Dáil Éireann debate -
Wednesday, 4 Dec 2002

Vol. 558 No. 5

Priority Questions. - Dental Service.

65.Mr. Ring asked the Minister for Social and Family Affairs when the dispute between her Department and the Irish Dental Association will be settled; if settled, the amount of money which was saved by her Department during the dispute; and the compensation which will be paid to the PRSI workers who have lost out due to this dispute. [24851/02]

Mary Coughlan

The dispute between my Department and the Irish Dental Association arose out of a claim by the association for substantial increases in the fees payable to dentists under the scheme. The action taken involved the imposition of increased charges by some dentists in breach of the contractual arrangements for the provision of dental benefit. This action commenced in early March this year.

Patients continued to be treated under the scheme at that stage while efforts were made to find a resolution to the underlying issue. In the absence of a resolution, my Department ceased in early August to accept claims from dentists who were not prepared to adhere to the contractual arrangements. However, the scheme continued to operate and patients continued to be treated by dentists who were prepared to adhere to their contracts. Following a temporary suspension of the action in October the association subsequently rejected proposals put to it and advised members to resume the action. Claims received while the association action was suspended have been processed in the normal way. The position in relation to those dentists who have resumed their action is that claims are not being accepted from them and their patients are being advised of the position.

Efforts to resolve the dispute are continuing but so far it has not been possible to reach agreement in a way which would afford the necessary level of protection for insured workers. Insured workers have been advised through the newspapers to check that their dentist is not imposing increased charges prior to starting treatment. They have also been advised that, where dentists offer to treat people as private patients, this is outside the terms of the dental benefit scheme and the Department will not be in a position to refund any costs arising. To do otherwise would undermine my efforts to secure a settlement which affords patients protection against the application of full private fees.

It will not be possible to assess the impact of the dispute on expenditure under the scheme until a settlement is reached and the impact on claims experience has been evaluated. At this stage, expenditure on the scheme in 2002 is budgeted at €35 million, the same level as applied in 2001.

Mr. Ring

The Minister has sacked the dentists despite the fact that members of the public have paid their PRSI and that we were led to believe from the previous Question Time that this issue would be resolved last month. Members of the public are being told by their dentists to contact their local Deputies. How many queries has the helpline received? What will be done for the people who have paid PRSI and have had to pay again to obtain dental treatment? How will the Minister compensate them?

Her reply stated that the €35 million provided in the budget was the same as was provided last year. Does that not prove what I have said all along, that this dispute is being used by the Department to save money? What will the Minister do for the people who obey the law of the land, pay their PRSI yet cannot obtain the service for which they have paid? It is like paying car insurance on which the insurance company will not pay out when one has an accident. What will the Minister do for my constituents and those of other Members?

Mary Coughlan

I am sure the Deputy agrees that my job and his as a Member is to protect the scheme—

Mr. Ring

It is to protect the people.

Mary Coughlan

—and to ensure participants who pay PRSI are protected.

Mr. Ring

They are not being protected.

Mary Coughlan

They are not being protected if full private fees are expected of these patients when there is a contract with the Department. I appreciate that the Irish Dental Association had concerns in the context of the fees available. I have always said and reiterate that I am more than prepared to negotiate, but I cannot do so when people are trying to get rid of the scheme. The scheme is a good one but I cannot have people making PRSI contributions, expecting dental treatment and not receiving it under agreed contracts I have with dentists.

I have negotiated on a number of occasions and put forward numerous proposals to safeguard the scheme but they have not been accepted by certain members of the dental profession. That is not to say there are not others in the profession who are participants in the scheme and who provide a service. I cannot allow people working within the scheme to proceed while also allowing others outside it to proceed as well. I would like to see a resolution to the dispute.

I agree that I said at the previous Question Time that we almost had an agreement, but it was not acceptable to the dentists. I believe they want private fees and I cannot agree to that. Otherwise there is no relevance to the dental benefit scheme. It is a good and worthwhile one from which people who pay PRSI believe they get value for money and a service. I am trying to protect that.

I reiterate my availability and that of my Department to examine realistically the cost of dental care and our openness to an independent evaluation if needs be. I also offered the option of an independent arbitrator where the dentists felt they could not work with my officials or myself. None of these offers was availed of. I would like the scheme and its participants protected and I would also like the dentists to be realistic and accept the proposals I have made.

Mr. Ring

When will the Minister meet the IDA again? How much longer can she let this continue? Is she considering methods to compensate people who have paid PRSI and who have also paid the dentists? These people have sent the bills to the Department and have made representations to me and other Members about this matter. When will she meet the dentists? If she does not do so there will be no discussion and therefore no action.

Mary Coughlan

I cannot emphasise enough the number of meetings my Department has had.

Mr. Ring

When is the next one?

Mary Coughlan

We had an agreement at a meeting some time ago but the IDA decided there was not much point in proceeding. I have written to it and been in touch with it on a regular basis. There was an offer of a meeting on 22 November. I have always said I am available, as is my Department. Unfortunately, the IDA does not see any use in having a meeting. I do not agree. It is best to talk and iron out the problems.

Regarding the other matter, I regret I am not in a position to pay for dental benefit where people are working outside the scheme. I have adverted to this in public notices.