Dentists challenge HSE over cuts to treatment under medical card

TWO dentists have started High Court proceedings aimed at preventing the HSE from implementing changes to the scheme which allows medical cardholders avail of dental treatments free of charge.

Dentists Martin Reid and James Turner claim the changes outlined in a circular issued last April – which they argue radically confine the services they can offer to medical cardholders to emergency services and one oral examination in a 12-month period – will have “a dramatic effect on public health”.

They also claim the HSE has breached an agreement with dentists to provide dental services for medical cardholders. The HSE has denied the claims.

The dentists sought injunctions yesterday restraining the HSE from giving effect to the circular of April 26 last, issued by the Primary Care Reimbursement Service, which resulted in changes to the Dental Treatment Services Scheme (DTSS).

They are also seeking an injunction preventing the HSE from breaching the agreement between dentists and the HSE for the provision of dental services to medical cardholders. If granted, the injunctions will remain in place pending the full hearing of the action.

The HSE claims it has acted properly in applying the changes to the DTSS.

Ms Justice Mary Laffoy, who heard the application, reserved her decision until next week.

Opening the case, Bill Shipsey, SC for the dentists, said they had brought proceedings because they believe the HSE’s decision unilaterally varies the terms of the DTSS amounting to a breach of contract.

Counsel said his clients did not accept that the HSE was entitled to amend the DTSS contact due to a provision in the 1999 agreement which states that the HSE has “the right to take whatever measures are necessary to live within budget and statutory obligations”.

In view of the current economic difficulties, counsel said the HSE sought to reduce the amount spent on the DTSS from an estimated €88m in 2010 down to the 2008 level of €63m.

Both dentists have expressed concern for their practices’ futures if the changes are implemented.

Mr Turner’s practice, which he shares with an associate, earned €95,000 under the DTSS in 2009, representing 30% of the practice’s income. Mr Reid’s practice in Co Donegal earned €230,000, some 68% of his practice earnings, under the scheme in 2009.

Mr Turner said the HSE failed to provide guidance to dentists if existing treatment plans should be continued and if dentists would be paid for their services.

Mark Connaughton, SC for the HSE, said the HSE had implemented changes to the DTSS in a “careful, considered and measured” manner. The changes, he said, were implemented after the Government instructed the HSE to cut its costs dramatically.

In a replying affidavit the HSE’s Patrick Burke said that the HSE discussed changes to the scheme with the Irish Dental Association before issuing the circular.