultation and publication in quarter 3 of this year. Once it is published, I assume it will be supported by further budgetary measures to try to address backlogs and fill critical positions.