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Dáil Éireann díospóireacht -
Thursday, 12 Mar 1992

Vol. 417 No. 3

Ceisteanna—Questions. Oral Answers. - Dental and Optical Benefits.

Eamon Gilmore

Ceist:

7 Mr. Gilmore asked the Minister for Social Welfare if, in regard to the statement made to Dáil Éireann on 19 December 1991, he will outline whether the decision to withdraw dental and optical benefit from persons earning more than £25,000 per year will also apply to their spouses; if he will outline the number of people from whom these benefits will be withdrawn and the number of their spouses, and if he will make a statement on the matter.

Michael Ferris

Ceist:

18 Mr. Ferris asked the Minister for Social Welfare when the dental scheme for spouses will be fully operational; and if he will make a statement on the matter.

I propose to take Questions Nos. 7 and 18 together.

As my predecessor indicated to the House on 19 December last, the Government have decided, in the interests of better targeting of social welfare benefits, that from next April persons earning in excess of £25,000 per annum will not be entitled to treatment benefit. Under the dependent spouses scheme which came into operation in October 1987, a dependent spouse can qualify for treatment benefits only if the other partner qualifies. Consequently, a dependent spouse will not qualify where the other partner is earning in excess of £25,000 per annum.

The measure will not result in benefit being withdrawn as it will apply to new claims made after the beginning of April. It is estimated that the measure will result in about a 4 per cent or some 18,000 reduction in the approximate 450,000 treatment benefit payments made in a year.

In relation to the treatment of spouses, I am optimistic that the dispute between my Department and the Irish Dental Association which has interrupted the treatment of dependent spouses of qualified insured persons under the dental benefit scheme will be soon ended. I am happy to inform the House that a formal offer has been made to the association which I am confident will bring this long running dispute to an end and enable dependent spouses to be treated by all dentists participating in the scheme.

The settlement proposals comprise the introduction of a new dental contract for participating dentists and a revised and restructured schedule of fees for dental treatment carried out under the scheme. The new contract will more adequately reflect modern dental practice and I am satisfied that the revised schedule of fees will give dentists a fair and economic return for their professional services.

The Irish Dental Association will shortly be balloting their members on the settlement terms which, if accepted, will be implemented with effect from 1 July 1992. The new contract will come into operation as soon as it is signed by individual dentists.

On what basis is the income of the £25,000 assessed? Will this new rule apply to people whose salaries are over £25,000 and to people whose basic pay is under £25,000 but who earn more than £25,000 due to bonuses and overtime? How does the Minister propose to explain to people paying PRSI, which is a form of insurance, that they will not get the benefits of the insurance which they are paying?

The Government decided on some cut-off limit and £25,000 was the figure agreed. The qualifying conditions will be the same as they were before. If a person is earning £25,000, whether he is a pound over the limit or £5,000 over the limit he is not covered. The relevant income will be the income on the P60 in the contribution year.

This question was tabled before we became aware of the Minister's Ard Fheis statement. We welcome the Minister's effort to tidy up this problem. Would the Minister agree that hardship has been caused to spouses who thought that under the scheme they were entitled to benefit? Because the scheme was not fully operational many spouses whose husbands made the required contributions and were within the required income limits did not get the service to which they were entitled. I congratulate the dentists who operated the scheme and I commend the Minister's efforts to reach a settlement. Would the Minister agree there is hardship, that patients have been neglected and are being forced to pay for a service to which they had contributed? Will the Minister consider reimbursing them?

I cannot consider reimbursing them, as the Deputy knows. It is obvious that, due to the lack of agreement between the Department and the dentists, people were denied benefits but I cannot introduce a scheme to reimburse those people. Much work was done by officials in my Department, before I was appointed, to try to reach a satisfactory conclusion to this dispute which has been going on for more than four years. I thank the people in the dental association who have brought the discussions to this stage. I hope the dispute will soon be resolved. The dental association members are being balloted and I hope for a satisfactory outcome.

The Minister's response to Deputy Gilmore's question has nothing to do with the targeting of resources. Will the Minister agree that to remove cover from the spouse of the insured worker earning in excess of £25,000, is discriminatory and affects womens' dental health? Why does the Minister feel he has the right to discriminate against insured workers who are paying PRSI? There is not any logic in that. The Minister should reconsider the position adopted by his predecessor. About 18,000 people have a very strong case on equality grounds, as citizens paying dearly under the PRSI scheme, for retaining the cover which the Minister proposes to remove from them.

Many people would find it better to resolve the dispute that has been going on for far too long. There is a cost involved in this scheme.

They are paying for it.

The scheme is funded by the taxpayer. It is paid for out of social insurance and the Exchequer makes a substantial contribution to overall social welfare expenditure. Perhaps, in the future I will consider some increase in the £25,000 limit, but this year that is the way it will apply. I am glad we have reached a stage where we can resolve this dispute and will be able to operate the scheme. The income limit obviously means that a number of people will be knocked out, but it is only a very small number out of the total number receiving benefit. My Department estimate that about 450,000 people this year will apply for treatment benefit and the cut-off figure will only affect 18,000 of them. This limit will only apply to new claims.

The Minister is optimistic that his offer will be accepted by dentists. Could the Minister guarantee that applicants from now on will be covered by the arrangements made?

Claims made after the beginning of April only will be involved. A number of dentists are not operating the scheme. People who apply to those dentists have not had the benefit of any treatment under the scheme. Like everything else, anomalies will arise but I am sure the Deputy will bring them to my attention. I hope there will not be that many of them.

Will the Minister confirm that anybody applying for optical or dental benefit between now and 1 April, if his income is over £25,000, will qualify? Second, having regard to the cost of dental and optical treatment has he considered the implications of a cut-off point at £25,000 for pay and pay bargaining of people who are reaching that marginal level of income? Whereas somebody on £24,500 will qualify for these benefits, a person whose income goes over £25,000 through overtime or whatever, will not qualify. Will this not create a very serious anomaly?

I do not think it will create a serious anomaly because, as I pointed out earlier, based on previous years' experience of treatment benefit claims, approximately 4 per cent of the total will be affected. No matter what cut-off point is used there will always be people who will attend constituency clinics and say they are just over the income limit. There will always be a few who come to the constituency advice centre when they are affected by an income limit for any social welfare scheme. The Deputy, as well as every other Deputy in the House, knows that.

It is an attack on women in the home. They will not now be entitled to dental treatment under their husband's PRSI contributions.

Only a very small number will be affected by the cut-off point. People should welcome the fact that the dental dispute will probably be over instead of cribbing about this.

Women's teeth will go rotten as a result of this.

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