Dental treatment scheme ‘on brink of collapse’

Oireachtas hears free service for 1.5 million hit by cost-cutting and dentists withdrawing

The State’s dental treatment scheme for 1.5 million medical card patients is “in crisis and on the brink of collapse” according to dentists.

The medical card scheme, which was set up to offer free dental treatment for those on reduced means, is currently the subject of a review undertaken by the Oireachtas health committee.

On Thursday, the committee was told the scheme had been hit with cost-cutting to the point where it was no longer fit for purpose and dentists were leaving in large numbers.

The committee heard the Health Service Executive imposed unilateral cuts to the dental treatment scheme in 2010, during the State’s economic crash. As a result, access for many patients to treatment was restricted and the majority of patients were entitled to just one examination a year and a maximum of two fillings irrespective of circumstances.

However, access to as many extractions as required was maintained.

‘Budget-led’

Fintan Hourihan, chief executive of the Irish Dental Association, told the committee the cuts to the medical card scheme “fundamentally altered” it “from a demand-led scheme to a budget-led scheme”.

He said adults between 16 and 99 years may no longer access the dental care they require to maintain their dental health. “Only those who have a significant medical condition from a narrow prescribed range are enabled to access more treatment items,” he said.

Listing the affected treatments, he said:

- A biannual scale and polish had been suspended;

- Fillings had been reduced to just two in an emergency situation; and

- Root canals, dentures, denture repairs and miscellaneous items were now consigned to emergency cases only.

“It is our view, and the expressed view of our members – the dentists operating the scheme on a daily basis – that the State’s dental treatment scheme for approximately 1.5 million eligible medical card patients is in crisis and on the brink of collapse,” he told the committee.

Medical cards

“The last year has seen an unprecedented number of dentists withdraw from the medical card scheme with serious repercussions for patients nationwide.”

Total spending on the scheme fell from over €63 million in 2017 to €40 million in 2020, a 36 per cent drop.

Mr Hourihan said, “Dentists want to be able to provide care for all patients, but the Government is leaving them with little choice but to minimise their involvement or withdraw from the medical card scheme.”

Sinn Féin TD David Cullinane said the numbers of dentists remaining in the scheme should be made known. He said a figure of 1,000 dentists had been suggested but he had been given to understand the real figure was much less than that.

He said the scheme as currently set up was not designed to promote good dental health by encouraging and undertaking preventative measures “but will happily remove the teeth”.