TWO DENTISTS have secured High Court injunctions restraining the HSE restricting the scheme for free dental treatment for medical card holders until the dentists’ full court challenge to the changes is decided.
Martin Reid and James Turner claim the proposed changes to the Dental Treatment Service Scheme outlined in a circular issued last April will radically confine the services they can offer to medical card holders to emergency services and one oral examination in a 12-month period.
They claim the changes to the dental treatment scheme unilaterally vary the terms of an agreement between dentists and the HSE and amounts to a breach of contract by the HSE. The health executive denied the claims.
The scheme was established in 1994 between dentists and the then health boards in order to provide dental care for those on the medical card scheme. The agreement was revised in 1999.
Yesterday Ms Justice Mary Laffoy said she was satisfied the dentists had made out a case for the granting of injunctions preventing the changes being implemented pending the outcome of the full court action.
She made an order restraining the HSE giving effect to the circular of April 26th last, issued by the Primary Care Reimbursement Service, which resulted in changes to the dental-treatment scheme
The judge also granted an injunction preventing the HSE breaching the agreement between dentists and the HSE for the provision of dental services to medical card holders. The injunctions will remain in place pending the outcome of the challenge, which the judge said should be heard as early as possible.
The judge ruled that the dentists had made out a fair issue to be tried as to whether, as a matter of contract, the HSE could unilaterally vary the terms of the involvement of dentists in the scheme as it purported to do in the circular.
On the evidence, the judge was satisfied, if the changes were implemented to the scheme prior to the trial of the action, the dentists would suffer irreparable damage to their practices for which damages would not be an adequate remedy. In all the circumstances, the balance of convenience favoured the granting of the injunctions, she ruled.
The judge said the nature of the injunctions was not mandatory but was prohibitive. What was being sought was an order to prevent the HSE “changing the rules” of the dental treatment scheme pending the full hearing and this was not a case where the HSE was seeking to terminate its contract with either dentist.
In seeking the orders, Mr Reid, with a practice at Moville, Co Donegal, and Mr Turner, a director of the Irish Dental Association, with a practice in Baltinglass, Co Wicklow, expressed concern for the future of their practices if the changes to the scheme are implemented.
They claimed the changes would have “disastrous consequences” for them as dentists providing services under the scheme and would also have “a dramatic effect on public health”.
Mr Turner’s practice, which he shares with an associate, earned €95,000 under the dental treatment scheme in 2009 representing 30 per cent of the practice’s income. Mr Reid’s practice earned €230,000 under the scheme, which accounted for some 68 per cent of his practice’s earnings in 2009.
In arguing the dentists were not entitled to the injunctions, the HSE claimed it had acted properly in implementing the changes to the scheme. It said the changes were implemented after the Government instructed the health executive to cut its costs dramatically. The HSE had sought to reduce the amount spent on the scheme from an estimated €88 million in 2010 to the 2008 level of €63 million given the economic difficulties, the court heard.