Dentists are concerned medical card patients are not getting 'basic care' in this country

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Dentists are concerned that medical card patients in this country are not getting the same standard of care as private patients, citing a 'system failure.'

A new survey finds that the overwhelming majority of dentists have no confidence in the Medical Card Scheme and are dissatisfied with the level of care they are allowed to provide under it.

According to the survey 90% say they are dissatisfied with the level of care they can provide under the scheme while an even higher number – 96% – say the Scheme prevents them from providing the same standard of care as private patients.

The survey also finds 97% of dentists lack confidence in the Dental Treatment Services Scheme (DTSS), the Scheme under which medical card holders receive treatment free of charge.

Three out of four of the 440 dentists who completed the survey said they would like to leave the Scheme within the next five years.

The CEO of the Irish Dental Association Fintan Hourihan said dentists could no longer deal with what is a system failure.

Mr Hourihan said: “The Scheme is 24 years old and unfit for purpose. 57% of dentists say they have experienced considerable or a huge amount of problems with it in the past five years. They are saying it’s a disgrace for patients and dentists, that it’s broken and underfunded. They are tired of battling with the HSE and having to explain to disappointed patients why they cannot provide them with basic dental care.”

In 2010 the HSE imposed unilateral cuts to the Scheme without informing or consulting patients, dentists or the Irish Dental Association. From that point on the only treatments available to patients were an annual oral examination, two fillings per annum and unlimited extractions.

Since 2010 the number of patients eligible for dental care has risen to 1,340,412 – an increase of almost 260,000 or 24%. Despite that increase the number of treatments funded by the HSE has fallen by 24%.

Hourihan said it was shocking that 38% of the dentists in the survey say they have been refused approval to provide treatment for exceptional or high-risk patients due to lack of funding.

He said:“Medical card patients have lower oral health levels, a greater need for treatment and a lower access rate to care and treatment. How has the HSE addressed their needs? They have quite simply removed preventive and restorative treatments from the very people with the greatest need. Research shows that there was a 38% increase in the number of patients admitted to hospital with severe infections in 2011 and 2012 following the introduction of those cuts.”

Mr Hourihan said:“While the PRSI scheme has been revamped and some treatments restored – a very welcome development -  the Medical Card Scheme by contrast continues to place a limit on fillings (ie saving a tooth) while allowing an unlimited number of extractions. This has led to a 41% increase in the number of surgical extractions and a 12% rise in routine extractions.The two-tier nature of these schemes cannot be allowed to continue any longer.”

He said:“We are calling on the Minister for Health to resume contract talks as a matter of urgency and to extend to dentists the same terms and conditions which have been offered to public servants and other health professionals who have seen FEMPI pay cuts reversed in full”

Mr Hourihan said:“There must also be a commitment in the forthcoming budget for multi-annual funding towards a new Scheme which focuses on prevention rather than treatment. Until that is in place the costs of poor dental health will continue to be borne by the most disadvantaged in society."

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