Smile agus Sláinte – Ireland’s new National Oral Health Policy – will cover 1.1 million children under 16. The policy, which was announced on 3 April, will also extend the dental care available to 1.3 million medical card holders.
However, the announcement is not without controversy. Dental professionals and commenters have questioned the government’s ability to deliver on its promises, as well as the real cost of providing the care.
A move to prevention
Under the scheme, under-16s will receive free oral heath ‘packages’ that will entitle them to examinations, assessments, advice, prevention interventions, emergency care and referral as appropriate. Medical card holders will have access to a similar suite of treatment.
The new plans will see private dentists providing the majority of this care under contract with the HSE, though details on how this will work have not been released.
The €80m estimated cost of delivery, carried out by the Economic and Social Research Institute (ESRI), does not take into account the cost of staffing, education, or governance.
The government is calling the proposals a move away from ‘diagnosis and treatment’, towards a more preventive approach.
Minister for Health, Simon Harris TD, said that Smile agus Sláinte ‘provides the guiding principles to transform our current oral healthcare service over the next eight years’.
Currently, children in Ireland are entitled to two dental examinations while they are in primary school, while some emergency treatments are also covered by the State. Their first examination is supposed to be when they are seven years old, with a final check-up in sixth class.
However, with a backlog of 84,000 children and adolescents on waiting lists, the Irish Dental Association (IDA) has previously warned that most children do not receive their first examination until they are at least 12.
Despite welcoming the policy as ‘long overdue’, the IDA has criticised the government for a lack of consultation with the profession.
In a statement, IDA president Dr Kieran O’Connor said: ‘…The fact that the Minister and his Department failed to consult in any meaningful way with the IDA – and other stakeholders – on the new policy indicates that key lessons haven’t been learnt’.
He added: ‘Over the last decade the government has slashed spending on oral health programmes, taking close to €1bn out of the system.
‘The proposed reforms – which are linked to the cross-party Sláintecare programme – will necessitate huge investment and resources by the state, so it’s essential that sufficient, ringfenced funding is set aside for them.
‘The new policy will also provide the first real test for the government of its commitment to Sláintecare. It’s all very well to promise free dental care to the under sixes and to say you are then going to extend it to all children under 16.
‘Delivering on that promise is another matter entirely.’