Dr. Anne O'Neill:

As somebody who has been hanging around the health service for a bit longer than Dr. Robins, I might be able to add more context to Deputy Durkan's question. There are two aspects involved. The first relates to what he said in the context of tax relief. This is dealt with by means of the MED 2 form, which covers root canal treatment.

That provides an advantage or tax relief predominantly for those who pay the higher level of tax. It does not work in co-operation with the medical card scheme, which is a fully funded scheme. The decision to provide root canal treatments for front teeth only was taken in the context of where we were back in 1994. The DTSS was the first structured contracted care scheme for adult medical card holders. It was designed to provide access to treatment on a national basis, which had not previously been available. It tried to fill the gap between the ad hocarrangements different health boards had in place, which shows how long ago this was, and where the patients were at the time. A new scheme is now needed because this one was developed in the context of people having little or no access to routine care. It developed and provided funded access to routine care for people back in the 1990s but, unfortunately, it has not kept up to date with dental science or with what is envisaged in current schemes. It would be remiss of me not to mention the oral health policy because it talks about embedding the principles of prevention in the scheme. These have been embedded in the children's services since the 1990s but there is no way to embed them in the current scheme. A new scheme needs to be developed, which will be appropriate for adult medical card holders who are, by definition, the vulnerable in our society.