A new government, a new approach to oral health?
As Ireland’s Dental went to print, Fianna Fáil leader Micheál Martin was meeting his Fine Gael counterpart Leo Varadkar for their first discussion after the Irish general election. Fianna Fáil won the most seats in the Dail in January’s election with 38, one ahead of Sinn Féin. Fine Gael, which had relied on a 2016 confidence and supply arrangement with Fianna Fáil to remain in government, finished with 35 seats.
However, Sinn Féin had the highest number of first preference votes. Mr Martin commented that a left-wing government in Ireland led by Sinn Féin was very unlikely. Parties need 80 seats to form a government.
The leaders of Fianna Fáil and Fine Gael have agreed to meet again, with a ‘reverse’ confidence and supply arrangement as one potential route to forming a new government.
However, as we report on page 26, 2020 will be seen as the year in which Sinn Féin fundamentally broke “the historical tight grip of the two traditional parties on Irish politics,” to quote Professor John Ryan, of the London School of Economics and Political Science.
For health policy generally, and dentistry in particular, the notion of a Sinn Féin government offered the prospect – at least on the basis of the parties’ stated policy positions – of a real shift in emphasis.
In the run-up to the election, Sinn Féin was the only party to respond to questions posed by the Irish Dental Association (IDA). It also stated: “Oral health has long been regarded as the poor relation of general health and has generally been overlooked. While a new national oral health policy has been published, we believe it is flawed and inadequate.” The party committed to consulting with the dental profession on how the new oral health policy can be improved and implemented, to bringing forward a reformed new policy that will have an implementation plan, and to replacing the 1985 Dentists Act.
“Oral health has long been regarded as the poor relation of general health”
As Professor Leo Stassen, President of the IDA, observed recently – general health and oral health are “intimately related”. The attempt, he said, by Ireland’s Health Service Executive HSE to “force general dental practitioners and the public dental service to implement a very naive policy, without having being part of the discussion is poor management”. As a result, dentists, both independent practitioners and public dental surgeons, do not believe in the new policy, he said, and are convinced that it is not in the best interests of our patients and oral healthcare in Ireland.
Last year, the IDA published a document entitled Towards a Vision for Oral Health in Ireland, and shared it with the former Minister and Chief Dental Officer (CDO).
The IDA has urged the next Ministers for Health, Social Protection, Finance, and Public Expenditure and Reform to review the document with the CDO and her advisory teams “to see what the people who will have to implement any oral health policy believe will work”.
The IDA’s Professor Stassen has argued that “there is not the capacity, the will, the finances, or the skill set in independent dental practice to take on the HSE’s responsibility for the provision of children’s and special needs’ oral healthcare, and the associated medical emergencies. Nor can independent practitioners take on the responsibility for ensuring each child referred to specialist centres receives their care, even if it takes a few years”.
The Association has said that it will engage with the Department of Health “as soon as they give us the same basic Framework Agreement as they gave our medical colleagues in the IMO [Irish Medical Organisation]. “This will allow us to engage in negotiations without fear of prosecution, as well as allow us to make some headway on the DTSS/Medical Card negotiations. This is a simple, important, non-confrontational request with no associated costs.”
It is to be hoped that a new government, when it is formed, will use the opportunity to adopt a new approach to oral health in Ireland.
Will is Editor of Ireland’s Dental Magazine. You can email Will at firstname.lastname@example.org and follow the mag on Twitter @irelandsdental.