asked the Minister for Social Welfare whether he is aware of the serious inconvenience caused to insured persons by reason of the suspension of dental benefit; if he will state what steps have been taken to bring about a settlement of the dispute between his Department and the dentists, and how the matter now stands.
Ceisteanna—Questions. Oral Answers. - Suspension of Dental Benefits.
Mr. Byrne
asked the Minister for Social Welfare if he is aware that the large number of fully paid-up members of the National Health Insurance Society who are entitled to dental benefits are not receiving these benefits; and, if so, if he will state the reason and if it is proposed at an early date to restore full dental treatment and benefits to insured persons.
I propose, with the permission of the Ceann Comhairle, to take Questions Nos. 46 and 47 together.
I am aware that persons insured under the National Health Insurance Acts have been unable since the 1st April last to avail of dental benefit under the scheme of additional benefits administered by my Department. The reason for the suspension is that the dental profession, after negotiation, refused to provide their services unless they were permitted to "contract out" for the supply of dentures —that is to say, unless they were permitted to charge for dentures what, in many cases, would be their private practice fees. I could not accept this principle as I am satisfied it would not be justifiable in a scheme of this kind to require insured persons to pay the additional fees required under such an arrangement. In March last, in a final effort to keep dental benefit available, I offered the profession a further improvement on the fees, which had already been increased by me as recently as August, 1951, but they decided to reject my proposals by what, I have been given to understand, was a very large majority. Since this rejection no steps have been taken to bring about a settlement of the dispute, and as the issue is a fundamental one I do not consider that any real progress can be made in reaching agreement until the dental profession withdraw their demand for "contracting out".
I regret that in the circumstances it is not possible to provide dental treatment under the Department's scheme or to state when this benefit will again become available to insured persons.
I should point out to Deputy Byrne that the National Health Insurance Society ceased to exist in 1950.
Arising out of the Minister's reply, would he be prepared, if the Dental Association agree, to submit this matter to independent arbitration?
No.
Therefore, in view of the fact that this dispute has continued for a long time, that the Minister will not submit the matter to arbitration and that it now looks as if the dispute will continue for a further prolonged period, would the Minister give favourable consideration to the question of paying to the insured persons the equivalent of what he previously paid to the dental profession in respect of the agreement which is now the subject of dispute. In other words, the Minister's Department should not be making a profit, at the expense of the insured person, out of the dispute which exists between the Minister and the dental profession.
I know the Deputy gave a lot of thought to this because he was up against the same problem. The proposition he makes is, in fact, giving the dental profession what they are looking for—that is, getting a certain subvention and then charging what they like on top of that. That is what they are looking for and it is entirely unreasonable.
I think there are obvious advantages to the dentists in having some kind of agreement with the Department, and clearly dentists ought to be reasonable in a matter of this kind because a comprehensive contract has considerable advantages for them. But it is no consolation to folk who are suffering from dental defects to be told that this dispute is going on and that there is a matter of high policy involved. This is no solace to toothless citizens or folks suffering from other dental ailments. Would the Minister consider doing something to enable the insured population who are entitled to dental treatment to get some grant from the funds available for such treatment in order to enable them to attend to their dental defects which cannot be postponed indefinitely.
Do I understand from the Minister that the only matter in dispute between the Department and the dentists is the price of dentures?
Yes, if you like. Under the old system there was a price laid down for dentures and the society, as is was then, or the Department now, usually paid half of that and the insured person paid the other half. Now the dentists want to give the person the option of "contracting out" for the supply of dentures. In other words: "If you pay more I will do as well for you as for a private patient." We think they should do it in any case and we do not want this additional amount added on.
The difficulty being entirely about dentures, do I understand that because of the difficulty with dentists about the price of dentures the Minister has deprived the ordinary people of the benefits to which they would normally be entitled in respect of treatment other than dentures, that is, has he deprived the ordinary people entitled to these benefits of these benefits in order to punish the dentists?
I am working on behalf of the insured people.
Even if we approve that stand is it not obviously unfair to the unfortunate folk who need this treatment that if they do have the treatment they must now pay out of their own pockets? Some of them are having the treatment but instead of the treatment being paid for as to half by the State under the national health insurance code they are having to pay it out of their own pockets. Where they have done that surely there is a good case for refunding whatever the State would normally have paid because you are now compelling them to pay out of their own pockets.
I admit this thing should not be going on.
Some people are paying on the double, a portion of the contribution under the national health, and at the same time, because they need treatment, they are obliged to pay dentists.
Yes, if they want urgent treatment.
Would the Minister look into that?
I am looking into it all the time.
I think it is unfair to treat this matter in the manner in which it is being treated. I know of a case where a man was ordered to get four teeth drawn——
This is a statement.
I am asking, arising out of Deputy Norton's question——
The Deputy is making a statement.
I want to ask if the Minister is aware that many dentists to-day are charging workers who are members of the society three guineas for drawing teeth. Is it not time that this dispute was ended, whether by arbitration or otherwise, so that these benefits may not be further held up?