An 8-year wait for dental care that tells you how our state is failing us all

Failing, chaotic and over-burdened - that's how best to describe our health system says John Dolan
An 8-year wait for dental care that tells you how our state is failing us all

Minister for Health Stephen Donnelly leaving Government Buildings, Dublin. Picture: Brian Lawless

POLISHED, presentable, and eloquent... three words that might easily sum up Stephen Donnelly.

And our Health Secretary brought all three of those qualities into a meeting the other day of his Fianna Fáil parliamentary party, where its TDs and senators gather to hear the latest from the seat of Government and mull over strategies.

Mr Donnelly had been summoned to present an update on his department’s latest initiatives and progress, and to give an overview of the direction our health system is heading.

Well, hunky dory isn’t the word for his reported remarks.

The Department of Health is toiling tirelessly to meet all its challenges, and to provide a healthcare system that will be the envy of the world - with Mr Donnelly toiling sway tirelessly at the helm - was the gist of his feedback.

Apparently, a few Fianna Fáil apparatchik came close to blushing, such was the top-spin given to the performance of our health service as it strives to recover from two years of pandemic.

Polished, presentable, and eloquent...

But let me tell you, they were not the three words I would have chosen to describe our Health Minister that very same day, on the back of a phone call I received regarding my son’s long wait for dental treatment in the public system.

Pitiful, under-performing, and delusional more like - if Mr Donnelly really believes he is doing a good job as Minister as he blows his own trumpet in a fanfare to his party colleagues.

As for three words to describe our health system: How about failing, or chaotic, or over-burdened? And that is putting it politely.

On the day Mr Donnelly was holding forth on his brilliant work, I received a phone call in the long-running saga of my son’s dental issue. It was autumn, 2019, when he entered the system and joined a queue for an assessment.

The phone call was to inform me that he should, all being well, receive an appointment for his assessment in the summer - nearly three years after registering.


There is a five year public waiting list for orthodontic treatment. Picture: Stock
There is a five year public waiting list for orthodontic treatment. Picture: Stock

But wait, this was merely the assessment. What, I tentatively enquired, was the waiting time for the actual orthodontic treatment that may be deemed necessary?

Ah, well, that could be as much as another five years...

Yes, five years, the length of a Dáil term, ironically.

That means there is a queue of eight years for a child to receive dental care in the public health system - by which time many of those children will be adults.

For a youngster who may require a brace, for instance, and who is at a self-conscious age, this is a disgraceful delay.

My son is trapped in a circle of hell along with thousands of others in the Cork/Kerry region alone, and although Covid has clearly played a part in these waiting times, it cannot be wholly blamed for the faults.

We all know the long delays and waits, the interminable queues, the unwritten nod-and-wink that tries to force everyone into the private system where they pay through the nose, have been with us for years - decades even.

But the sense that the queues are getting longer, that nothing is being done to address them, and that our politicians and health management are simply unwilling or unable to fix them, is only growing by the day.

The current Health Secretary may have inherited this mess, and he may point to a hundred or a thousand bureaucrats he pays to address these problems, but the buck stops with him.

Just before the pandemic, more than 3,500 children and adolescents were on waiting lists for orthodontic assessments and treatments in Cork and Kerry, including one patient who had waited more than four years.

Well, now there is at least one in my household who faces a wait of double that! The orthodontic waiting list for children nationwide by the end of last year stood at more than 13,000.

The figures released in January, 2020, were obtained from the HSE by Cork TD and Fianna Fáil Minister Michael McGrath - just before the last election - who described them as “appallingly high” and “particularly worrying”.

I wonder what his view is of the current waiting list, and whether he asked Mr Donnelly about them in that cosy Fianna Fáil parliamentary meeting? Perhaps he didn’t want to halt the polished Health Minister while he was in full flow about his achievements?

A few days after my phone call, I read about yet another change to the HSE management structure, as Mr Donnelly received Cabinet approval for his plan to introduce Regional Health Areas (RHAs).

These are designed “to align hospital and community healthcare services, with a defined population and their individual local needs”, we’re told.

Will this help address lengthy waiting lists and overcrowded hospitals? It seems more like the rearranging of deckchairs on the Titanic to me. 

All we ever seem to hear about are management structural changes that don’t address the core issue for people and patients: The huge waiting times.

In a previous life, Mr Donnelly was a management consultant and he still gives off that aura of believing there is no problem that can’t be solved by a change in management structure, with a fancy new name, delivered by a man in a shiny suit. I look forward to the six-figure fee we taxpayers will have to fork out for the fancy new logos for these six RHAs...

We have heard all this before. Centralise, then regionalise, the centralise... and, oh, is there anything to be said for another regionalisation.

The issue with our health system is not lack of funds. The entire system is top heavy with managers - none of whom will ever reduce our lengthening queues by getting their hands dirty.

Two years ago, there were only two consultant orthodontists to cover all Cork and Kerry, and Mr McGrath complained: “We need more staff to cope with demand.”

Did we get those extra staff, Mr McGrath and Mr Donnelly? Or will these shiny new RHAs enable us to get them? Because, if not, the queues will only grow longer.

In the past, the HSE have pointed to the fact they have a priority waiting list for orthodontic treatment, including those with cleft palate; a functional waiting list; and a routine fixed waiting list. In present circumstances, I imagine the strain on all of those is only getting worse.

Of course, dental treatment is only one element of our health system, which is creaking across the board. On Wednesday, there were 568 patients waiting for beds in hospitals nationwide, according to the INMO; 466 were waiting in the emergency department, and 102 elsewhere in the hospital.

If Mr Donnelly is reading this, he may want to follow some common sense advice from the streets: The problem of waiting times and queues will not be sorted by extra box-tickers, clerical staff, or bureaucrats. Clearly, it will only be addressed by hiring a lot more people who can do the assessments and work needed.

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