Irish Times article by Martin Wall, Monday 13th May 2019
The Government’s new oral health policy for children and adults is seriously flawed, economically unviable and operationally unworkable, dentists have said.
The Irish Dental Association said it considered the new policy, which was launched by Ministers in April, as merely a starting point for a long overdue discussion on oral health, new State contracts and new legislation.
More than 200 members of the association met in Dublin on Saturday to consider their response to the new policy.
Last month, Minister for Social Protection Regina Doherty and Minister for Health Simon Harris launched a new plan, “Smile agus Sláinte”, which aimed to see the dental service evolve from a “diagnose and treat” to a person-centred, proactive and preventative approach available locally.
Under the Government policy, all children up to 16 years would receive eight oral healthcare packages including examinations, assessments, advice, prevention interventions, emergency care and referral as appropriate. Oral healthcare packages would also be provided for medical card holders over 16 years. The packages of care would be provided in a primary care setting by oral healthcare practitioners contracted by the Health Service Executive.
The association’s chief executive, Fintan Hourihan, said the policy would require a fundamental shift in the attitude of the State towards the dental profession in tandem with a new approach towards promoting oral health into the future.
“The focus on prevention and the policy’s provisions in regard to building links between oral and general health through a common risk factor approach are positives. However, our members are telling us forcefully that there is simply no prospect of the current approach advocated to achieve these aims working,” he said.
“The spin on the policy was that ‘free dental care’ was to be extended to the under-sixes and eventually to under-16s. How is this going to happen? The ESRI research, on which the department appears to be relying, assumes that dentists in private practice will treat children on the basis of fees for treating adults which were insufficient 10 years ago, before they were cut even further. This is a deluded and dangerously misleading notion.”
The association maintained that some of the provisions in regard to care and treatments of adults with medical cards represented “little more than repackaging of the meagre treatments which people are currently entitled to”.
“In fact, in some cases it believes adult medical card patients could be left with even fewer treatments than they can currently access,” Mr Hourihan said.
The association said that for the 60 per cent of adults who did not have medical cards, the new policy offered no supports towards the costs of dental care above and beyond the very limited PRSI benefits which covered an annual examination and contribution towards cleaning.
Mr Hourihan said that while oral health in Ireland was improving, most of the gains were being recorded by higher-income groups in the main.
“The resulting chasm in oral health status according to income is widening as a direct result of the massive cuts in State support. For a start, the current medical card scheme must be scrapped while fee cuts introduced under [financial emergency legislation[ Fempi must be reversed.”
“Our public-service members are hugely concerned about plans to switch the provision of dental care to children from the public service to private practice. Once again we restate our complete and unequivocal support for our members in the public service. We are ready to ballot our members for industrial action in defence of their employment and contractual rights should the need arise,” Mr Hourihan said.