asked the Minister for Health whether he has any proposals for early application whereby persons holding medical cards will be provided with dentures much more expeditiously than at present; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Provision of Dentures.
13.
I have already explained today, in reply to a question by Deputy O'Higgins, that holders of medical cards are not necessarily entitled to be provided with dentures under Section 14 of the Health Act, 1953. They may, for instance, be entitled to a grant towards the cost of them under the Dental Benefit Scheme operated by the Department of Social Welfare and if they can meet the balance of the cost from their own resources, they would not be entitled to avail themselves of the health authority service. Where they are unable to meet the full amount of the balance, health authorities have been put in a position, since last September, to make a contribution. This change should assist in clearing off some of the backlog without encroaching on the resources in dental man-power available to health authorities for the provision of their services.
In a circular issued by my Department in March last, health authorities were advised that, while they should continue to concentrate their limited funds and dental personnel on the provision of dental treatment for children, some reasonable provision should be made for a denture service for adults in the lower income group.
Despite the special steps which I have mentioned and the improved position regarding recruitment of dentists, I fear, however, that a fully comprehensive and satisfactory dental service, including the supply of dentures, cannot be provided until a substantial improvement in the dental health of children will have been secured. The fluoridation of public piped water supplies will achieve this in due course but in the interim all possible measures will be taken to improve the existing services.
Is the Minister aware that a number of persons who hold medical cards have had teeth extracted under the county council dental scheme as long as three and four years ago and that they have been unable to obtain dentures since then from the county council? Would the Minister use his position to bring home to county managers and county medical officers of health the necessity for devising some means by which persons, unable to provide dentures from their own resources, will have dentures supplied by the county council, without having to wait three or four years for them?
Does the Minister take into account that dentures supplied by the Department of Social Welfare cost at least three times the price of dentures provided by health authorities? Furthermore, is the Minister aware that an applicant is supposed to contribute a sum of £7 to avail of dentures provided by the Department of Social Welfare, whereas dentures provided by the health authority, and which, to my mind, are just as good as, if not better than, the other dentures, cost in the neighbourhood of £3 10s. or £3 15s. per set?
In his reply, the Minister used a phrase which I did not observe him using in reply to an earlier question, that holders of medical cards are not necessarily entitled to dental services. Is it not so that Section 14 of the Health Act provides that in respect of a person who fulfils the definition and who subsequently becomes entitled to a medical card, health authorities shall provide all necessary dental and other services? Is that not what the section says? If the section says that, how does the Minister say such a person is not necessarily entitled to such services? If a person comes within the section, the section clearly says he is entitled to them.
Oh, yes; if the person comes within the section, and most of these people do, but do not forget what the section says. It refers to those who are unable to provide these dentures for themselves by their own industry or other lawful means and, of course, one of the lawful ways of providing them would be entitlement under the social welfare code. Therefore, what I said is quite correct. If the person can get these dentures under the social welfare scheme, then he is not entitled to them under Section 14 of the Act.
We can take it the persons we are talking about cannot?
The Deputy takes too much for granted. With regard to the point which Deputy Murphy has raised, it is quite true there is a discrepancy which is, perhaps, one of the things to which the Select Committee might devote some attention in order to ascertain how the discrepancy arises. Do not forget there is a very wide choice of dentist under the social welfare scheme and that may have something to do with the discrepancy in cost. In any event, as I pointed out, the local authorities have now been put in a position, where a person is unable to meet that contribution, to come to his assistance.
With regard to Deputy Norton's question, Kildare appears to be in a rather special position in this connection because there is a heavy backlog of cases there dating back, as the Deputy has said, in some cases to 1958. However, I do not understand why it should be because so far as the general population of Kildare is concerned, they would seem to enjoy greater facilities for securing dental treatment than most other counties.
Would the Minister bear in mind the fact that the dentists employed by the Kildare County Council are employed for five of the six days per week in dealing with dental complaints in respect of school-going children, with the result that they have only one day per week to deal with the cases of adults who are entitled to free dental treatment because they cannot provide that treatment from their own resources? Would the Minister, in the circumstances, authorise Kildare County Council or any other county council with a backlog of applicants to take some special steps for the employment of additional dentists in order to clear the backlog?
That surely raises another matter.
I should like to reply to the latter part of the Deputy's question. Additional dentists are being employed. It has not been easy to get dentists, and it has certainly not been easy when the amount of money at the disposal of the Minister for Health is strictly limited. Nevertheless, we have succeeded in recruiting in the past few weeks a considerable number of dentists who, we hope, will be able to help us to reduce this backlog.