asked the Minister for Health the total number of medical card holders and their dependants at present awaiting dental treatment and the measures he proposes for immediate improvement of these services.
Ceisteanna—Questions. Oral Answers. - Dental Services.
9.
Health boards do not maintain separate records identifying children receiving dental treatment whose parents are medical card holders.
The number of other persons covered by medical cards who were awaiting dental treatment on 31 January 1980 was 27,911. This is substantially less than the corresponding figure of 35,675 for 1 January 1979 and this reflects the fact that an increasing proportion of adult patients are being catered for by dentists in private practice.
Arrangements were introduced last year to this end. Under these arrangements, health boards engaged private dentists on the terms which had been negotiated under the Social Welfare (Dental Benefit) Scheme to treat medical card holders. The dentists told me they were withdrawing from this arrangement at the end of March because of their dissatisfaction with some aspects of the structure of fees under the social welfare scheme.
Two main improvements had been requested by the profession—the introduction of a separate fee for dental examination and general consultation and restructuring of the scale of fees for extractions. I was disappointed that the profession should have thought it necessary to withdraw from the scheme for medical card holders seeing that I had arranged for discussions on these and other aspects of the social welfare scheme to commence on 10 April.
I have told the Irish Dental Association that I agree in principle with the changes which they have asked for in the fees structure. I intend that the Department of Social Welfare will now press on with negotiations with the association aimed at agreeing on a new scale of fees.
In these circumstances I have asked the dentists to resume the arrangements for the extended application of this scheme to medical card holders, with a view to the further reduction of the waiting list.
Will the Minister tell the House if they have acceded to his request?
Not as yet. This has occurred only quite recently. I spoke to the association last Saturday night.
Can the Minister give the House an indication when the new Bill will be brought forward? That might solve many of the problems mentioned in the question.
I hope we will be in a position towards the end of the year to bring forward the new Bill. I should like to emphasise the two improvements that I mentioned and which could go by unnoticed very easily. They are two major improvements, and this is particularly the case with regard to the first one. The other improvement is one the dentists have been looking for for quite some time. I believe the introduction of a separate fee for examination and general consultation will be a major step forward in dental hygiene, medicine and care generally. I am particularly pleased I have been able to introduce this improvement. It indicates the direction in which dental care is going and I am glad I was able to do it.
I was glad to hear the Minister mention this major step forward in dental care. Is he satisfied that the dental care available to medical card holders is satisfactory when, as Members of this House, we know of cases where there are delays of up to five or six years in some health board areas? Further, will he state if the agreement reached some time ago where medical card holders could go to private dentists for dental care has been terminated? Will he tell the House the present position with regard to this agreement?
To some extent the confusion arises from the time at which negotiations with regard to the new scale of fees normally takes place each year and the fact that this other short-term, temporary scheme which was introduced and which it was hoped would continue was tied in with those discussions. The discussions were scheduled to start at the end of March but, in effect, they began on 10 April by agreement and arrangement with the Irish Dental Association. Meanwhile before the discussions took place the association decided to withdraw from the scheme. Part of the discussions dealt with the question whether the examination fee could be introduced and also the changed method of payment for extractions. These were two problems in principle. They have been granted and I hope the dentists will continue to operate this scheme. It has been a valuable one and we welcome it. As I mentioned, it has led to a substantial reduction in the number of people on the waiting lists. I hope the discussions will be concluded shortly and that the scheme will continue. Present commitments will be honoured by the Department and presumably by the dentists also. We have really only been informed that the association is to withdraw from the scheme and the extent to which this happens remains to be seen.
With regard to County Mayo where special problems have arisen in relation to dental care for insured persons seeking treatment, is the Minister taking any steps to have the matter regularised? If so, will he tell the House what are those steps?
These matters relate directly to that problem.