Ivan Yates
Question:3 Mr. Yates asked the Minister for Health the proposals, if any, he has to introduce a referral dental routine maintenance scheme for adult medical card holders and their dependants.
Ceisteanna—Questions Oral Answers - Dental Treatment.
Eamon Gilmore
Question:42 Mr. Gilmore asked the Minister for Health if his Department has carried out an assessment of the waiting lists which exist for dental treatment; if he will consider allowing dental treatment to be included on the medical card with a choice of dentist similar to the choice of doctor; and if he will make a statement on the matter.
I propose to take Questions Nos. 3 and 42 together.
The ad hoc dental scheme which provided medical card holders with routine dental treatment through private dental practitioners was established in 1979. The scheme was found by the health boards to be expensive to operate and most boards began to curtail services in the mid-1980s which resulted in lengthy waiting lists developing.
It was in the context of these excessive waiting lists that the Government decided to make an additional £3 million available to the health board dental services in the current year. Of this amount, £2.2 million is being allocated to the health boards to provide routine dental treatment for adults. It is expected that about 20,000 persons will benefit from this allocation. The health boards have been asked to make arrangements appropriate to local circumstances in order to ensure that a routine dental service for adults is provided in a cost-effective and efficent manner.
It is not proposed to establish a full scale "choice of dentist" scheme for medical card holders and their adult dependants at this time.
Is the Minister of State aware that the amount allocated is not sufficient to deal with the numbers seeking dental treatment? Is he also aware that, under the 1970 Health Act, there is a legal obligation on health boards to provide a proper dental service for fillings, extractions and routine dental care? Is the Minister also aware that all health boards are failing in their legal obligations to meet this? Will he bring forward proposals so that there will be a referral scheme as health board dentists could not cope with the numbers involved?
I am aware that for at least five or six years dental services were not properly funded. The Minister for Health made a major effort to ensure that resources were made available and, at his request, the Government made an additional £3 million available for the scheme this year, of which £2.2 million has been allocated to the health boards to provide routine dental treatment for adults. It is virtually impossible to estimate the demand for this service even though we have a good estimate in round figures. I appreciate that, under the 1970 Health Act, people are entitled to certain services and it has been the priority of the Minister for Health, since he was appointed in 1987, to ensure that a proper level of service is available right across the board. As resources become available they are being allocated to the areas where they are required.
Will the Minister agree it is a national scandal that bank managers and company directors can get free dental treatment under the PRSI dental scheme while, at the same time, old age pensioners and medical card holders are being asked to pay £300 or £400 for dentures? This is unjust and unfair. Will the Minister reconsider the position and introduce one national dental scheme to ensure that the poorest people have some level of service?
The language used by the Deputy is very extreme.
It is accurate.
There are some difficulties in regard to the social welfare scheme about which I am not prepared to comment. Consequently, the availability of the scheme for the people to whom the Deputy referred is being questioned at this moment. The Deputy should be aware that between 1983 and 1987 the ad hoc scheme which had been in place since 1980 was terminated because of lack of funds. We have done our utmost since our return to Government in 1987, and particularly this year, to ensure that extra resources are made available. We are reasonably confident that, with the extra funds being made available this year, we will reduce the waiting list for adults by approximately 50 per cent in one year, a major contribution in a short period.
For dentures?
For services.