Dental scheme for medical card holders 'in a state of crisis'
The scheme's lack of preventive options 'perpetuates inequality and results in higher long-term costs for the State', says Irish Dental Association chief executive Fintan Hourihan.
The dental scheme which provides care for the country's medical card holders is "in a state of crisis", and its decline will only worsen without meaningful reforms, the Oireachtas health committee will be told today.
Irish Dental Association (IDA) chief executive Fintan Hourihan will also outline the urgent need for investment in workforce and training reforms and for the rejuvenation of school screening services.
“The DTSS, which provides care for medical card holders, is in a state of crisis,” his opening statement reads.
“Active participation has collapsed, and holders struggle to receive care. Fewer than 600 dentists currently operate under the scheme, compared to 1,452 in 2012 and 1,664 in 2016.
"Between 2009 and 2023, the number of eligible medical card patients has increased from 1.48m to 1.61m adults. Treatment volumes have plummeted from almost 1.6m treatments in 2009 to just over 970,000 in 2023. This decline is certain to continue, without meaningful reform."
He claimed dentists have left the scheme due to "State-imposed restrictions on the treatments they can provide compared to other patients, restrictions on the materials they can use, due to the administrative red tape and the amount of paperwork required for very routine treatments, particularly where prior approval by the HSE is necessary, and because fees offered are considerably below the costs incurred in providing the treatments".
He said that despite fee increases, the scheme remains restricted to emergency care and extractions, with limited preventive options.
"This perpetuates inequality and results in higher long-term costs for the State," he will say. "The Irish Dental Association has proposed a voucher-based model and interim measures such as evening clinics in HSE facilities, but formal negotiations on a new scheme were ended by the Department of Health in 2008.”
Mr Hourihan also says Ireland faces a severe shortage of dental professionals.
"We estimate we need at least 500 additional dentists across public and private sectors to meet demand. We welcome the opening of the new RCSI dental school, which will provide a welcome increase in our graduate capacity.
"The two dental schools in Cork and Dublin graduate about 90 dentists annually, but 50% are non-EEA students, most of whom return home.
"We also have concerns as to the plans for the Cork dental school, considering the failure to commence building a new dental school which was due to be completed in 2023.
"We believe that the number of places for non-EEA students in all dental schools should be capped at 20%, but this would also require significant extra State funds to cover the shortfall in funding for dental schools which would follow.”
The IDA is also appealing for the restoration of school services.
“The HSE school screening programme, once a flagship of preventive care, has deteriorated sharply," he will say.
"The State’s policy from 1994 promises screening at three stages in primary school (second, fourth, sixth class), but many children are seen only once — or not at all.
"In 2023, fewer than 104,000 children were screened, compared to 152,000 in 2018, despite an eligible cohort of 200,000," he will state.
"School screening is vital to ensuring children can access preventative care, which dramatically reduces the need for future interventions. In some regions, screening rates are as low as 19% in Limerick, while 87% are reached in Tipperary.
"Consequences include rising decay, increased extractions, and delayed orthodontic interventions.”
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