Noel Ahern (Dublin North West, Fianna Fail)

I am taking this Adjournment matter on behalf of the Minister for Health and Children, Deputy Harney.

As the Senator will know, and it is important to point out, responsibility for the Competition Act rests with the Tánaiste and Minister for Enterprise, Trade and Employment. That Department is currently engaged in a review of the Competition Act and has been having consultations with various interested parties in that regard.

In so far as the Department of Health and Children is concerned, the question of the Competition Act as it applies to dentists arose, as the Senator said, in the context of a review of the dental treatment services scheme or the DTSS. The DTSS provides for a range of dental services for adult medical card holders from participating dentists holding contracts with the Health Service Executive.

During the course of the review, based on legal advice made available to the HSE, an issue arose in regard to the negotiation of fees with the Irish Dental Association. Section 4 of the Competition Act 2002 prohibits and makes void all agreements between undertakings, decisions by associations of undertakings and concerted practices which have as their object or effect the prevention, restriction or distortion of competition in trade in any goods or services in the State or in any part of the State.

This reflects the provisions of EC Treaty Article 81, which contains a similar prohibition in regard to agreements, decisions and concerted practices which may affect trade between member states. The HSE was advised that the coming together of the DTSS contractors under the auspices of the IDA to negotiate fees would constitute a breach of the Act. The IDA was advised of the legal situation and in January 2007 discussions on the fee aspects of the review were put on hold.

In general there is nothing to prevent the State, as a purchaser of services, from consulting representatives of professional organisations on the fees for those services. The key requirement in all cases is that the State must have the final say in setting the price it will pay for the services concerned. As the Senator said, a similar issue has arisen regarding the role of the Irish Medical Organisation in negotiating fees for general practitioners involved in the GMS and other medical schemes. Having considered the matter, the Government is satisfied that the scope of the engagement by general practitioners in the delivery of primary health care for the overall efficacy of the public health system makes a more direct form of engagement with the representatives of general practitioners both necessary and desirable in order to protect public health. Accordingly, it is the intention to pursue appropriate amendments to section 4 of the Competition Act to enable the IMO to represent its members in negotiations with the HSE and the Department of Health and Children in respect of the services provided to the public health service. The legal provision to be made will be subject to and consistent with EU competition rules.

This initiative has arisen regarding the IMO. The Minister for Health and Children has not concluded that there is a case for adopting a similar approach to other professional representative bodies, including the Irish Dental Association. Any such case would need to be examined in light of the objective of ensuring a high level of public health protection and associated public interest considerations and the scope to adopt such an approach in a manner consistent with EU competition law. The Minister for Health and Children has agreed to meet the Irish Dental Association next week and this matter will be on the agenda. I hope that at that meeting some progress can be made on this issue and some of the other items the Senator mentioned. If the Minister is coming face to face with the association I hope some progress will be made at that level.