Committee Reports::Report No. 19 - Proposed Dublin Dental Hospital::21 March, 1986::Appendix



1. The educational and financial factors which have influenced the Authority in recommending that there be only one Dental School

1.1. The educational factor

Dental teaching is strongly based on science, both biological and physical, and scientific advance in all such areas leads constantly to new teachniques and the development of new fields of specialisation. Sooner rather than later provision has to be made accordingly in the curricula and this in turn requires the recruitment of staff skilled in the new fields.

The larger the teaching unit, in terms of student numbers, the easier it is to provide specialised staff without inflating costs per student to unacceptable proportions. Small dental teaching units of their nature become either intolerably costly or else find themselves unable to provide the spread of teaching skills demanded and so fall behind the larger units academically. From the educational standpoint, therefore, one centre would be preferable to two.

1.2 The financial factor

On present information the difference between the combined capital costs of the two new dental hospitals currently envisaged (one in Dublin to admit a maximum of 50* students annually and one in Cork to admit 25*) and the cost of a single hospital (admitting 75 annually) might be of the order of £400,000. With regard to recurrent costs, studies by the Higher Education Authority of data available in relation to both Irish and British Universities indicate that the annual expenditure on one centre with an intake of 75 students would not fall much below that on two centres, one with 50 and the other with 25 annual entrants, provided always that the same level of staff: student ratio were maintained in both. As explained in paragraph 1.1., however, if staff: student ratios were the same in both, the smaller centre would in time find it difficult to maintain the same academic standards as the larger.

2. The demographic grounds for our recommendation that the Dublin Dental School be the sole centre

2.1. Given that there should be only one School, the selection of a site for it must be mainly based on the demographic considerations of:

(i)availability of patient supply, in sufficient numbers and presenting a sufficient variety of dental conditions to ensure adequate clinical experience for all the students; and

(ii)availability of sufficient professional, technical and ancillary staff.

Current patient attendances at Dublin (less than 40,000 annually) and Cork (about 21,000 annually) are not a fully valid guide to the future patient requirements of a teaching hospital with an annual intake of 75 students. Present plans for buildings are based on the assumption that if Irish qualifications are to continue to be acceptable abroad, our clinical courses will within the next few years have to be extended by at least six months, that is, to about the same length as present British courses. Such an extension would, however, require a disproportionate increase in the number of patient attendances, as the extra time is expected to be spent by the students mainly on clinical work as a preparation for the practice of their profession. It would thus appear that a centre providing the extended course for an intake of 75 students annually might, at a rough estimate, require about 100,000 patient attendances each year i.e. nearly five times the present level of attendances in the Cork Dental Hospital.

2.2. As regards staffing, it may be presumed that full-time professional and teachnical posts would attract suitably qualified personnel irrespective of where the single centre might be. Irish clinical dental teaching still depends very greatly, however, on the part-time services (on a sessional fee basis) of local practitioners. Despite strong pressures to increase very substantially the ratio of full-time to part-time teaching staff (following the post-war pattern in Britain) it is unlikely that it will be practicable in the foreseeable future to meet the very heavy cost which such a change would involve. Accordingly, the number of appropriately qualified practitioners working in an area will continue to be an essential factor in the adjudging of its suitability as the sole centre for clinical teaching.

The present 65 places (46 in Dublin and 19 in Cork) to be filled annually, with a further 10 places envisaged, hypothecate an attendance of 225 or more students at a given moment. It must be questioned whether, even with a continuance of Cork’s present rapid rate of development, there would be available there in the foreseeable future an all-round sufficiency of suitable staff to cater for a centre of this size. Dublin, however, could reasonably be expected to meet the staffing needs in question.

3. Conclusion

On educational, financial and demographic grounds, therefore the case for the rationalisation of our Dental teaching by providing for it in a single centre, and for the selection of the Dublin Dental Hospital as that centre, is in our opinion, overwhelming.

* The actual numbers of students (i.e. Third Year dental students) admitted to the Dublin and Cork Dental Hospitals in 1970/71 were 33 and 19 respectively.