I wish to raise the need for the Minister for Health and Children to address the issue of the Competition Act 2002 in relation to Irish dental practitioners. The Minister of State will undoubtedly be aware of this problem. I have spoken to many dentists who are extremely concerned about the possible collapse of the State's dentistry scheme for medical card holders. The case seems to be getting more and more acute. Even today the Irish Dental Association has issued a statement indicating there is a danger that this scheme will collapse. Dentists throughout the country are fed up with the way it operates.
It is sometimes difficult to make a case for professional people, particularly when the defence is the Competition Authority and the Competition Act. Professional people who practise an art like dentistry cannot be expected to operate at a loss. They certainly cannot be expected to operate a system which it is patently obvious is not working. The real problem here is the refusal of the HSE to engage in conversations with the dentists. This is typical of the HSE and has resonances of its battle with the pharmacists when it was almost impossible to get the HSE to even negotiate prices with dentists, pharmacists and so on.
The first and single most important demand I make to the Minister of State is that the Department of Health and Children and the HSE should engage in discussion with the Irish Dental Association before this becomes a crisis. The Minister of State will know there is a dispute about the figures, namely, about how many dentists have withdrawn from this scheme. It is certainly conceded by the Department and by the Minister for Health and Children that at least 200 have already withdrawn from it. If 200 out of 1,400 dentists have withdrawn, that is approximately 15%, and many others are threatening to withdraw from it.
One of the extraordinary aspects of this scheme is that, although the Department of Health and Children states that the numbers joining it are beginning to make up for the numbers leaving it, the Department refuses to reveal the figures. I do not believe the figures being issued by the Department of Health and Children or by the HSE. The HSE is again bullying a group of professionals, there is a bit of eye-balling going on, and the opinion of the Attorney General has been sought.
One of the odd aspects of this battle between the Irish Dental Association and the Department is that they both got legal opinions which suit them. One can always get a legal opinion which suits one. That is one of the problems here. The legal opinion, whether it is that of the Attorney General or anybody else, is not worth much because somebody else could get another legal opinion which would counter that and then one would be back to square one. I gather there is a call for and an expectation that the new Attorney General — the last legal opinion came from the previous Attorney General — will deliver a new opinion on the matter. I do not know whether it will be the same as the current one, but a new and fresh look will taken of the Act. There is a clause in section 4(5) of the Competition Act, which allowed the IMO to opt out of an opinion which stated it was anti-competitive to discuss issues of price with professionals, and as a result negotiations were entered into in that case. I do not understand — the Minister of State might be able to enlighten me on this — why this letter cannot be also applied to the dentists.
The first concern must be the patient. I know that the sort of iniquitous propaganda which can arise when one puts forward a case for people who are earning money from the medical schemes — they have to earn a living — is that they are exploiting the schemes, and they can do. Regardless of the propaganda, it is important that the patients are paramount in regard to this cost, not the State nor the bullies in the HSE. It is also fair that dentists should make some sort of a living out of the medical scheme, not vast sums, but they should not be expected at any stage to operate at a loss. We should not ask them to do that.
I ask the Minister of State to respond to the points I made. I also ask him, in passing, to comment on the fact that dentists are unhappy, as are patients, with the budget provision under which some allowances for tax relief for orthodontic and other treatments were reduced by 50%. That may or may not be correct and it may not be fair, but it appears that dentists and their patients are suffering. Patients are not getting their teeth repaired, cleaned or treated in the way they should because of the lack of such tax relief. The other downside of this measure is that dental tourism is increasing. That is not something we want to see happen.
I ask the Minister of State to reply to this matter and to bear in mind one aspect, namely, the effect on patients. Patients are suffering and the Irish Dental Association and Irish dentists are being ignored, or the Government and the HSE are refusing to talk to them. Why have the talks not started and can we have an assurance they will start immediately?
