asked the Minister for Health if he is aware of the increasing difficulties felt by many middle income families in meeting dental bills; if he will consider proposing to the VHI that they might operate a scheme in this area; and if he has any other proposals to assist these families.
Ceisteanna—Questions. Oral Answers. - Dental Bills.
3.
The Voluntary Health Insurance Board already cover dental and orosurgical operations. The possibility of a broader scheme is under review. However, the board do not consider it appropriate to extend cover to routine dental care at this time.
I should point out that many persons in the middle income group are insured workers and are, therefore, entitled to dental services under the Department of Social Welfare's dental treatment benefit scheme. The pregnant wives of insured workers are also entitled to avail of dental treatment under this scheme.
In addition under the provisions of the Health Acts, all pre-school children and children attending national schools, which would include the great majority of children under 12 years of age, are entitled to free dental treatment in respect of defects discovered in the course of pre-school and national school examinations, irrespective of the means of their parents. A very substantial portion of the middle income group is, therefore, eligible for State-funded dental services.
I have no plans to extend eligibility for health board dental services at present.
Has the Minister any plans to change the ridiculous regulation which says at the moment that only pregnant women can avail of the dental service on their husbands' insurance? Is that not quite a discriminatory regulation? Would the Minister consider expanding that section of the code as soon as possible?
There would be great difficulty in extending it on an insured basis, for example, to all spouses of insured workers. I ran into great difficulty in extending the scheme to cover pregnant spouses of insured persons. A general extension would require a total recosting of the scheme and an integration of the social welfare scheme with a general scheme being run for the public at large by the dental profession. It would cost a great deal of money and is not regarded as an immediate priority.
Is the Minister not concerned that dental bills today, particularly for the women at home, can be as expensive as any medical bill and indeed more so? That is a serious situation which should be looked at. I am aware of the cost element and I am not unmindful of the pressures on the Exchequer, but does it not seem ridiculous to extend the scheme only to pregnant women?
At the moment about one million people are entitled to dental treatment under the social welfare dental benefit scheme. The great majority of these would be in the middle income group. The treatment of the wives or spouses of insured persons other than those who are pregnant is being done on a private basis. Even on the most tentative inquiry — and this applies equally to previous Ministers for Health — I met with total opposition from the dental profession to an expansion of the scheme into that area. This would affect their private practice. If we were to expand the scheme in that manner, the cost would be enormous. I have yet to meet an insured worker who is prepared to say that he would favour an increase in his PRSI contribution to enable his wife to have that benefit. We all want the services but none of us wants to pay for them. That would require an extra £15 million per year.
If the Deputy wants to recommend an increase in the PRSI rate and social insurance under the proposed Social Welfare Bill——
The Minister is advising pregnancy.
——I could recommend it to my colleague. Deputy Hussey.
I am surprised at the Minister defending the interests of the dental profession. He stated that one million persons were entitled to benefit under the social welfare scheme. However, the dependents of those persons, as Deputy Brennan has pointed out, are not entitled to benefit. The Minister also stated earlier that those with medical cards and children of pre-school and primary school age are entitled to free dental services. He must accept that, in reality, there is no dental service available to many of these people. We have established that fact. There are no dental services for the dependants of social welfare recipients and there are 40,000 children on the waiting list who are eligible for and entitled to these services.
That is a very long question, Deputy.
Is the Minister aware that there are 40,000 children awaiting dental service? Is he also aware that there are community care areas where no adult, irrespective of eligibility — medical card holder or not — will get the free service he or she is entitled to because the service is not available to the health boards because of——
We are entering into a discussion now.
There is need for some kind of insurance scheme so that people will be able to provide a dental service for themselves.
I am quite in favour of providing a scheme, but the parallel requirement is that people are prepared to pay for it. On the basis of the existing social insurance schemes it just is not possible to pay out another £15 million unless people are prepared to pay through their social insurance contributions.
Every side of the House wants this scheme and the Minister for Health would be undyingly popular with every woman in the country if that were agreed and I would be totally in favour of it. Simultaneously, the uproar which greets any increase in PRSI contribution rates to pay for this, as the Opposition well knows, is a matter about which the Opposition would not want to get on the band wagon. These are the facts of life. I am quite in favour of extending the scheme, but we must be prepared to pay for it.