I want to raise a matter of real concern which may never cross most people's radars: the serious lack of access to dental care and surgery for people with disabilities, wheelchair users and those with significant challenges. The issue is not theoretical. In recent weeks I spoke to a constituent of mine who uses a wheelchair and has been waiting over 18 months for essential dental surgery. That is 18 months of pain, infection and distress, and all because there is nowhere in her region equipped to safely treat her. She is not the exception; she is one of many. Much of the information I am sharing today comes directly from the Irish Wheelchair Association, which has always been clear and consistent in highlighting the barriers people with disabilities face in accessing even the most basic dental care.

Right now, Ireland is reported to have only two specialist dental beds for public use that can allow dentists to carry out procedures on someone who cannot be treated in a standard dental chair. Two beds, and that is for the 20% of people living with some form disability.

There are hundreds of people right across the country waiting for treatment for months or possibly years. Many are living on soft or pureed foods. Some are taking repeated courses of antibiotics or relying on daily painkillers just to function. We are not talking about cosmetic procedures here. They are urgent, medically necessary treatments for infection, decay and severe pain - the same conditions that, for the rest of us, will trigger emergency care. This is not due to a lack of dedication from our dental professionals. Our dentists and nurses throughout Ireland are doing exceptional work under impossible constraints. The problem is capacity. Just to be a wheelchair-friendly surgery is not enough. We do not have the facilities, the specialist equipment or the trained staff to meet even the basic oral health needs of people who cannot physically access a standard dental chair. It is not acceptable that in 2025, in order to receive care under anaesthetic, a person with a disability must travel to Dublin and hope to get access to one of only two available dental beds. It is not acceptable that families are told again and again to keep waiting while their loved one lives on in pain. It is not acceptable that disability continues to mean de-prioritisation within our health system.

I am hoping for some urgent action. I have a bit of a wish list here that may help. It asks for a national review of special care dentistry capacity, including access to theatres and anaesthetic support, immediate funding to expand dental surgery facilities beyond Dublin into every region and the installation of a specialised dental chair for routine and ongoing care in every primary care centre in the country so that people with disabilities can access preventative and restorative dental treatment locally without needing hospital referral. It also asks for a long-term workforce plan to train and recruit more clinicians in special dental care.

This is not a matter of luxury. We are not talking about people getting cosmetic dentistry. It is one of dignity, equality and health. Oral health is integral to overall health. We all take for granted that we can pop to our dentist and have a check-up, but it is not that easy for people with mobility issues. Right now, their access to that care depends on luck, geography and the ability to fight their way through a system that, to be honest, was never designed for them in the first place. Two specialist beds for an entire country is not a health system. It is an oversight that I feel is bordering on neglect. I ask that this issue be treated as a matter of national priority. I ask the Minister of State to please bring forward a plan, one that ensures every person with a disability in every part of Ireland has access to the dental care they deserve, provided locally, safely and, of course, with the utmost dignity and respect.

Before I call the Minister of State, I welcome Senator McCarthy's visitors from Ukraine. Pryvet. I hope you have a good time in the Oireachtas.

I also welcome Rodion and his family. We are delighted to have them here.

I am taking this Commencement matter on behalf of the Minister for Health, Deputy Carroll MacNeill. I thank the Senator for the opportunity to address the issue of accessibility and dental services for people with disabilities. The national oral health policy has two key goals, namely, to provide the supports to enable every individual to achieve their personal best oral health and to reduce oral health inequalities across the population by enabling vulnerable patients to access oral healthcare and improve their oral health.

The Government has invested over €230 million annually in the provision of oral health, including an additional €15 million in reoccurring funding since 2019-20, to support progress on the national oral health policy. The dental treatment service scheme provides a range of care, free of charge, to medical card holders aged 16 and over. More complex care, as well as a broader range of treatments for patients with additional needs and high-risk patients, are available, subject to the approval of the local HSE principal dental surgeon.

Last year, the HSE oral healthcare service provided dental care to over 150,000 adults and children. This includes almost 50,000 emergency appointments to eligible patients, either on a same-day or next-day basis. It also includes those with additional needs who cannot receive care in a general dental practice. The HSE provides these patients with an oral health examination and, where necessary, their treatment is provided using additional supports.

The HSE has invested in additional equipment, including wheelchair tilts, which enhance the accessibility of dental surgeries for wheelchair users who cannot self-transfer to a dental chair.

There are currently 12 wheelchair tilts in place nationally, with a further five being considered as part of dental location developments. There is a further range of patients who are wheelchair users who are unable to attend routine dental treatment due to comorbidities. These patients can be supported to access treatment under sedation or general anaesthesia.

Through the implementation of the national oral health policy, Smile agus Sláinte, the Government has committed to reforming oral healthcare services for people with disabilities. I know this is a priority and I understand that there are challenges that we definitely need to address. The Senator mentioned the Irish Wheelchair Association. The work that it does around the country is exceptional.

Oral health services will be prevention-focused and will be tailored to each age group across the life course, from birth to old age. Patients with additional needs will be supported to mainstream to a local general dental practice of their choosing, while the HSE oral healthcare service will reorient to provide care for those who cannot receive the entirety of their care in a general dental practice. The HSE will also develop the necessary models of care, clinical guidelines and care pathways to support the provision of these services. In budget 2025, a further €2 million was invested. The overall amount will increase to €4 million in 2026, which includes a commitment to provide an additional 15 HSE staff to deliver oral healthcare services, on top of continued efforts to address current vacancies.

I thank the Minister of State for her detailed response. It is good to see that it is being noted and looked at, and that there is provision. From my point of view, I hear from people who are suffering and have been for the past couple of years. What can happen in an implementation plan is different from what is on the ground. The idea of it being prevention focused - on the root cause, if the Minister of State will pardon the pun - is the ideal scenario. That is not what is happening at the moment, which is that people are not being treated quickly enough. There is a misnomer that many dental surgeries are wheelchair accessible, but that does not mean that somebody can go and get treated there. I welcome the fact that there will be more investment next year and the following year. I would still like to see more of these beds being put into primary care centres, not just to allow a wheelchair to be tilted but also in order that people can be treated with dignity on a bed or in a hospital of their choosing. I thank the Minister of State for that.

I thank the Senator for raising this matter. I assure her once again that the Government is committed to supporting access to oral healthcare services for people with disabilities, which is evidenced by the significant investment in recent years. A package of measures was introduced in 2022 to expand the care available under the dental treatment services scheme, DTSS. Significantly, increased fees have been paid to contractors. These measures have improved access to care. Payments for contractor claims in 2024 showed 227,691 additional treatments were provided nationally under the DTSS, with more than 44,208 extra patients treated compared with 2022. In the long term, the national oral health policy sets out a complete transformation of oral healthcare services and the expansion of care available for both children and adults.

Under the new model of care being developed by the HSE, families will be able to access free, age-appropriate oral healthcare for their children at a dental practice of their choosing in their local community which holds a contract with the HSE. Children will be able to attend for care starting from birth and continuing regularly throughout their childhood. The HSE oral healthcare staff will have a key role in the new model. There will be an important new model set out under the national oral health policy, which will be oriented towards patients with additional needs who are less able to attend a general dental practice and who must be enabled to have greater access to oral healthcare.

I understand totally. It is important that if someone needs a service, particularly if they are in pain, the service is there. I will go back to the Minister, Deputy Jennifer Carroll MacNeill. I will also be fully supporting this and, as I said, I will highlight concerns that are there but going forward, we will see change.

To reiterate, I really appreciate the Minister of State taking the time with regard to the national oral health policy. I will be keeping a close eye-----

Senator, we are out of time.

Gabhaim buíochas leat.

I thank the Minister of State and the Senator for their contributions.