Lucinda Creighton (Dublin South East, Fine Gael)
Link to this: Individually | In context

I thank the Minister of State for taking this Adjournment matter. I wish to raise the issue of the abolition of the PRSI scheme for dental and optical services for people throughout this State. I wish to put on record that my party and I are more than disappointed by the scrapping in the recent budget of essential services for which people pay. I believe the full impact and implications of this course have not yet been realised by the public at large. However, people will realise this as the year progresses. They will make appointments to have their regular checkups, to have their teeth cleaned or to undergo the usual treatments they have come to expect under the PRSI scheme, only to find they are no longer available to them. First, I wish to stress that the treatments that were available for dental and optical services under the PRSI scheme were not free, as they were paid for through the PRSI scheme. People pay PRSI from their pay-cheques to participate in and avail of these highly successful schemes. For example, the optical scheme was introduced well over 40 years ago, I believe by a Fine Gael-led Government. Negotiations took place at which it was agreed that basic needs of ordinary people would be covered by this scheme into which people paid and made a contribution.

It is fair to state that both the optical and dental schemes have played a highly significant role in improving the health of ordinary people nationwide. They have ensured that the optical and dental well-being of people has improved greatly and has been transformed over the past two decades. It is lamentable that the Government can be so short-sighted, if Members will pardon the pun, to eliminate such services almost completely for such short-term financial gains. Moreover, the Minister of State should not attempt to dress this up as these schemes have been virtually completely wiped out in the recent budget.

To put this in context, the optical scheme is very interesting. Approximately 200,000 people benefited from the scheme on an annual basis at a cost of just €15 million to the Exchequer. Consequently, no major saving is involved. It is a minor and unnecessary saving in the grand scheme of things, when one considers the type of savings that were being found in the most recent budget. Similarly, with regard to the dental scheme, it is estimated that in 2008, 400,000 patients presented under the PRSI scheme for approximately 1.5 million dental treatments at an estimated cost of approximately €100 million. Consequently, in the grand scheme of things, the savings achieved are extremely small when compared with the benefit that was derived from the operation of such schemes.

It is no exaggeration to state this will do untold damage to the nation's health because the early detection that resulted on foot of the provision under both schemes of checkups, in particular, will be a significant loss and will lead to a deterioration in the nation's health. I also believe it will cost more to the Exchequer in the long term to try to repair the damage that is being done by unravelling the scheme. From a business perspective, I know of opticians who have invested significant sums of money in new equipment to be able to compete in the world of Specsavers and similar chainstore opticians. Although such people raised their game to meet this challenge, they were given only three weeks notice of the abolition of a scheme that had existed for more than four decades. Moreover, even their contracts with the State stipulated that they should have been given three months notice. Although there is a question as to whether a breach of contract took place, perhaps that is a discussion for another day. I will conclude by referring to a cliché that has been bandied about but that also is a fact. The Government was happy to bail out bankers when the time came and was happy to underwrite the debts incurred voluntarily by reckless developers. However, it also is happy to sacrifice the health of the nation to make minuscule savings. People are beginning to wake up and realise what has happened in the most recent budget. By the end of the year, the Government will be faced by hundreds of thousands of angry people who are being denied essential services by the State.

John Moloney (Laois-Offaly, Fianna Fail)
Link to this: Individually | In context

I wish to respond on behalf of the Minister by stating that treatment benefits are paid to insured persons from the social insurance fund, SIF. Although the SIF has operated a surplus since 1996, this position began to change in 2008, when expenditure had to be partially funded from the accumulated surplus. Expenditure continued to exceed PRSI and investment income to the fund in 2009 and it is expected that the accumulated surplus will be completely exhausted in the first half of 2010.

It is further estimated that the Exchequer will be required to subvent the fund by more than €1 billion this year. The McCarthy report of the special group on public service numbers and expenditure programmes advised the Government that, given the other pressures on the social insurance fund, continuation of the treatment benefit scheme was no longer affordable. It is against this backdrop that the Government took the difficult decision to reduce expenditure on the scheme and changes were announced in budget 2010.

From 1 January 2010, people claiming under the optical and dental elements will receive a free examination. The medical appliances element of the scheme has not changed and hearing aids and contact lenses required for medical reasons will continue to be provided for on the same basis as before. This means that a grant of 50% of the purchase price, to a maximum of €760, is available towards the cost of an appliance or appliances under the scheme. People who, at 31 December 2009, were undergoing a course of dental or optical treatment or who had applied for approval to commence treatment, will have their applications processed under the rules which operated prior to 1 January 2010.

In the period between the budget announcement and the end of December 2009, more than 150,000 applications for approval in respect of dental treatments and more than 20,000 in respect of optical treatment were received from practitioners on behalf of the customers. These approval requests have been processed and notification issued to the dental and optical practices concerned. Treatments must commence within three months of approval being given and must be completed with six months of commencement.

Savings of €54 million were originally envisaged in 2010 and while the increased level of inquiries for treatment in the last few weeks of 2009 will have an impact on that figure, it still is anticipated that substantial savings will result in 2010. More than 2 million PRSI contributors still are eligible for the free dental and optical examination and medical appliance benefit in 2010. In 2009, more than 418,000 customers claimed a free dental examination at a cost of more than €14 million. In addition, 219,000 free eye examinations, at a cost of almost €5.5 million, also were provided. There also were 7,500 treatments under the medical appliance scheme, at a cost of more than €7.5 million. Similar level of applications can be expected this year. The continued provision of a free examination will allow people to continue to have regular optical and dental check-ups and help ensure the early detection of disease and other health issues.

The Department of Health and Children, under the medical card scheme, provides dental and optical services for customers on low incomes. The service is provided through the same group of contractors that supply services under the treatment benefit scheme. It should be noted that treatment benefits are just one of a range of pensions and benefits from which pay related social insurance, PRSI, contributors can benefit. Recent statements from some parties have suggested that employed people are paying up to €53 a week in social insurance and getting no benefit from it. On the contrary, the provision of a wide range of pensions, injury, unemployment and other benefits are and continue to be directly funded by PRSI contributions via the social insurance fund. The Government has indicated that it will review its decision on the treatments benefit scheme in advance of the next budget in the light of prevailing financial circumstances at that time.

Lucinda Creighton (Dublin South East, Fine Gael)
Link to this: Individually | In context

The next election more like.

John Moloney (Laois-Offaly, Fianna Fail)
Link to this: Individually | In context

The Government is a bit long in the tooth for that.

Lucinda Creighton (Dublin South East, Fine Gael)
Link to this: Individually | In context

There is still life in the old dog.