Dentists call for freeze on public service to be lifted

THE IRISH Dental Association (IDA) has called for an explicit commitment from the Department of Health that the recruitment embargo introduced in March to limit public spending be lifted so vacancies for key dental practitioners can be filled.

In a submission to the Department of Health and Children on Resource Allocation and Financing in the Health Sector, the IDA says the provision of dental services has been “significantly and adversely affected” by the embargo and that the appointment of front-line clinical dentists must be “prioritised”.

“Years of under-investment in the Public Dental Service mean that any further freeze on recruitment to the service would seriously undermine its ability to maintain a credible function,” it states.

The IDA submission calls for the appointment of a chief dental officer in the Department of Health, a post which it says has been vacant for six years despite ministerial assurances that it would be filled urgently.

It also says a senior dental clinician should be appointed to the senior management structure of the Health Service Executive (HSE) to co-ordinate current public services and improve existing efficiencies and standards of care.

The submission also states, that in a climate of scarce resources, the Government “must prioritise support for dental treatment for medical card patients”.

According to the IDA submission, the administration of the Dental Treatment Services Scheme (DTSS), provided by the HSE to adult medical cardholders, has “major difficulties” and “is seriously under-funded and on the verge of collapse in many areas”.

The demand-led scheme, which has experienced a considerable increase in patients as unemployment has soared, should be recognised by providing supplementary funding, IDA chief executive Fintan Hourihan said, adding that supporting it on a multi-annual rather than a once-off basis should be considered.

Mr Hourihan said that dentists needed to engage with the HSE about the DTSS as there was a lot of unhappiness about how payments were administered.

“There is huge dissatisfaction with the handling of claims and delays in receiving payments,” he said.

“Certain items under the scheme require approval from the HSE such as X-rays, dentures and root canal, and this is causing delays in providing care.”

He said dentists’ payments should be in line with prompt payments legislation, which Minister for Enterprise Mary Coughlan in May reduced from payment within 30 days of invoicing to 15 for small businesses in a bid to help ease cash flow problems.

Mr Hourihan said research indicated that, comparing the first two months of this and last year, the overall income for dentists had fallen by 11 per cent on average, and that anecdotal evidence suggested earnings would decline further as the year progresses.

He said a decision in October’s Budget to cap tax relief on all medical expenses at 20 per cent, as opposed to 41 per cent, from January should be reconsidered as it had “exacerbated a downward trend” by cutting “the single biggest support dentists and their patients receive from the State”.

The submission states that “dentists are supportive of incentives being built into their contracts which would be aligned with agreed goals for the public healthcare system”.

These incentives would allow dentists to perform preventative examinations and procedures on patients, which the IDA believes would make sense for dentists, patients and the Exchequer.

The submission also calls for consideration to be given to the introduction of accelerated tax reliefs on capital spending by dentists and grant support for support staff and a move towards computerised records.