The state’s dental plan for 1.5 million medical card patients is “in crisis and on the verge of collapse”, dentists say.
The medical card scheme, which was set up to provide free dental care to people with reduced resources, is currently under review by the Oireachtas Health Committee.
On Thursday, the committee was told the program had been hit by a cost cut to the point that it was no longer fit for purpose and dentists were leaving in large numbers.
The committee heard the Health Service Executive impose unilateral cuts to the dental plan in 2010, during the state’s economic crash. As a result, many patients’ access to treatment was restricted and the majority of patients were only allowed one examination per year and a maximum of two fillings under any circumstance.
However, access to as many extractions as needed has been maintained.
Fintan Hourihan, chief executive of the Irish Dental Association, told the committee that the cuts to the medical card system “have fundamentally changed it” “from a demand-driven system to a budget-driven system”.
He said adults aged 16 to 99 may no longer have access to the dental care they need to maintain their dental health. “Only those with a significant medical condition within a narrow range of prescriptions are allowed access to more treatment items,” he said.
Listing the treatments affected, he said:
– A biannual and Polish scale had been suspended;
– Fillings had been reduced to only two in an emergency situation; and
– Root canals, dentures, denture repairs, and miscellaneous items were now for emergencies only.
“We believe, and the opinion expressed by our members – the dentists who administer the plan on a day-to-day basis – that the state dental plan for approximately 1.5 million medical card eligible patients is in crisis and on the verge of collapse,” he said. told the committee.
“The last year has seen an unprecedented number of dentists withdraw from the medical card system with serious repercussions for patients nationwide.”
Total program expenditure fell from over €63 million in 2017 to €40 million in 2020, a decrease of 36%.
Mr Hourihan said: ‘Dentists want to be able to provide care to all patients, but the government is giving them no choice but to minimize their involvement or opt out of the medical card system.’
Sinn Féin TD David Cullinane said the number of dentists remaining in the scheme should be known. He said a figure of 1,000 dentists had been suggested, but he understood the actual figure to be much lower than that.
He said the program as currently set up was not designed to promote good dental health by encouraging and undertaking preventative measures “but will happily remove the teeth”.