HSE denies fees dispute is delaying dental care

THE HEALTH Service Executive (HSE) has denied a claim by dentists that medical card patients are having their treatment delayed or cancelled because of a dispute about fees.

The Irish Dental Association said medical card holders were having to wait longer for dental treatments and in some cases were not receiving treatment at all because of the withdrawal of dentists from the dental treatment services scheme.

The association said it was "self-evident" that there was now severe shortages of dentists available to medical card holders as one in seven dentists nationwide had withdrawn from the scheme.

It said medical card holders in rural areas of Kerry, Mayo and Carlow/Kilkenny had been among the worst affected by the steady withdrawal of dentists from the scheme.

The dispute between the HSE, which manages the scheme, and the dentists became public when Minister for Health Mary Harney revealed in a parliamentary question that 190 of the 1,400 dentists involved in the scheme had withdrawn from it over the last 18 months.

The HSE said it is precluded from negotiating set fees with all dentists because the Competition Act 2002 does not allow it to do so.

Section 4 of the Competition Act bans any agreements, which could lead to the prevention, restriction or distortion of competition. It has also been cited in relation to the HSE's dealings with pharmacists and GPs.

Irish Dental Association chief executive Fintan Hourihan said it had legal advice which suggested that the HSE was wrong in its assessment of the law. "We've engaged advice which confers our entitlement to represent dentists and this has been confirmed at European Commission level," he said.

The dentists claim that the payments which are made for many procedures do not cover the cost of them and they are subsidising medical card holders through their private patients.

Mr Hourihan said a review of payments had been promised since 2004 and stalled in January last year because of concerns over the Competition Act.

The HSE in response said it had not been made aware of delays currently being experienced by medical card patients and it said that all emergency needs will continue to be met under the present scheme.

It said the number of dentists who had withdrawn from the scheme is "relatively small" and it is satisfied that there are sufficient dentists currently operating within the dental treatment services scheme to meet demand.

The HSE is now seeking clarity from the Attorney General's office about how to proceed with an alternative to the present scheme.

Sinn Féin health spokesman Caoimhghín Ó Caoláin, who tabled the original question in relation to the issue, accused Ms Harney of knowing about the breakdown of negotiations between the HSE and the dentists and doing nothing about it.

Labour's Seanad health spokeswoman Phil Prendergast said it was "unthinkable" that waiting times for medical card patients should get longer.

"I would urge the HSE and the Irish Dental Association to discuss this matter and to come to a resolution which ensures that patients do not suffer," Ms Prendergast said.