Hundreds of dentists have withdrawn from providing free dental care to medical cardholders since the start of the year and others are likely to continue to do so in large numbers, the Irish Dental Association (IDA) said yesterday.
Their withdrawal could effectively lead to the collapse of the State's free dental treatment scheme for one million medical cardholders.
Ciara Murphy, chief executive of the IDA, said her feeling from talking to dentists was that they can no longer absorb the losses they incur when they operate the scheme on behalf of the Health Service Executive (HSE).
The dentists want their fees for providing care to medical cardholders renegotiated, but the HSE believes for it to negotiate fees with their representative body (the IDA) would be in breach of competition legislation and could be regarded as price fixing.
Members of the IDA have voted by over 92 per cent in favour of their union withdrawing its support for the free dental treatment scheme.
Ms Murphy said the result of the ballot, announced yesterday, was an indication of the low confidence of members in the scheme. But she said it was up to individual dentists at this stage whether to opt out of the scheme or not. "There is no collective boycott underway here," she said.
Unions cannot advise members to boycott schemes as it is understood the ordering of a boycott in itself could be regarded as a breach of competition law.
Dentists withdrawing from the scheme must give the HSE three months notice.
Ms Murphy said the HSE informed the IDA three months ago that it was seeking the attorney general's advice on whether talks with the union on new fees for dentists would be in breach of competition law. The advice was still awaited.
"I find it very strange that it takes three months to get it . . . I feel that both the HSE and the Minister for Health are clearly not taking this matter seriously," she said.
The HSE said it had not received any formal communication from the IDA regarding its ballot.
"The HSE has not been told by the Irish Dental Association what its members have been balloted on, nor have we been advised as to the number of dental contractors who actually participated in the ballot, the outcome of this ballot or what the association intends to do on foot of the ballot," it added.
The scheme under which dentists provide free care to medical cardholders on behalf of the State began in 1994. The IDA said a review of the scheme was due to begin in September 2000 but it did not begin until September 2006. Then the review of the scheme suddenly stalled in January as a result of legal advice obtained by the HSE, it said.
The HSE claims it is only the fee-setting part of the review that had been put on hold, pending clarification of legal issues.
"During the course of the review, a legal issue arose in relation to the setting of fees with individual undertakings such as private dental contractors. The IDA was fully appraised of this situation and at its request, pending receipt of clarification on the legal issue from the Office of the Attorney General, discussions on this aspect of the review were temporarily put on hold," the HSE said.
"A determination on this issue by the Office of the Attorney General is expected soon and this will determine the appropriate mechanism and process for setting fees for a new contract," it added.
Similar difficulties have arisen regarding negotiating fees with pharmacists and GPs.