Dentists describe Medical Card scheme as ‘broken and underfunded’ - IDA publishes major new survey of members

Dentists describe Medical Card scheme as ‘broken and underfunded’ - IDA publishes major new survey of members

(29 May 2018)

Major new survey finds;
-          96% of dentists say Scheme prevents them from providing same standard of care as private patients
-          97% lack confidence in the Scheme
-          3 out of 4 dentists want to leave it within next five years
-           38% of dentists refused approval to provide treatment for exceptional / high risk patients due to lack of funding
-          “The system is a disgrace to both patients and dentists”
-          Irish Dental Association calls for immediate resumption of contract talks

Tuesday 29th May 2018. A new survey has found that the overwhelming majority of dentists have no confidence in the Medical Card Scheme and are dissatisfied with the level of care they are allowed to provide under it.

According to the survey ninety percent say they are dissatisfied with the level of care they can provide under the scheme while an even higher number – 96% – say the Scheme prevents them from providing the same standard of care as private patients.

The survey also finds 97% of dentists lack confidence in the Dental Treatment Services Scheme (DTSS), the Scheme under which medical card holders receive treatment free of charge.

Three out of four of the 440 dentists who completed the survey said they would like to leave the Scheme within the next five years.

The CEO of the Irish Dental Association Fintan Hourihan said dentists could no longer deal with what is a system failure. 

“The Scheme is 24 years old and unfit for purpose. Fifty seven percent of dentists say they have experienced considerable or a huge amount of problems with it in the past five years. They are saying it’s a disgrace for patients and dentists, that it’s broken and underfunded. They are tired of battling with the HSE and having to explain to disappointed patients why they cannot provide them with basic dental care.”

In 2010 the HSE imposed unilateral cuts to the Scheme without informing or consulting patients, dentists or the Irish Dental Association. From that point on the only treatments available to patients were an annual oral examination, two fillings per annum and unlimited extractions. 

Since 2010 the number of patients eligible for dental care has risen to 1,340,412 – an increase of almost 260,000 or 24%. Despite that increase the number of treatments funded by the HSE has fallen by 24%. 

Hourihan said it was shocking that 38% of the dentists in the survey say they have been refused approval to provide treatment for exceptional or high-risk patients due to lack of funding.

“Medical card patients have lower oral health levels, a greater need for treatment and a lower access rate to care and treatment. How has the HSE addressed their needs? They have quite simply removed preventive and restorative treatments from the very people with the greatest need. Research shows that there was a 38% increase in the number of patients admitted to hospital with severe infections in 2011 and 2012 following the introduction of those cuts.”

“While the PRSI scheme has been revamped and some treatments restored – a very welcome development -  the Medical Card Scheme by contrast continues to place a limit on fillings (ie saving a tooth) while allowing an unlimited number of extractions. This has led to a 41% increase in the number of surgical extractions and a 12% rise in routine extractions.

The two-tier nature of these schemes cannot be allowed to continue any longer.”

“We are calling on the Minister for Health to resume contract talks as a matter of urgency and to extend to dentists the same terms and conditions which have been offered to public servants and other health professionals who have seen FEMPI pay cuts reversed in full”

“There must also be a commitment in the forthcoming budget for multi-annual funding towards a new Scheme which focuses on prevention rather than treatment. Until that is in place the costs of poor dental health will continue to be borne by the most disadvantaged in society” Hourihan concluded.


Note to Editor

Over 440 dentists – who are all IDA members - completed the survey which was taken in the first two weeks of May 2018.


What dentists say about the DTSS / Medical Card Scheme


“It is an unethical scheme. It provides the illusion of care.”

“It’s utterly, utterly broken and only the foolishness of dentists like myself keep it afloat.”

“Dentists are fed up of being underpaid and undervalued”

“I needed counselling for work stress and anxiety”

“I will leave it before the end of 2018 unless it changes”

“DTSS is a Third World System. It is archaic and detrimental to health of the poorest and most vulnerable in our society”

“Having to beg for money for treatments carried out in good faith is demeaning and unfair.”

“I am opting out of the DTSS scheme. I will suffer short term for this but not as much as my poor patients. I just can’t do it any longer.”

“I don't feel dentists have any say in how this scheme is designed, run or overseen. Can you imagine planning and carrying out a major infrastructure project like Metro North if you never involved architects and engineers.”

“Overall a heart-breaking system to be involved with.”