Funds for just nine public dentist roles in Cork and Kerry for vulnerable groups

A senior dental surgeon in a special needs job may work with frail, elderly patients or people with mental health conditions. The role can also include treating homeless people or asylum seekers, according to recent HSE job advertisements. File picture

Cork and Kerry have funds for just nine senior public dentist roles to treat children with disabilities and other vulnerable groups, in spite of long-standing Government vows to ensure better access.

The low numbers have been described as “astonishing” by the Irish Dental Association, while a Government TD demanded “decisive action” on the gaps.

Former health minister Stephen Donnelly said as far back as 2021 that “root-and-branch” reform of the HSE’s dental treatment services scheme (DTSS) was needed.

Many people with disabilities need to go under general anaesthetic to have dental care, including autistic children.

A senior dental surgeon in a special needs job may work with frail, elderly patients or people with mental health conditions. The role can also include treating homeless people or asylum seekers, according to recent HSE job advertisements.

Figures from HSE South West show last year the equivalent of 7.73 roles were filled in Cork by 11 senior dental surgeons, with some working part-time.

In Kerry there are two senior dentists covering the equivalent of 1.6 full-time roles. Another role, equivalent to 0.4 of a full-time position, is vacant.

The only slight change in both counties is an extra allocation of hours equivalent to 0.2 of a full-time role. This brings the total to the equivalent of 9.33 roles.

The interim head of service for primary care, Mari O’Donovan, said recruitment has started for the Kerry vacancy.

In a letter released with the figures, she said the service is for adults and children with special needs, children under 16, medical card holders, and others in the care of the HSE.

These patients are split between HSE dental clinics and private dentists under contract through DTSS.

The update was released to Fine Gael TD Colm Burke following a parliamentary query. He said the figures confirm what families already know — that there are simply not enough dentists in the public system.

This is most stark for children, where delays to screening and treatment can have lasting consequences.

There has been “a severe reduction in public care for children”, said Mr Burke, adding that there are now 640 fewer private dentists working on the DTSS than 12 years ago.

He called for recruitment and reform of the DTSS among other measures. “Without decisive action on recruitment, contract reform, and training capacity, children in Cork will continue to wait far too long for basic dental care,” he said.

Irish Dental Association chief executive Fintan Hourihan said the workforce is “absolutely a very low number”, adding: “Given the population of Cork and Kerry, they’re woefully understaffed.”

He said “the collapse” of DTSS is adding to the strain for the small number of senior public dentists. “There’s over 1.6m people entitled to hold a medical card and they’re finding it impossible to get a dental appointment because there are fewer private dentists in the scheme.

“So they’re now presenting to HSE clinics,” said Mr Hourihan. “The HSE dental services doesn’t have enough [dentists] to see children and special care patients but they are now dealing with international protection patients, medical card holders.

This is a perfect storm now. They were falling behind in terms of the dentist numbers to see their patients but now they’re seeing additional patient cohorts.

Analysis by the Irish Dental Association, prepared in November last year, shows 104,000 children nationally waiting for a public dental appointment. This comes to about half of those eligible. It identified a six-year waiting list for orthodontic care, including braces for children.

The schools programme is also under pressure, with 31,000 fewer children seen in 2023 than in 2017, it said.

The association will meet the Oireachtas health committee next week.