I very much welcome the opportunity to speak on this motion and I thank Sinn Féin for introducing it this evening. The Labour Party will very much be supporting this motion. The Government has effectively watched our public community dental services collapse over the last decade. It is very clear that oral healthcare is very much the poor relation of the health service. It is almost a year to the day since we had a debate in this Chamber last year, with a motion then sponsored by Deputy Stanley. It is clear that almost little or nothing has happened since then. We are seven years on since the smile agus sláinte national strategy on dental care was published, yet we have seen a deterioration and disregard for public dental services in this country. One of the critical things we know about dental care is that prevention is as important as treatment. We know the one organisation that was set up 40 years ago to promote oral health awareness, the Dental Health Foundation, lost a massive chunk of its funding a number of years ago. We have to ask serious questions about the seriousness and intent of the Department of Health with regard to oral healthcare in this country. We know that so many people out there are now having to go abroad for cosmetic dental surgeries to make up for years of neglect by the public dental system. The size of your wallet should not determine your health, yet, in oral healthcare in particular, it absolutely is the case. People are no longer just afraid of the dentist's chair. They are terrified of the cost of visiting the dentist. We know that children in particular are not getting the dental care they need. Along with anybody else who was contributing to the debate last year, we looked at the drop in the number of public dentists and those participating in the dental treatment scheme. It is devastating to see and was reflected in the cross-party report that Deputy Rice spoke about. It was from the Oireachtas health committee and was published a number of months ago. It very clearly set out what needs to happen. We have seen little or no response from the Department of Health since then. Earlier this year, the Irish Dental Association told our committee that more than half of dentists had withdrawn from the medical card scheme, leaving thousands of patients without the free care they are entitled to. If that were to happen within GP care, there would be absolute uproar and alarm - rightly so. Yet, we are not seeing that same level of attention or care for our public health service. The reality is that as of April this year, there are just 232 whole-time equivalent dentists across the public health service. In 2009, there were 330. It is scandalous that we have seen such a decline. I know from talking to public dentists on the ground there are enormous challenges with regard to trying to get additional dentists recruited into the system. Business cases sit there for months on end. That is absolutely unacceptable if we are to take public dental care seriously. The reality is that those on medical cards and those who struggle to afford to see a dentist are the ones who are most disadvantaged by this. They are the ones suffering from real inequality. People are genuinely delayed for months, just to save the money needed to get basic treatment. With regard to children, the number of children participating in targeted programmes and scheduled appointments within community dental services has significantly dropped. We know that across all CHO areas, the number of children in first and second class, or fifth and sixth class and other targeted groups, attending scheduled appointments has dropped dramatically over the past five years. Tens of thousands of children are leaving primary school without any basic checks. Last year, I relayed a story in this Chamber of a public dentist telling me that she had patients, who were no longer children because they were driving a car, driving themselves to an appointment they were supposed to get in sixth class but they were in fifth or sixth year by the time that appointment came through. That is absolutely unacceptable and the costs we are storing up for our health service further down the line because of those delays to care is frankly outrageous. We know there was a 30% drop in the number of children attending these scheduled assessments between 2019 and 2024. The reality is there is a bit of a ticking time bomb here. If we do not put the money in early to the preventative aspect of our dental healthcare system, we will end up with a health system that has much greater costs further down the line. Surely, the ambition and aim of all of us here should be to ensure we are looking after people's health as opposed to ill-health further down the line. I very much welcome in particular the reference to general anaesthetic services in this motion because the reality is there are hundreds of children across this country who need general anaesthetic to receive dental care. Many are waiting over a year. There are children and special care adults left in excruciating pain with simply nowhere to go. We know people have to travel very long distances. In the south west, 310 people with additional needs are waiting more than a year for general anaesthetic. In some parts of the country, like my own area of Dublin north city and west, there is no special care service for children at all. We know children have to travel to either Louth or Kildare to get general anaesthetic if that becomes available and, of course, they are in the queue with everybody else from that area. The reality with the dental treatment services scheme, DTSS, is that we have seen a drastic reduction in the willingness of dentists to participate in it over the last number of years. We must have a serious conversation with dentists about that. It is not good enough to just wave our arms in the air and say there are dentists going into cosmetic surgery and they should stay in dentistry. We need to have a serious conversation about the number of dentists who are currently in the private system and the number who would be willing to get involved with the dental treatment services scheme if the conditions were right. This is not about a free pass for dentists. This is about a serious negotiation. The other aspect of it that is critically important is what is actually available within the DTSS. It is frankly bizarre if you have had two fillings and require a third one in a particular year, you have to wait a further year but there is no limit on the number of extractions done. That is from the dark ages and we have to change how the dental treatment services scheme is designed. It is also critically important to say the recruitment of dentists needs to be significantly looked at. We know there has not been any significant expansion or investment into our dental schools in decades. Barely half of the 70 dentists who graduate in Ireland each year opt to practise here in the long term. We know we need to add dental nurses and hygienists to critical skills lists. The other key issue for me is that notion of an apprenticeship scheme for dentists. I remember 20 years ago, which was a time dentists were coming out of college around the same time as myself. Dentists were able to do part-time work with the HSE and part-time with a private practice. It was excellent training for that year after they graduated. Many dentists stayed in the private system but continued to provide that public care through the DTSS. Unfortunately, that system fell away in the intervening years and we do not have that nature of apprenticeship now within our dental services in this country. That needs to be restored. The plea is that we will not be standing here again this time next year talking about the same issues. We need to make sure the right investment goes into dental services and, in particular, there needs to be an absolute focus on prevention so that we are not storing up greater issues for our health service further down the line.

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