What's happening to people who get a toothache during the dentists' dispute with the Government? Alison Healy reports
A toothache is never to be welcomed, but getting one during a dentists' dispute makes it even worse. About 91 per cent of dentists who provide treatment under the dental benefit scheme are in dispute with the Department of Social and Family Affairs (DSFA) over fees.
Under the PRSI scheme, the Department pays for certain services such as check-ups and polishing, and pays 70 per cent of a set fee for treatments such as fillings. Dentists say they have been forced to increase their charges as these set fees are far too low.
Since Tuesday the DSFA has been refusing to accept claims from dentists who have been charging increased rates to PRSI contributors since March.
As a result, a PRSI patient receiving treatment from a dentist involved in the dispute has to pay the full charge, rather than receiving the treatment free, or at a reduced rate.
The Minister for Social and Family Affairs, Ms Coughlan, says she is protecting PRSI patients and will only talk to the dentists if they drop these new charges. The dentists say they will not do this until the Minister enters into serious negotiations.
Stuck in the middle are more than 1.5 million PRSI-paying patients. If they do not wish to pay the full rate, they have a pool of about 60 dentists - 10 per cent of the dentists normally available in the scheme - to choose from. Or they can opt for private treatment.
To make matters worse, the dispute is happening at the peak holiday season when the availability of dentists is already reduced.
So what do you do if you get a toothache? The DSFA has advised people to check if their dentist is not imposing increased charges before starting treatment. If they want a dentist not involved in the dispute, the DSFA will provide names on a lo-call number (1890 400 400, extension 4480).
Thursday was the busiest day for the help line, with nearly 300 calls. Staff are suggesting alternative dentists, or a number of dentists to callers, a spokesman says.
The Department's actions have outraged dentists who say the DSFA has no right to encourage patients to switch dentists. The Irish Dental Association (IDA) says patients are staying loyal to their dentists and are blaming the Minister.
"They are still paying their full PRSI but now they are getting nothing back," says Mr Donal Atkins, IDA director general.
He says there is no backlash against dentists and he has not heard of large numbers of people deferring treatment.
That view is backed by dentists around the State. In Cork Dr Martin Holohan has had two cancellations this week, and says they may not be related to the dispute. "I certainly haven't seen the impact of it," he says.
If the dispute continues, he predicts a fall-off in business of about 10 per cent. But ignoring dental problems could lead to much more expensive problems. He says an untreated broken filling could result in expensive root canal treatment, for example.
He maintains that people do not switch dentists lightly. "A lot of people don't like dentists but they do put their trust in you and build up a sense of being comfortable with you."
He believes the Minister may find it very hard to put the scheme back together if the dispute continues. "If we get into a more comfortable mode, without additional paperwork and bureaucratic problems, she may not be able to resurrect the scheme," he says.
A Co Mayo dentist, Dr Anthony Sweeney, says dentists are being strongly supported by their patients. He believes the Department's actions are cutbacks under another guise.
Dublin-based dentist Dr Roger Gufferty says they are being paid a half or a third the going rate for some services. "In 10 years our fees have increased by 18 per cent while VHI payments have gone up by 108 per cent."