John Moloney (Laois-Offaly, Fianna Fail)

I thank the Deputies for raising this matter. I also met a dentist yesterday who gave me a similar briefing to them. Clearly the impact of the changes on medical card holders may result in more cost to the State than what may be saved initially. I intend to engage with the HSE over the next few days to establish what other proposals could be made to ensure people will not be victims of this serious cutback. I will try to respond to the Deputies as quickly as I can.

I am happy to have the opportunity to address the issue of the changes to the dental treatment services scheme, DTSS. The scheme was set up in 1994 and its financial aspects are administered by the primary care reimbursement service on behalf of the HSE. It is monitored at a local level by HSE principal dental surgeons. The two objectives of the DTSS are to improve the oral health of adult medical card holders and to provide dental services to adult medical card holders in a cost-effective and equitable manner. The scheme has provided a range of basic dental treatments to adults who are medical card holders. These have included routine examinations, fillings, extractions as well as amputation of roots and the provision of dentures. The service is offered by approximately 1,400 dentists nationwide who hold a contract with the HSE. The dental treatment is free to the patients and dentists working in the DTSS are reimbursed on a fee per item basis.

Expenditure on the scheme was approximately €85 million in 2009, which was a substantial increase on the 2008 figure of €63.4 million. In addition, over the past five years expenditure on the DTSS increased by approximately 60%. In view of this increased expenditure and the current position of the public finances, the Government decided in the context of the budget last December that it was necessary to reduce expenditure on the scheme. The decision was taken to limit 2010 expenditure to the 2008 level of approximately €63 million. This reduction in funding reflects the imperative to achieve overall reductions in public expenditure, while providing essential health services to patients and the public. Having carefully considered the issue, and after obtaining clinical and other advice on the issue, the HSE advised DTSS contracted dentists that the new measures would be introduced from 28 April last. These changes to the scheme will allow the HSE to contain DTSS expenditure at the 2008 level. I have taken on board the points made by both Deputies and I will make them aware of the outcome of talks with the HSE within the next two weeks.

See this speech in context