Olwyn Enright (Laois-Offaly, Fine Gael)
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Question 82: To ask the Minister for Social and Family Affairs the number of dental applications made on behalf of multiple customers without their knowledge; the action she will take in this regard; and if she will make a statement on the matter. [1674/10]

Mary Hanafin (Dún Laoghaire, Fianna Fail)
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Changes to the treatment benefit scheme were announced in the 2010 budget. From 1 January 2010, treatments available under the scheme are limited to a free optical and dental examination together with the treatments previously available under the medical appliance scheme, namely hearing aids and contact lenses required for medical reasons. People who at 31 December 2009 were undergoing a course of treatment or who had applied for approval to commence treatment will have their applications for dental benefit processed under the rules that operated prior to 1 January 2010.

In the period immediately after the changes were announced in the budget, there was a sharp increase in the number of inquiries from customers and from dentists on behalf of customers seeking approval for dental treatment. From the level of correspondence received from some dentists, it was clear they were submitting bulk applications on behalf of their patients. Claims involving many hundred customers were received from eight dental practices. These applications were supplied in alphabetical order as if downloaded from a database.

On checking with a number of customers, it became evident that many of them had not approached the dentist to seek treatment nor had they authorised the dental practice to submit an application on their behalf. The dentists concerned were contacted and agreed to withdraw the inquiries and resubmit them in the proper manner.

In order to avoid any repetition of the problem, a letter was issued to all dentists clarifying the procedures to be followed in submitting eligibility and approval inquiries. These procedures include the need to ensure that the patient had given approval for the inquiry to be made and the need to provide a confirmed appointment date and contact number for each customer. This was difficult in some cases because the customers had passed away. It has been noted that since the letter issued, the majority of inquiries have been submitted in the correct manner. Inquiry applications received without all the relevant information are being returned. A number of dentists have been in contact with the Department since the issuing of the letter to advise that they submitted inquiries in error, to ask for them to be withdrawn and to advise that they will submit a revised list of inquiries in the correct manner. It is estimated that over 150,000 eligibility inquiries for dental treatment were received in the period between budget day and 31 December last. The inquiries in question are being processed. It strikes me that dentists were very busy in the ten working days between budget day and the end of the year. Priority is being given to confirming patient eligibility. Officials will perform spot checks on inquiries to ensure that they were submitted properly and with the consent of patients. Any breaches of the guidelines will be reported to the Office of the Data Protection Commissioner for appropriate follow-up action.

Olwyn Enright (Laois-Offaly, Fine Gael)
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I welcome this example of vigilance on the part of the Department. Does the Minister know how many dental practices attempted to submit lists of patients without such applications having been signed by the patients in question? How did the Department realise that dentists seemed to be submitting patients' names without their consent? Was the alphabetical order issue the main one in this regard? Will any sanctions be applied in cases of this nature? Have the applications been returned to the people in question? Has everyone on the list been contacted by the Department to make them aware that their dentists submitted this information?

Mary Hanafin (Dún Laoghaire, Fianna Fail)
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This phenomenon came to light when applications were submitted in bulk and in alphabetical order. In some cases, all of the forms were signed with the same signature. That may have been erroneously done by receptionists. When departmental officials conducted cross-checks within the system, they found that some of the customers who were anticipating getting treatment in the future were actually dead. When some of the people on the list were telephoned on foot of those spot-checks, they said they had not been to the dentist recently. In some cases, people who had not been to the dentist for a couple of years were on the list as having been approved for future treatment.

Noel Coonan (Tipperary North, Fine Gael)
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They could come back from the dead for treatment, like certain people do on voting day.

Mary Hanafin (Dún Laoghaire, Fianna Fail)
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I mentioned in my reply that the bulk of the claims to which I refer came from eight dental practices. In fairness to the officials in the relevant section of the Department, they copped on very quickly to what was happening and started to contact the dentists in question. By the time they contacted the third dentist, the word had got out and he was expecting the telephone call. Two professional groups of people - opticians and dentists - were affected by the decision that was announced on budget day. When I met the opticians, I found they were particularly keen to retain the examination, which is the best way of identifying real problems. As a result, the examination was retained and there has not been a word from the opticians since. They are getting on with their work in a professional manner. By contrast, the dentists conducted an enormous campaign, involving postcards as well as radio and television advertising. They were well within their rights to do so. A number of dentists are making an awful lot of money from the system. Eligible people who properly made their appointments and submitted their applications will, of course, continue to be treated in the first few months of this year. It is important for professional bodies like those we are discussing to realise that these cuts were made with difficulty.

Róisín Shortall (Dublin North West, Labour)
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This is one of the budget cuts of which people are not yet terribly well aware. It seems extraordinary that the Minister has changed the rules in a manner that drastically cuts the entitlements of those who have been paying into the social insurance fund for 25, 30 or 40 years. A lot of trouble is coming down the track in this regard. The word has not got out terribly well yet. As people try to make appointments with dentists and opticians, they are starting to discover that the Minister has interfered with their entitlements to this extent. I would like to ask the Minister about the specific abuses that are the subject of the question before the House. What was the largest number of claims to be made by an individual practice during the period between budget day and the end of the year? Does the Minister have any penalties at her disposal? What sanctions can she impose on practices that have engaged in this kind of abuse?

Mary Hanafin (Dún Laoghaire, Fianna Fail)
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People have been making their contributions into a fund that is now in deficit.

Róisín Shortall (Dublin North West, Labour)
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It is not their fault.

Mary Hanafin (Dún Laoghaire, Fianna Fail)
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I know it is not.

Róisín Shortall (Dublin North West, Labour)
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They have paid their social insurance contributions.

Mary Hanafin (Dún Laoghaire, Fianna Fail)
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When we made decisions in advance of last month's budget, we had to ascertain how best the fund could be protected. We do not intend to retain these changes on a permanent basis. My aim is that they will be in place for just one year. We have maintained the two most critical elements of this scheme. The examination can highlight basic difficulties in addition to a myriad of much more serious diseases. We have protected the basic scheme while changing the eligibility criteria. We hope those changes will last just a year. As I have said, some 150,000 names were submitted in total. I am aware that one or two individual dentists submitted hundreds of names, which is quite significant. I do not have the exact numbers to hand.

Róisín Shortall (Dublin North West, Labour)
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What sanctions are available to the Minister?

Mary Hanafin (Dún Laoghaire, Fianna Fail)
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The first sanction is that somebody can be reported to the Office of the Data Protection Commissioner. The use of people's information without their permission is quite a serious offence. The Department may consider the possibility of striking individual dentists from the panel, if it is felt they were deliberately trying to defraud the system. The relevant section of the Department is trying to work through the 150,000 names to determine the degree of eligibility in each instance. We will see if anything else comes to light as a result of that.

Róisín Shortall (Dublin North West, Labour)
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Does the Minister intend to take action against any of the practices?

Mary Hanafin (Dún Laoghaire, Fianna Fail)
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As this is just the third week of January, we are still in the process of taking a look at the names.

Olwyn Enright (Laois-Offaly, Fine Gael)
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Were the dentists involved in communication with each other?

Brendan Howlin (Wexford, Labour)
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I want to make some progress by calling the next question.