Kieran O'Donnell
Limerick City · Fine Gael · Ireland
“The triangle of supports of home care, day care and meals on wheels services — including dementia-specific supports — plays a vital role in helping older people to age well in their own communities. Meals on wheels services provide much more than nutritious meals.”
“The organisation currently operates a day care service four days per week, supporting approximately 60 registered users, and a meals on wheels service with 104 registered users. The HSE has advised that increased funding has been committed to support the organisation.”
“I join the Leas-Chathaoirleach in welcoming the Kellehers to the Seanad, which is a beautiful building in its own right. I thank Senator Kelleher for raising this important matter. He has advocated for Westgate Foundation over a sustained period of time and that has to be acknowledged. I know the work it does is close to his heart.”
“I again thank the Senator for raising Westgate Foundation in Ballincollig and the work it does on behalf of the community, particularly older people. The Senator referred to housing on-site. It is very much an integrated model. I could see how committed the staff and the board, many of them voluntary, were.”
“The Government has significantly increased investment in meals on wheels services in recent years. Funding increased from €3.5 million in 2022 to €6.25 million in 2025, with a further €2 million allocated in budget 2026 to support service expansion and maintenance.”
“The shared objective of the HSE and Westgate Foundation is to ensure high-quality day care and meals on wheels services continue to be available to older people who rely on them, particularly in the greater Ballincollig area.”
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“I move amendment No. 1: To delete all words after "Dáil Éireann" and substitute the following: "recognises that: — a national policy on adult safeguarding will be introduced for the health and social care sector, as set out in the Programme for Government, and this policy will commit to the development of adult safeguarding legislation for the sector, including nursing homes, and will build on the range of existing legislation, policies, and procedures already in place in the sector for preventing, reporting, and responding to abuse; — a framework for safe nurse staffing and skill mix will be developed for nursing homes, and this framework is a systematic, evidence-based approach to determine the number of nurses and Health Care Assistants required to provide safe and quality care, based on patient need/dependency; and — the remaining provision, Section 68 of the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023, will be commenced, providing additional powers for the Health Information and Quality Authority (HIQA)/Chief Inspector with regard to serious patient safety incidents in nursing homes, and the Chief Inspector will have the power to carry out a review of an incident which may have caused an unintended or unanticipated death or serious injury to the patient, and which occurred in the course of the provision of care to that patient; notes that: — a review will be established of the effectiveness of the Chief Inspector's inspection and monitoring processes, and this review will include such elements as how to further strengthen the monitoring of leadership, culture and governance in designated centres, how to better capture indicators of staff culture and other areas of service delivery, which is critical for safe and good quality support for residents; — a plan for additional public nursing home bed capacity will be published, and the Department of Health, alongside the Health Service Executive, is currently developing a new public long-term residential care additional capacity plan, which will be published in 2025, and the delivery of additional public long-term residential care capacity is required to deliver on Programme for Government, Sláintecare, and Project Ireland 2040 commitments; — new design standards for long-term residential care settings for older people across all sectors will be created, describing what good building design looks like for long-term residential care settings for older people, and providing a common benchmark against which the standard of these settings can be measured, and the Department of Health report entitled 'Design Guide for Long-Term Residential Care Settings for Older People Public Consultation Report', was published in January 2025; — ownership structures will be reviewed to enhance transparency and strengthen accountability in the long-term residential care sector, and carrying out an evaluation of the implications of complex corporate ownership structures against current regulatory powers will identify opportunities for regulatory reform; — the Government has reiterated its well-established commitment to the development of the statutory home care scheme in the 2025 Programme for Government, and the first element in delivering this is the Health (Amendment) (Licensing of Professional Home Support Providers) Bill 2024, which will establish a licensing framework for professional home support services and provide for regulation by HIQA; — the Programme for Government commits to strengthening the nursing home sector, by increasing funding for the Nursing Homes Support Scheme, also known as Fair Deal, while investment in Budget 2025 was €67.6 million, and this followed on from an increase in 2024 of €45 million; and — the Government established an independent Commission on Care for Older People, which is charged with examining the provision of health and social care services and supports for older people, and with making recommendations to the Government for their strategic development, including long term residential care; and further notes that from 2021 to 2025, the Government provided funding of €21.4 million, to enable people under the age of 65 to transition to an alternative community-based placement and provide in situ supports as appropriate.".”
“We are all looking to ensure that nursing homes are safe for older people. We have a responsibility. It is all about that for me. Nursing homes have the ultimate responsibility but it is how we can enhance regulation in this area so that if older people choose to go into a nursing home, they feel safe and have good care.”
“We also want to assist AHBs in that area by looking at a multitude of areas from the cradle to the grave in order that people can stay at home, go to work, etc. It might be independent living but light independent living, and the next step is more supported independent living. It is about the degrees so that people have that choice. It is something I feel very strongly about. HIQA has acknowledged that there is a need for an ongoing review of procedures, which is something we will strengthen. In response to Senator Rabbitte, we will look at transitional schemes. Senator Clonan referred to the younger cohort. It does not come under my direct remit but nursing homes do. However, it is something I will look at with the Senator. I thank Members for a very constructive engagement.”
“Once that is up and running, we have to define what statutory home care is. What do we want to see? We then need to bring in a system that gives people the choice to stay at home for as long as they wish. There will always be a requirement for long-term residential care because people's needs may be so great, so we need to make sure people feel safe in that environment. It is already there in that local authorities are working in the area of independent living, but I want to do that in a more structured way. The Department of Housing, Local Government and Heritage is looking at policies in this area. The programme for Government commits to local authorities looking at suitable sites for the provision of independent living.”
“There are regulations from 2013 and HIQA publishes standards on safeguarding with which nursing homes must comply. We will strengthen safeguarding. We want to provide safe nursing homes for older people. We are all working collectively in that regard. Senator Clonan made reference to the collective. I note the work he is doing with the Minister for Children, Disability and Equality. It is something I want to keep an eye on in terms of its general application. As Minister of State for older people, I am in two Departments - the Department of Health and the Department of Housing, Local Government and Heritage - so I look at health and housing. I want to provide statutory home care. The first step in doing this is regulating home care providers, which are unregulated at the moment. I hope to bring legislation on that to Government very soon.”
“At the moment, anyone who buys the shareholding in a nursing home takes on what is the existing regulatory history of the nursing home and does not have to reapply. It has to inform regarding a change of directors. In terms of consistency, these are things we can do. Senator Stephenson asked about the changes that will be made. It is a valid point. A body of work is under way with HIQA on processes in which it is engaged. The two nursing homes are key along with the overall Emeis group. There is safeguarding legislation coming in. The Senator asked about safeguarding. The HSE has set up a national safeguarding office. It does not have the powers to enter a nursing home uninvited but most nursing homes will allow it to come in. We will be looking at that in terms of overall safeguarding.”
“Fines constitute the other area we will look at and, if there were to be a significant shift in staffing levels in a nursing home, it would be obliged to inform HIQA. This was a key issue regarding Beneavin Manor and is something we need to look at. There is a lacuna where HIQA carries out inspections of individual nursing homes but does not have power regarding an audit of the parent company of that group. We are going to change that. I would like to see these companies audited and that any change in ownership of a nursing home, whatever form that takes, would necessitate re-registration. It makes sense that when a sole trader who owns a nursing home sells it, anyone who buys that nursing home would have to apply to re-register it.”
“Senator Costello referred to safeguarding, which is hugely important. I covered all the points raised by Senator Ryan. At the moment, HIQA carries out inspections and publishes reports after inspections. These reports deal with the day of the inspection. I want the reports to provide an update as to when there has been compliance with any conditions. It is a logical thing to do. It means that when reports are published, we will not only learn about the inspection, we will also learn about nursing homes that have complied with conditions or requirements imposed by HIQA. This is a positive thing. It would allow people looking at a nursing home on the HIQA website to see it in real time.”
“We are very much looking at that in this context. It is a priority for me, the Minister, Deputy Carroll MacNeill, and the rest of the Government. I have been in this role a relatively short time, but it is something I take very seriously. Senator Costello made a couple of points. HIQA has a power to go in unannounced to any nursing home, whether public or private. It regulates all nursing homes, regardless of whether they are public, private or voluntary, in the same way across all sectors. Senator Nicole Ryan referred to its powers. HIQA has the power to go to the District Court to enforce any aspect, including asking the court to impose fines. HIQA cannot impose fines directly. We are very open to giving HIQA the power to fine nursing homes directly. Financial penalties were mentioned.”
“I am grateful for the very good contributions of Senators. I probably will not get to every point but I want to deal with the points as raised. Senator Byrne was first up and said we had a balance in the model. Regulation is key to that, and that is why I want to strengthen the regulation in terms of HIQA to give that reassurance. She asked if funding could be provided to ensure activities for people in nursing homes. We can certainly look at that. Virtually everyone brought up safeguarding. I will give the House the context. It is correct that the legislation is there. It is being prioritised, to answer Senator Black. The programme for Government commits to bringing forward a national safeguarding policy. Within that will be the provision of legislation. The Law Reform Commission has done a huge body of work on this.”
“The Minister, Deputy Carroll MacNeill, the wider Government and I are committed to ensuring everything possible is done to ensure the distressing scenes we witnessed in the recent "RTÉ Investigates" and "Prime Time" programmes do not happen again in any nursing home across the country. Furthermore, I want to state clearly that I am committed to delivering a better future for older people in this country.”
“What we saw on the "RTÉ Investigates" programme was horrific and showed an absolute neglect and abuse of older people, but there are a lot of very good nursing homes out there with good and dedicated staff providing good care, and that is something that needs to be acknowledged as well. It is clear that the scenes that were witnessed in the recent RTÉ programmes have highlighted clear deficiencies in the standards of care being provided in some long-term residential care settings. I want to firmly reiterate that poor care, mistreatment or any other form of abuse of any person living in a long-term residential care centre is wholly unacceptable and will not be tolerated. Every resident of a nursing home deserves dignity, respect and the highest standard of care.”
“In my dual role as Minister of State with responsibility for older people and housing, I am also committed to a particular focus on housing options for our older population in the context of the new housing plan to follow Housing for All. It is absolutely vital we continue to increase the housing options and choices available to older people. Across the country, nursing homes in the public, private and voluntary sectors play a vital role in the provision of long-term care and other services. It is important to acknowledge the committed, compassionate and dedicated providers and care staff operating in the sector. There are a lot of very good nursing homes.”
“The 2025 programme for Government commits to a range of actions that will advance a social care model that supports older people to live full and independent lives, in their own homes and communities, with the appropriate wrap-around supports. Home support is an essential and highly valued service for thousands of people each day in the country. The programme for Government commits to design a statutory home care scheme, which is a key priority for me as Minister of State with responsibility for older people. That statutory home care scheme is something on which I am actively working and it is an priority for me and the Government.”
“The Government's strategic goal is to deliver a new model of integrated older persons' health and social care services across the care continuum, supporting older people to remain living independently in their own homes and communities for longer, in line with the Sláintecare vision for receiving the right care in the right place and at the right time. Engagement with the older population clearly indicates a preference to age in place, in their own homes, for as long as possible. As Minister of State with responsibility for older people, in conjunction with partners in the health sector and beyond, I am determined to support and facilitate this.”
“The commission is charged with examining the provision of health and social care services and supports for older people and with making recommendations to the Government for their strategic development. Subsequently, a cross-departmental group will be established under the auspices of the commission to consider whether the supports for positive ageing across the life course are fit for purpose and to develop a costed implementation plan for options to optimise and implement these supports. The commission will publish its first report in due course.”
“In this context, the Department of Health, alongside the HSE, is developing a new long-term public residential care additional capacity plan, which will be published in 2025. The programme for Government commits to building more public nursing home beds. This is an absolute priority for the Government. People are living longer and the number of older people in the total population is growing. The success that has been achieved in improving health outcomes and extending life expectancy must be acknowledged and celebrated. However, we also recognise the challenges we will face in a range of areas in the coming years as our population ages. It is within this context that, in March 2024, the Government established an independent Commission on Care for Older People.”
“I also advise the Seanad of ongoing work by the Department of Health to develop a framework for safe nurse staffing and skill mix for long-term residential care settings for older people. This work is being overseen by a task force. A research team from UCD and UCC have undertaken substantial research and testing of a methodology for determining safe staffing in the sector. The work is nearing completion and I expect to receive recommendations shortly on how it can be implemented. The Government is committed to continued investment in healthcare infrastructure which supports the highest quality care for the older population. It is recognised that long-term residential care will continue to be a crucial part of the overall continuum of care.”
“The Minister, Deputy Carroll MacNeill, and I are fully committed to introducing an adult safeguarding policy for the health and social care sector, including nursing homes. The policy will commit to the development of adult safeguarding legislation for the sector, including nursing homes, and will build on the range of existing legislation, policies, and procedures already in place in the sector for preventing, reporting and responding to abuse. The policy is at an advanced stage and our intention is to bring it to the Government as a matter of priority. The Government has included a health (adult safeguarding) Bill in its current legislative programme to facilitate this. It is recognised that this will be an important further development in preventing and protecting vulnerable adults from abuse.”
“Last Friday, as requested, I received a report from HIQA which provides a comprehensive overview of the Emeis group and its regulatory history, including, but not limited to, regulatory compliance, escalating enforcement actions, and any additional conditions of registration. The contents and findings of both reports are being considered, including the need for additional regulatory powers in respect of nursing homes, with actions in this regard to be taken as a matter of priority. HIQA has acknowledged the importance of examining its processes and methodology. It is essential that these are continually being looked at for ways to improve the inspection and regulation of nursing homes.”
“HIQA's chief inspector continues to intensively engage with the two nursing homes featured in the RTÉ programme. HIQA has completed a series of recent unannounced inspections of both nursing homes in the evening, the early hours of the morning and during the day to ascertain the level of care being provided at all times - day and night. Both providers were issued with an official warning of cancellation of registration by HIQA should they fail to implement significant improvements in the care of residents. I assure Members of the Seanad that the Minister for Health, Deputy Carroll MacNeill, and I and the Department of Health will continue to closely monitor developments regarding both nursing homes. The welfare of residents and their families will remain our highest priority.”
“The Minister, Deputy Carroll MacNeill, and I, along with officials from the Department of Health, met with HIQA on 17 June to discuss the interim report. It is critically important that residents of nursing homes reside in a caring and safe environment. I have had significant engagement with key stakeholders in the nursing home sector, as well as HIQA, plus the HSE and representative bodies from the sector. I am continuing this engagement with an immediate focus on delivering the highest quality of care to the residents of nursing homes in Ireland. A review of safeguarding concerns raised about the two nursing homes is ongoing. The HSE has also confirmed that it will be engaging with all nursing homes in the Emeis group in the coming period.”
“I, along with officials from the Department of Health, met with HIQA on 4 June to discuss regulatory activity relating to the nursing homes featured in the "RTÉ Investigates" programme. At this meeting, HIQA's chief inspector confirmed its continuous intensive engagements with the two nursing homes in question. As requested, on 13 June, HIQA furnished me with an interim report on its engagement with the two nursing homes in the previous two weeks, which was published on 17 June. This interim report details HIQA's inspection of these nursing homes since the "RTÉ Investigates" programme was broadcast and its ongoing work in this regard. It also provides a brief overview of the Emeis Ireland group.”
“Responsibility for the safety and care of residents ultimately rests with the individual provider of each nursing home and their staff. The governance and management of nursing homes is a critical aspect of ensuring the safety and welfare of all residents. Staff must be equipped with the tools and supports they need to provide those in residential care with person-centred care. As the national independent regulator of nursing homes in Ireland, I expect HIQA and the office of the chief inspector to utilise all powers available to them to ensure rigorous oversight and accountability in nursing home care. HIQA's role is to ensure that the systems, structures and processes that have been put in place by nursing homes work to ensure safe and effective care and support for residents in residential care.”
“It is important to acknowledge the committed, compassionate, and dedicated providers and care staff operating in nursing homes across the country. Like everyone else watching the programme, I was shocked and deeply concerned at the level of non-compliance with care standards in evidence from the distressing footage that was aired. Nursing home residents deserve, and should expect, the highest standards of care at all times. Poor care, mistreatment, neglect, or any other form of abuse of any person living in a long-term residential care centre is completely unacceptable. I expect the highest standards of care to be upheld by providers for every resident in every nursing home in the country, and anything less than this standard will simply not be tolerated. I welcome confirmation that referrals have been made to An Garda Síochána.”
“I welcome the opportunity to discuss nursing homes and the care of older people with Members of the Seanad. I acknowledge the "RTÉ Investigates" programme that was broadcast on 4 June. This hard-hitting and harrowing programme highlighted a litany of poor care standards in two nursing homes, showing clear neglect and abuse of older people, namely, The Residence Portlaoise and Beneavin Manor in Glasnevin. The welfare of both the residents and their families was obviously at the forefront of my concerns following the RTÉ programme. I am very conscious of the impact this programme will have had on the residents, their families, and the staff in the nursing homes featured in the broadcast. I am also conscious of the impact of the programme on the nursing home sector more generally.”
“The context here is quite simple. I always go back to the needs of older persons in nursing homes. What we saw in that programme with the residents in the nursing homes in Portlaoise and Beneavin was wanton neglect and abuse of older people. We want to look at the regulatory system and how we can improve it. All aspects will be considered. This is ultimately about improvements and ensuring that older persons have the right and entitlement to be in nursing homes that are safe. We are working with HIQA to ensure that we enhance the regulatory system.”
“In the context of HIQA’s enforcement powers, it is correct to say that HIQA cannot issue fines directly. We have no issue in this regard. It is something HIQA recommends and we very much support. When it comes to liability, these are all areas we are looking at. The key thing is that HIQA has acknowledged the need for change in terms of updating schedules. We will work with it on that.”
“The Deputy and I have engaged intensively at the health committee. I will go through the points she raised. With regard to the licensing, there is absolutely a lacuna there at the moment. Within a group of companies, the licensing inspection is on individual nursing homes and who they are run by, but the parent company is not under HIQA's remit. I want that to be changed. There is an acceptance in that regard. In respect of the inspection regime, HIQA does an inspection on the day. When it publishes its report, which might be a number of months later, it is based on that inspection. I want to see that report updated with the current position of the nursing homes and whether they have complied with any conditions required of them under the inspections. That makes common sense.”
“The Minister for Health is committed to working with and supporting further consideration of safeguards or other opportunities to enhance consumer protection. The Competition and Consumer Protection Commission is the statutory body responsible for promoting compliance with, and enforcing, competition and consumer protection law in Ireland and is best placed to advise on such matters. I thank the Fine Gael Senators for bringing forward this motion and the other Senators who have contributed. I assure the Senators that the Minister for Health, Deputy Carroll MacNeill, will continue the ongoing work being delivered by her Department to fundamentally reform the oral healthcare sector through the implementation of the National Oral Health Policy.”
“In building the necessary capacity to meet the current and future oral health needs of our population, we must also look to other members of the dental team to ensure they are supported to work to the top of their expertise. We will explore the opportunities for new and expanded roles within the traditional dental teams, providing opportunities for a wider scope of capacity and more opportunity for dental professionals to provide more care and a greater variety of care. We all recognise and are sympathetic to any situation where patients are impacted financially following a sudden closure of a dental or orthodontic practice. This is something Senator Kyne referred to. Consumer law is primarily the responsibility for the Department of Enterprise, Tourism and Employment.”
“It is envisaged that funding allocated in budget 2025 for an additional 15 dental staff will go towards alleviating this as an interim measure. The focus is on continuing to build and maintain a sustainable workforce. The National Oral Health Policy envisages major transformation of oral health services, requiring a greater role for dental contractors in providing a wider range of care through a model that focuses on primary care. It also requires a much enhanced and reoriented public dental service which will, among other things, play a key role in providing services to patient categories that are often underserved, including people with disabilities, people living in residential services and people requiring more complex oral health interventions.”
“Ensuring adequate capacity to train future dentists is part of our broader commitment to workforce planning that supports the health and well-being of our population. This is a recurrent theme with nearly all of today's contributors. The Minister for Further and Higher Education, Research, Innovation and Science has remit over providing more funding for dentistry places through the Higher Education Authority. The Department of Health supports any expansion in the oral healthcare workforce. The Government provided €2 million in budget 2025 to support 15 additional new whole-time equivalent posts, specifically to improve staffing levels within the HSE community dental service. It is acknowledged that there are issues with the school screening programme and many Senators raised that here today.”
“In parallel to these interim reforms, work is commencing on a fundamental review of the Dentists Act 1985 with the ultimate aim of developing a new, modern, fit-for-purpose regulation, which aligns with the reform envisaged in the oral health policy. I note there are now more dentists than ever registered in Ireland. There are 3,888 dentists on the Dental Council register as of June 2025. This reflects ongoing upward trends in the number of registered dentists in the State, and compares favourably with the number in April 2019, when Smile agus Sláinte was published, which as 3,100. This is an increase of over 25%. The Government is firmly committed to ensuring that our healthcare system is supported by a steady and sustainable pipeline of highly skilled graduates, including in critical areas such as oral health and dentistry.”
“The Minister for Health is committed to reviewing the legislation underpinning the regulation of oral healthcare professionals, the Dentists Act 1985. A priority for 2025 is the development of new provisions to amend the 1985 Act in areas which have been identified as prime concerns by the Dental Council and to proceed with these where appropriate. This will include enabling provisions for the Dental Council to develop a statutory scheme of continuous professional development, CPD, and competence assurance for registered dentists, in line with that provided for other regulated health professions. This long-overdue intervention will make CPD a mandatory requirement. We must acknowledge that the entire regulatory framework requires reform.”
“The public oral healthcare services provided by the State include orthodontic treatment. There has been particular focus on supporting patients to access these services. A total of €17 million in non-recurring funding was provided between 2022 and 2024 to address orthodontic service backlogs. Some 511 patients were removed from the grade 4 orthodontic treatment list through this funding in 2024. In addition, a new orthognathic jaw surgery waiting list commenced in September 2023. These are complex surgeries which can require a lengthy hospital stay. Some 77 patients received this type of surgery in 2024. A further €2.85 million is being invested this year to support the continuation of measures to reduce orthodontic waiting lists.”
“This requires substantial change in dental training and education, and an enhanced role for a wider range of dental professionals, including nurses and hygienists, in the dental team providing oral healthcare. Both are provided for within the programme for Government, which refers to an increased number of college places and to an expanded role for other dental professionals. Progress on the reform envisaged in the policy has been slower than the Minister would have liked. It has been by the pandemic, among other things. However, to support a focused and structured implementation of the policy, the Department of Health and the HSE are developing an implementation plan for the 2025-27 phase of its roll-out. This plan is currently being finalised for publication.”
“This will ensure a greater emphasis on prevention, and earlier intervention for children, where intervention is needed. Senator Lynch made reference to fair, reliable and consistent care. I note what she said about UCC as well. We recognise that much work is still to be done here, including the design of an operating service model, the development of a contractual framework with the dentist representatives and supporting legislation. For adult medical card holders, the HSE is committed to the design and development of packages of expanded preventative care. As we work systematically through the implementation of the policy, we will walk through a public conversation on what kind of oral healthcare is needed in Ireland, within the framework set out within the policy, which is in turn based on international evidence.”
“The Government has provided €2 million in budget 2025 to enable the HSE to progress initial scoping work to better understand the oral healthcare needs of people living in residential settings so that the HSE can then design the oral healthcare services that best meet their needs. This may include mobile units. Senators have referred to those, so this is a positive. For children, the HSE is progressing with the design of comprehensive and prevention-focused oral healthcare packages, starting with children aged from birth to seven years. This aims to support children to attend a local dentist from birth, representing a significant expansion of care compared to the current model, which centres on three examination appointments, starting at the age of seven.”
“Smile agus Sláinte was informed by and aligned with other relevant Government health policies, including the primary healthcare approach, Sláintecare, our overall framework for better healthcare in Ireland, and Healthy Ireland. The two goals of the policy are: to achieve personal best oral health across the life course from birth to old age; and to reduce oral health inequalities across the population. The current model of oral healthcare services does not adequately provide for those who need additional support to access oral healthcare, including those living in residential settings and those accessing services under the umbrella of inclusion health.”
“Through implementation of the national oral health policy, the Minister for Health, Jennifer Carroll MacNeill, wants to do more to improve oral healthcare services and to address the access issues that are still there. In 2019, the national oral health policy, Smile Agus Sláinte, was published. This Government policy aims to radically transform our current oral healthcare service, recognising that we need an entirely new approach to oral healthcare to meet the needs of our population into the future. The policy provides a framework to transform oral healthcare services in Ireland, with prevention and promotion are an integral part of all service provision.”
“Our measures are having an impact, with access to care increasing in 2022 and increasing further again into 2024. The range of treatments provided includes scale and polish, fillings and extractions. Comparing 2022 to 2024, these measures have had an impact on activity and expenditure. The fees paid to contractors increased from €49 million in 2022 to €69 million in 2024. Over 300,000 patients received care in 2024, which was an increase of 44,000 on 2022. In terms of the volume of care received, over 222,000 additional treatments were provided in 2024 versus 2022. However, we must acknowledge that challenges still exist. People, especially children, are waiting too long for care. Our oral health service, notwithstanding the commitment and dedication of all front-line oral healthcare workers, is not aligned with WHO standards.”
“This includes an additional €15 million in recurring funding between 2022 and 2024 to progress the national oral health policy. A further €17 million in non-recurring funding has been invested to improve access and respond to waiting lists. A range of measures have been put in place since 2022 within the DTSS for adult medical card holders. This introduced and reintroduced elements of preventive care. The Minister for Health also increased the fees paid to contractors for most treatment items by 40% to 60%. Fees paid to dentists for DTSS care are now aligned with other European countries that provide comparable public dental care, noting that many European countries, especially in the southern and eastern regions, do not have any scheme in place for adults that is free at point of access.”
“Senator Byrne made specific reference to the mobile dentistry scheme and that the service should be fair and reliable. Senator O’Donovan referred to the mobile service and the Health Act. Senator Boyle made a telling point on nursing homes and dental care for older people. The Government allocates over €230 million to the provision of oral healthcare every year. This shows our commitment to delivering oral healthcare services. All the points raised by the Senators will be brought back to the Minister and the officials. A senior official from the Department is attending this debate, which I felt was important. Improvements in access to care and in reducing waiting times over recent years have been supported by significant additional investment.”
“The overarching theme was to have more young people seen for orthodontic treatment. Senator Nelson Murray spoke about student places as well as work permits. Senator Kyne, the leader of the Fine Gael group, spoke about oral health and referenced our colleague, Deputy Colm Burke’s proposals in this area. A theme that arose was that of retired dentists and the question of whether they had a role to play - Senator Kyne mentioned this, as did many others - in examinations as opposed to clinical practice. Am I correct in that interpretation? I take Senator Conway’s point that we need more dentists in both the public and private systems. That is in the programme for Government. Senator Costello spoke of the need to update the 1995 Act and the DTSS. Senator Ryan referred to increasing the numbers being seen, as did Senator Tully.”
“Under the programme, the Government will: implement Smile agus Sláinte; hire more public dentists; agree a new dental treatment service scheme for medical card holders, which is the dental treatment services scheme, DTSS, and something that many of the Senators have referenced; expand access to the orthodontic scheme for children and strengthen the school dental programme; update the Dentists Act 1985, an issue that has been raised a lot in today’s debate; and recognise and regulate more dental specialties. I recognise what many of the Senators have said about older people in nursing homes. This is something I will take up with the Minister and officials. The mobile service, which was raised by many Members, is very important. Senator Byrne spoke about increasing the number of college places.”
“I thank the Senators for their contributions, and particularly the Fine Gael Senators for tabling the motion and providing us the opportunity to discuss dental services and outline the Government’s priority to fundamentally reform these services over the coming years. I am taking this debate on behalf of Minister for Health, Deputy Carroll MacNeill. She is not opposing the motion. Before I begin with my formal speech, many of the issues Senators have raised have a common theme. Many are identified in the new programme for Government, which refers to increasing the number of college places, with one of the faculties being dentistry.”
“Ultimately, out of this absolutely terrible situation for people in both these nursing homes, the Residence in Port Laoise and Beneavin Manor, we want to get a better system in terms of the regulation of nursing homes to ensure that all older people, wherever they are in a nursing home, get a standard of care they deserve. It is something that in my role as Minister of State with responsibility for older people, along with the Minister, Jennifer Carroll MacNeill, we are determined to achieve, with Members' help.”
“Once the commission on care reports, a cross-departmental group will be established under the auspices of the commission to consider whether supports for positive ageing across the life course are fit for purpose and to develop a cost implementation for options to optimise these supports. The commission on care has a key role to play. Following the programme, I had engagement with HIQA and the HSE in terms of their safeguarding teams. They have been into both nursing homes and they will engage with all nursing homes throughout the group. They have put directors of nursing into both nursing homes.”
“That is something we are committed to as a Government. Furthermore, we have an ageing population, as people have said. That is something we should celebrate. People are living longer, but with that comes challenges. The Government in the past year set up the commission on care for older people. That is chaired by Alan Barrett and is due to report. The first element of its report will be about the existing services and whether they can be improved. That will include the provision of nursing home care. I met with the commission some time ago. I very much want to see the report and the commission's recommendations.”