A row between dentists and the Health Service Executive (HSE), which has left many medical card holders unable to access free dental care, shows no sign of being resolved, writes Eithne Donnellan, Health Correspondent.
The Irish Dental Association (IDA) said yesterday it is now very difficult to find a dentist who will cover medical card patients in Kerry, Carlow/Kilkenny, in the northwest and in south Dublin.
A woman in the west, who obtained a medical card on her 70th birthday, told The Irish Times yesterday she had contacted her dentist on Friday about having new dentures fitted but was told they could not be provided under the medical card scheme because of a dispute between dentists and the HSE.
She was told no dentist in her area was now treating medical card patients and if she decided to pay for the dentures herself they would cost her around €800.
Dr Maurice Quirke, chairman of the general dental practitioner group of the IDA, admitted patients were being disadvantaged by the dispute, but he blamed the HSE.
He said the dispute arose when the HSE told the IDA a year ago it would not negotiate a new fee structure with it on behalf of its members.
He said there was anecdotal evidence to suggest hundreds of dentists had resigned from the medical card scheme as a result. "There are large areas of the country where you just can't get treatment carried out on your medical card," he said.
The HSE claims that for it to negotiate fees with the IDA would be in breach of competition legislation. Last April it said it was awaiting advice from the Attorney General.
Dr Quirke said there had been no progress since. "To the best of our knowledge that advice has still not come from the Attorney General or if it has we have still not been advised of its existence by the HSE," he said. "I feel sorry for the woman in the west myself. She is entitled to treatment and I would suggest to that lady that she contact the HSE.
"The responsibility here lies with the HSE . . . we said a year ago this was going to cause a problem for patients. We wrote to the Minister for Health and the chief executive officer of the HSE . . . but nothing has happened," he said.
The HSE, he said, seemed to be quite happy with the status quo.
A review of the dental treatment scheme for medical card holders began in September 2006 but it stalled last January on the basis of legal advice received by the HSE.
The HSE said yesterday it is still waiting for clarification "on the nature of the process by which the Dental Treatment Services Scheme (DTSS) will be reviewed ensuring that any process will be in compliance with the Competition Act".
It disputed IDA claims that hundreds of dentists had withdrawn from the scheme. It said it understood only around 100 dentists had withdrawn and that more medical card patients had been treated by dentists last year, when the dispute began, than the year before.
"Any reduction in the number of dentists operating under the DTSS scheme has been marginal and where any discrepancy in service has occurred the HSE has ensured that emergency needs continue to be met," it said.