Still waiting for a policy on oral health

 

Sir, – One year ago, in the December 2017 edition of the Irish Dental Journal, the president of the Irish Dental Association penned a special editorial about the oral health policy then due to be presented by the Minister for Health at the end of January 2018.

In his editorial, Dr Robin Foyle was scathing about lack of stakeholder engagement and no consultation with the Irish Dental Association in the formulation of the impending policy.

The association was not invited to make a submission, and the stakeholder meeting that took place in Limerick in 2015 was described as a waste of time.

Since the publication of that editorial, it has come to light that the University of Limerick was engaged and tasked with consulting with the dental profession about the oral health policy.

The method of research should have involved consultation with dental students, dental educators, primary-care dentistry providers and other dental health professionals.

This research was abandoned by the university on the instructions of the Department of Health or its secretariat, the Dental Health Foundation, on October 17th, 2017.

Despite significant cost to the exchequer, the process was never completed, and the findings of these consultations were never reported.

On December 5th this year, Dr John Morley, dean of the Royal College of Surgeons in Ireland’s faculty of dentistry, stated that the Department of Health failed to consult with his faculty on the oral health policy.

On this basis, it is reasonable to assume that the RCSI was not the only academic body to be excluded from the consultation process and that the other Irish dental schools had little or no input either.

In short, the Irish Dental Association was never consulted in any meaningful way, and dental educators were not consulted at all, despite major concerns in the profession about foundation training, continuing professional development and access to specialist consultant training.

The work of the Department of Sociology in the University of Limerick to consult with the profession in order to gain a comprehensive insight of the profession’s views was never completed.

The Oral Health Policy Academic Reference Group was responsible for identifying and collating information to provide an evidence base for the decisions taken when developing oral health policy.

Part of their brief was to take account of the feedback from the Practitioners’ Group.

We now know that this could never have happened because there was no feedback.

Furthermore, on December 18th, 2018, Minister for Health Simon Harris stated in an answer to a written question in the Dáil that: “the work has drawn on a wide range of inputs including deliberations of oral healthcare professionals through a series of working groups, detailed research and service user surveys which were commissioned to inform the work, consultation with a wide range of dental and oral health organisations and engagement on specific topics with dental practitioners”. The evidence suggests otherwise.

Despite these ministerial assurances, it is difficult to understand how this new oral health policy was informed and how we can look forward to any meaningful improvement in the provision of dental care for the Irish public for 25 years to come.

Dentistry in this country is a shambles and has been for many years.

We are the only country in the first world where a dental graduate from an Irish dental school is free to take on the most complex dental case without vocational help or supervision on their first day in practice.

For almost a decade, limited dental care is rationed for the poorest of our people with a bias in favour of extraction of teeth and provision of dentures over restorative or preventative care.

Our children’s dental health, the responsibility of the State, is in complete disarray through lack of funding and proper audit.

Meanwhile, thousands go abroad for complex dental treatment every year, with little or no follow-up care.

We are looking for guidance for the future from this new oral health policy which the profession can have little faith in because it appears that the views of the profession have either never been asked for or have been ignored.

On December 18th, 2018, the Minister for Health stated that the oral health policy is currently being finalised and will be published in early 2019.

Déjà vu! – Is mise,

Dr PÁDRAIG

Ó REACHTAGAIN,

Dental Surgeon,

Roscrea,

Co Tipperary.