asked the Minister for Social Welfare when it is expected to introduce full dental and optical benefit for the spouses of insured workers.
14.
Ceisteanna—Questions. Oral Answers. - Dental and Optical Benefits.
1.
asked the Minister for Social Welfare if his attention has been drawn to the view of the Irish Dental Association concerning the proposed extensions of eligibility under the social welfare treatment benefits scheme; the inadequate level of service provided for the number now eligible; and if he will make a statement on the matter.
38.
asked the Minister for Social Welfare if, in the light of the refusal of the Irish Dental Association to operate any extension to the State dental service to include dental benefit to the wives of insured workers, he will indicate the way in which he intends to implement the decision as he indicated he would do, with or without the association's co-operation; the progress, if any, that has been made with the extension of optical benefit to the wives of insured workers; and if he will make a statement on the matter.
39.
asked the Minister for Social Welfare the progress, if any, that has been made in reviewing and updating State dental services in his Department; and particular areas of contention between himself and the Irish Dental Association; and when he hopes to be in a position to bring forward a modern scheme which recognises new techniques in treatment.
I propose to take Questions Nos. 1, 14, 38 and 39 together.
As announced in the budget, the Government have decided to extend the existing social insurance treatment benefits scheme to the dependent spouses of qualified insured persons from October 1987. The extension embraces the entire treatment benefits scheme which includes dental and optical benefits and the provision of hearing aids. I am pressing ahead with the necessary arrangements to ensure implementation by mid-October this year.
Those newly qualified under the extension will include dependent spouses of PAYE workers and dependent spouses of insured unemployed, of disability benefit recipients and invalidity, retirement and old age contributory pensioners. The extension is primarily aimed at providing the benefits of the scheme to wives working in the home.
I recently met with representatives of the Irish Dental Association to discuss the implementation of the extension in relation to dental benefit. In the course of the meeting I agreed that, in the context of the arrangements for the extension, a review could take place in order to consider if improvements could be made in the dental benefit scheme. Arising from that meeting, I invited the Irish Dental Association to participate in discussions with officials of my Department to discuss possible improvements in the dental benefit scheme in the context of the October extension. The association did not, as yet, take up that invitation. It appears from their public statements that they have decided not to support the extension of dental benefit to dependent spouses.
I am satisfied that the social insurance dental benefit scheme, which has been in existence for a number of years is a scheme which provides a good service to the insured worker. I accept that certain minor improvements could be considered and I agreed with the Irish Dental Association at our meeting that I and my officials would be available to meet them and to discuss such improvements. I am, therefore, disappointed at the failure to date of the Irish Dental Association to co-operate in the extension and in the working out of improvements in the scheme.
The Minister for Health, who has responsibility for dental services provided by the health boards has also agreed to meet the Irish Dental Association shortly to discuss the services provided by the health boards. These are separate from the services provided under the dental benefit scheme operated by my Department for insured persons.
The implementation of my planned extension will involve revision of the formal agreement under which dentists contract to provide these services to eligible persons. A new version of the agreement, providing for the inclusion of dependent spouses in the eligible category, is now virtually ready and will shortly be sent for signature to the dentists on the Department's panel. Other dentists who are not on the Department's present panel may, of course, also apply to sign this agreement and thereby become members of the panel. In the circumstances in which the Irish Dental Association has so far failed to co-operate in the extension to dependent spouses, I will shortly have no option but to send the new agreement to individual dentists for signature without further consultation with the association. I would welcome the co-operation of dentists in the extension of dental benefit to so many women working at home who are not at present in a position to provide dental treatment for themselves.
Naturally, I hope that the Irish Dental Association will agree soon to meet with myself or my officials to discuss potential improvements in the scheme. I, and my Department, are available for such discussions at any time at short notice and this will continue to be the position even after the new agreement has been issued to dentists generally.
I also recently met representatives of the association of Optometrists, who represent the opticians, in order to discuss the extension in relation to optical benefit. That association have agreed fully with my proposals to extend optical benefit to the dependent spouses of insured workers.
Will the Minister indicate how many people will qualify under the extension of the scheme; the specific objections to the scheme by the Irish Dental Association and the steps being taken to ensure that the extension of the scheme, which I welcome, will not simply result in longer waiting lists and longer queues for women and children seeking optical and dental care?
In my view the scheme will result in shorter waiting lists in that those who are not entitled to benefit under the general scheme will now be entitled to benefit and, therefore, will not have to wait for approval from health boards. That element has not been referred to very often but it is a cross-over that will occur. I should like to tell the Deputy that approximately 300,000 dependent spouses of insured workers will come into benefit. With regard to his question about the specific objections of the Irish Dental Association, I suggest that it would be more appropriate for them to list their objections. They have circulated their views. They want a review of the two schemes together, that operated by the health board and this scheme. In their circular they say they want priority given to certain categories such as the handicapped and children who come under the health board schemes. They want any funds available allocated in that direction. That is a separate matter to the insurance scheme and I would like Members to be clear about that because it is being confused in the public mind for particular reasons. When I said I was looking at improvements in the scheme I was referring to improvements in the social welfare dental benefit insurance scheme. When they are talking about combining the two schemes they want it done in a way which would not be particularly advantageous to people on the social welfare insurance scheme.
While I accept the niceties of the differentiation the Minister is making between the social schemes, and the health schemes, it would strike the ordinary citizen as peculiar that a priority which seeks to extend a scheme, which I welcome, at the same time is not making provision for dental benefit for handicapped children. Is the Minister aware that due to the £500,000 cut back in the South-Eastern Health Board region that both the dental and optical benefits available under the GMS scheme are no longer in operation in the south-east?
We must be very clear in our minds whether we are talking about insured workers or other groups. My function here is in relation to insured workers. Queries relating to the GMS scheme to children and to the handicapped come under the Minister for Health.
Nobody will be treated this summer anyway.
What is being done in this scheme will lighten the burden at the health board end and this should improve the position. As I listed in the early part of my reply, a large number of unemployed and their wives will benefit, the wives of old age pensioners will benefit and people on low incomes. In the middle income group, the woman working in the home will also benefit and this is something most Deputies were anxious to see happening. We are talking about the PRSI insurance scheme and I am loath to see this put at a disadvantage.
It is clear that the Irish Dental Association envisage the application of conditions to the award of dental benefit which would be broadly equivalent to those applying for eligibility to the GMS schemes. I would be very concerned about that because that would exclude a number of people who are already covered by the insurance scheme. This would have the result of reducing significantly the number of persons entitled to benefit and correspondingly increasing the numbers in the private dental practice areas.
Will the Minister not agree that what was announced in the budget was the postponement until October of the introduction of a scheme which was to have been introduced in July? Would the Minister spell out how much spouses of insured workers will have to pay for extractions, fillings, cleaning and crowns, and in the other area, for spectacles and hearing aids? It is important that people know what is involved. Secondly, has the Minister made provision to deal with a flood of claims in the early days of the extension of this scheme? I expect many of those who will be eligible are waiting to have their dental and optical treatment until this scheme is introduced.
The first question is very detailed because there are different rates worked out in a scale of fees, which have been standard, for extractions, fillings, root treatment and so on under the social insurance scheme. I do not have the details here at the moment.
Will the Minister send me the information?
The standard scheme which applies to other insured workers will apply here also. This is the area where the dentist would like to see some minor improvements and minor changes. It is that schedule of fees which will apply.
What about the early flood of claims which can be expected? Will there be many applications in the initial weeks and months? Will people have to wait a very long time for treatment or will the Minister make special provision to deal with this flood of claims?
Inevitably in extending the scheme there will be difficulties at the setting up stage. One of the first questions to be faced is the new agreement which is almost ready.
May I remind Deputies that we have devoted 15 minutes, a quarter of ordinary Question Time, to this question. It is time to move to the next question. A very brief supplementary from Deputy Stagg.
I appreciate the Minister's difficulty dealing with this treatment in isolation. In view of normal collective responsibility in such matters, will he tell the House what action is being taken to shorten the two year average waiting list for treatment for medical card holders——
This question deals specifically with social welfare recipients. If you have a question dealing with medical card holders that is the responsibility of another Minister.
Has the Minister any proposal to cover the children of insured workers between the ages of 12 and 16 who are excluded from all the benefit schemes?
That does not come under my brief. The present proposal is to benefit the dependent spouse of the insured worker. There is a Review Body on State Funded Dental Services in which the Department of Health and the Department of Social Welfare are co-operating.
When will they report?
If I remember rightly, I think I set up this committee in 1981. The Clinical Dentistry Treatment Scheduled Subcommittee have met on a number of occasions and agreed lists of treatments etc. which were sent to the Irish Dental Association for their views. The committee have not received a response from them yet. The second committee, the Admnistration Organisation Subcommittee, have also had several meetings and a number of documents prepared relating to eligibility, options, costings, administration and monitoring. These were discussed but no firm conclusions were reached. In April 1985 the general secretary of the IDA undertook that his association would submit a document for discussion which would outline their views on eligibility. The IDA have not done so yet. That is where that review stands at the present. Meanwhile, a decision has been taken in the House to extend the benefit to dependent spouses of insured workers. I have a draft agreement ready and I will very shortly be in a position to circulate it.
An inordinate length of time has been devoted to Question No. 1. Let us make progress on other questions. I am calling Question No. 2.