Dentists are to withdraw tomorrow from the Department of Health's scheme for medical card holders. About a million adults will be affected by the dentists' action, which is being carried out in pursuit of higher fees.
The decision was taken at a meeting of the Irish Dental Association's national council at the weekend. Children up to 16 years of age will not be affected by the dispute and IDA members will continue to treat emergency cases. The IDA defines emergency treatment as any treatment needed to relieve pain, rather than restorative procedures. There have been informal discussions between the Department, the Health Employer Services Agency and the IDA over the past couple of weeks, but no substantive proposals emerged. It is understood the management side is anxious to introduce an element of productivity into the review of fees.
However, dentists see the issue as one of parity between treatment of people on the medical card scheme and those on the Department of Social, Community and Family Affairs' PRSI-funded scheme.
The dispute arose because the medical card scheme fees agreed in 1994 have not kept pace with those paid to dentists for treating people in the PRSI scheme. According to the IDA, there is no added productivity element to the increases granted under the PRSI-funded scheme.
Yesterday, the IDA's general secretary, Mr Donal Atkins, said withdrawal from the scheme "is inevitable in view of the department's failure to make an offer on parity of fees".
He said the withdrawal had been clearly flagged by the association two months ago, when 96 per cent of members voted for industrial action. Besides different fees schedules, Mr Atkins said medical-card holders did not have ready access to treatment, as prior approval was required from the health boards for dental treatment.
He said as few as 12.9 per cent of eligible medical card holders received routine dental treatment in 1998. Although one million people were supposed to be eligible for treatment, lack of funding meant that, in practice, there was virtually no service. The president of the IDA, Dr Martin Holohan, said the association was "insisting that the most needy in our society get the treatment which they are legally entitled to and which they deserve".
The Labour Party spokeswoman on Health, Ms Liz McManus, said last night that it was "entirely unacceptable, when we have billions of pounds in surplus revenue, that people are losing their teeth and children are growing up without treatment. There are 6,649 school pupils in the Eastern Health Board region alone awaiting assessment for orthodontic treatment and a proposal for two further assessment units has still to be implemented."
She accused Mr Cowen of "showing himself to be lethargic and uninterested in his area of responsibility".
A spokesman for the Minister said last night negotiations were continuing with the IDA. "We would hopeful that a resolution can be reached," he said.