Increase in fees for medical card treatments won't stop 'exodus' of dentists

Irish Dental Association CEO Fintan Hourihan said dentists are losing money on treatments provided to patients under the Dental Treatment Services Scheme.

An increase in the fees given to dentists for certain treatments under a scheme for medical card holders won’t address the “exodus” of practitioners from the scheme.

That’s according to the Irish Dental Association CEO Fintan Hourihan who said it may not be until 2023 until a new system is put in place that will meet the needs of medical card holders seeking dental treatment around the country.

“It could be June before talks start [with the Department of Health],” he said. “We’re waiting for the call. I don’t see this problem being sorted soon. There’s no urgency being attached by the Government to dealing with this problem.” 

Under the Dental Treatment Services Scheme (DTSS), adult medical card holders can access a range of dental services and treatments such as an examination, two fillings in each calendar year, and extractions as necessary.

However, the number of dentists registered to provide treatments under the scheme has been in decline and this decline accelerated during the pandemic. 

This has led to patients often having to travel long distances to avail of a dentist still offering the scheme.

The scheme was first brought in in 1994 and, in a recent parliamentary response, Minister for Health Stephen Donnelly said he recognised that it must be reviewed.

Work on a substantive review of the DTSS contract will commence before the end of June, he said.

“I have also acknowledged immediate issues of concern with the Scheme, which I am addressing as a matter of priority,” the minister said. 

I have now given approval for significant fee increases to be paid to contracted dentists across a number of items, including the Dental Examination and Fillings.

“I have also approved the reintroduction of Scale and Polish for medical card patients on the DTSS.” 

Mr Donnelly also said these changes should align the DTSS more closely with the scheme for PRSI patients, and that €26m in additional funding would go towards it this year.

However, Mr Hourihan from the Irish Dental Association said members have not yet had sight of what these “fee increases” may be.

“There’s a few things with the scheme,” Mr Hourihan said. “For one, dentists are losing money on the treatments. And then there’s also limitations on it. 

"There’s many rules which prevent them from offering treatments patients want.” 

On that end-of-June deadline for further talks on the system, Mr Hourihan said they’ve been hearing deadlines “for well over a year”.

“In the meantime, people are finding it harder to get a dentist to see them [on the scheme],” he said. “The reality is we’re no closer to solving this.” 

Fee increases won’t solve it. The system is nearly 30 years old and completely outdated.

A report commissioned by the Irish Dental Association, and published earlier this year, recommended a voucher scheme that could replace the DTSS, but, until those talks take place, there’ll be no solution found according to Mr Hourihan.

“It’ll be solved by a new scheme,” he said. “The sooner they’re ready to talk the better, but it’s looking like the situation won’t improve until 2023 at the earliest.” 

In a statement, the Department of Health said the minister had given a commitment to begin work on a “substantive review” of the DTSS later this year.

“Pending that review, the minister has approved a number of changes to scheme which are designed to address access issues for patients and to promote the viability of the scheme,” a spokesperson said.

“Departmental officials are engaging with their HSE counterparts with a view to implementing these changes as soon as possible.”