I welcome the Minister of State to the House and thank the Cathaoirleach for giving me the opportunity to raise this matter, the purpose of which is to look at the dental profession, particularly the orthodontic side, in an attempt to reduce the enormous costs of such treatment.
Most public representatives get calls on a weekly basis from parents about the huge cost of orthodontic treatment. The health boards provide treatment for a number of children with serious dental problems, but they do not cover cosmetic problems. Parents have to bring their children to orthodontists for such treatment and are often asked for huge sums of money for relatively simple cosmetic treatment — in the region of £1,000 or £1,200.
I discovered some very interesting facts on this subject. Orthodontic work is rarely carried out by dentists in this country whereas in other jurisdictions up to 80 per cent of orthodontic work is carried out by ordinary dental practices. That raised my eyebrows to some degree. I also discovered that charges are much less in other jurisdictions. I decided I had to bring to the Minister's attention the fact that Irish parents are paying through the teeth — if one wanted to make a pun — for the service. I am sure the Acting Chairman receives similar telephone calls from parents about the cost of orthodontic treatment. Those costs should be reduced because they do not need to be so high.
Many of the simpler treatments could be carried out by dentists. The business of straightening teeth and treating people with crowded mouths, where a tooth or two must be removed and the other teeth pulled into different positions, is relatively simple. It is usually achieved by fitting some sort of device. I do not believe it is necessary for a person to have specialist education to fit those devices. Every dentist I know would be capable of doing it. Why do they not do it? I think it is just a matter of practice; in other words, it is not done. Talking to the Minister a few minutes ago, we agreed lately qualified dentists and the students of today are probably receiving more tuition in orthodontics. Over the years, we will probably find that more dentists will practice orthodontics, thereby achieving what I seek tonight.
There are also restrictive practices in the dental profession which promote that kind of ethos anyway. Dentists stick to their own corner and leave everything else — and even work they could do themselves — to others. For example, the code of practice for dentists is quite antiquated in my view and out of kilter with the kind of world in which we live.
Dentists are not allowed to advertise and are protected and cosseted by the code of practice in a way which prevents competition. Such competition as exists is of an accidental nature; you really do not know much about a dental practice until you get a toothache and go looking for one. They never advertise their wares and, as a result, dentists' prices tend to be higher also.
The Minister should examine the legislation which dates from the 1980s — I looked at it at one stage but I do not have a copy of it in my possession — to see whether he can open the window and let some fresh air into the area of dentistry with a view to making it more competitive and providing the public not with better care — the care offered by dentists is of a very high standard — but with more modern care so that dentists may operate in the same competitive world as other professions.
I hope the Minister will be able to spend some time on this matter. To give an example of the antiquated nature of the documents presented by the General Dental Council, on incentives, section 46 (ii) of Professional Conduct and Fitness to Practise dated May 1993, states: “the Council would not approve of a financial incentive being paid to a third party by a dentist in return for encouraging or promoting the uptake of dental care by individual members of the public;”.
When you read that you ask "What does that mean?" it means there is no advertising. Why not? The Dental Council will tell you that if there is advertising, the persons likely to suffer will be members of the public. I cannot see how that could be. If dentists want to promote their business, they should be allowed to do so. If they want to offer a service at a different or cheaper price to that of other dentists, they should be allowed to do so. They should be allowed to advertise in the newspapers the same as anybody else who offers a service. If that was done and the Minister legislated accordingly, we would all have a better and more competitive service and orthodontics, in particular, would benefit. More people would avail of the service and they would get it at a much lower price.
I do not want to labour this any further. I know the Minister of State has a positive approach to this matter and that his Department understands the costs, because the health boards are paying huge amounts every year for orthodontic treatment for children. The Minister will have all those facts and will know much more about it than I. I look forward to his response.
