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Dentists say it’s time to consign ‘unfit for purpose’ Medical Card Scheme to history New President of Irish Dental Association says revamped PRSI scheme shows what can be achieved with sufficient funding and a change of attitude

(27 Apr 2018)

The Irish Dental Association has urged the Government to seize the opportunity which now exists to end the two-tier dental care system which exists in this country and to consign the ‘unfit for purpose’ DTSS /Medical Card Scheme to history.

Since 2010 the IDA estimates that over €700 million has been cut from the two schemes available to the public; the DTSS scheme and the PRSI scheme. While the number of people eligible for Medical Cards has risen to around 1.5m, cutbacks to the DTSS scheme, means it effectively operates as an emergency only scheme.

Welcoming upcoming talks with the Minister for Health Simon Harris on a new DTSS contract, the newly elected President of the IDA, Dr Kieran O’Connor told delegates at the Association’s annual conference in Galway that it was time for the Government and the HSE to adopt a new approach.

“The DTSS scheme was set up in 1994 to ensure that everyone in society had access to professional oral healthcare services. Prevention is better than cure and while the scheme wasn’t perfect, it worked relatively well until the HSE introduced savage cutbacks to it in 2010. As a result, the dental care of hundreds of thousands of Irish patients has been neglected for close to a decade.”

“The cutbacks also placed intolerable pressure on dentists who are providing a vital service to their communities but a service which remains unviable under current pay levels. The last time contract talks were held was 2007 and those talks were terminated abruptly by the HSE. By way of contrast the newly revamped PRSI scheme shows what can be achieved with a proactive approach and adequate funding” O’Connor said.

Late last year the Government reinstated PRSI dental benefits that had been cut and opened up the scheme to the self-employed and farmers who make certain PRSI contributions. In addition to the free annual check-up, the scheme now covers a payment of €42 towards either a scale and polish or clinically necessary periodontal treatment. If the scale and polish costs more than €42, the balance paid by the patient is capped at €15; there is no cap for periodontal treatment.

Expenditure on the revamped scheme is expected to cost the Government over €40m in a full year compared to €10.5m for the limited scheme in 2016. The Department of Employment Affairs and Social Protection is now forecasting a 38% per cent increase in dental examinations in 2018 compared with 2009, a 24% increase in scale and polish treatments and a 450% increase in protracted periodontal treatments.

Dr O’Connor says while there have been some issues with the scheme its introduction has been managed successfully because of meaningful engagement with the Department of Employment Affairs and Social Protection.

“In the wake of the cutbacks we needed to encourage people to attend to their dental health and that is what we are seeing now with those eligible for the PRSI where there’s been a huge and most welcome rise in uptake. However, unless we act with urgency the 1.5m people on medical cards who derive so little benefit from that scheme will be left even further behind.” Dr O’Connor concluded.