Mr. Fintan Hourihan:

Yes, it is definitely hindering it. As medical card patients were not given access to all dental treatments, implants, crowns and so on were never part of the scheme. In simple terms, the scheme provided the essentials or routine treatments. After 2009, there was a scaling back or reduction in the number of routine treatments that were covered automatically. There were some treatments that could be approved on application to the HSE. To give a short answer to the Deputy's question, the dentist sees the patient and draws up a treatment plan, which will encompass some treatments that are covered automatically by the medical card, some which can be applied for and others that will never be covered. The great difficulty is that the HSE has not recognised that a treatment plan will include prescribed treatments that are not available automatically, if at all, and has made no provision for that. While I accept the point made by Deputy Durkan that we cannot return to the position that pertained in 2009, we can go some way towards it or, failing that, we could introduce a completely new system because the medical card system is completely unfit for purpose.