Rónán Mullen (Independent)

Cuirim fáilte roimh an Aire. Táimid uilig ag súil le cloisteáil cad iad na himpleachtaí dá Roinn ón cáinfhaisnéis amárach. The background to the matter I am raising is the proposal made in the McCarthy report that the dental treatment benefit scheme, DTBS, or the PRSI scheme as it is commonly known, should be abolished. The scheme is an insurance scheme that operates on the basis of contributions made by workers in the expectation that they will receive benefits in return. I have benefited from it myself. It is crucial that the Government rejects the recommendation set out in the McCarthy report and instead upholds the DTBS.

Approximately 2 million workers and their family members are entitled to dental benefits through their contributions to the PRSI scheme. The DTBS offers them the highest standards of quality care and valuable discounts to the market rate for any items not covered fully under the scheme. Last year over 400,000 people visited their dentist for an annual examination under the scheme. In addition, there were over 1.5 million treatment items such as fillings and extractions availed of by patients.

Oral health and oral health preventive measures are important to the overall health of a person and contribute to a reduction in the down the line cost to the State. Annual examinations and regular dental treatment provided under the DTBS can help in identifying early indicators of systemic diseases such as oral cancer, diabetes, heart disease and gum disease and can help to indicate low birth rates and premature births. Oral cancer causes more deaths nationwide than melanoma, leukaemia or cervical cancer. On average, three new cases are identified by dentists every week. Early detection of abnormalities can make a huge difference to a person's life expectancy, as oral cancer can be cured at a rate of 90% when discovered early. In recent decades the dental health of the population has improved immensely. The DTBS is the single best scheme available for the nearly 2 million people that it serves and is arguably the single greatest contributor to this improvement in dental health.

Abolition of the scheme would have a negative effect on public health and cost the Exchequer €112 million a year, as estimated in the research of Dr. Brenda Gannon, a health economist at NUI Galway. The Irish Dental Association commissioned Dr. Gannon to conduct a cost-benefit analysis of the scheme. Her analysis shows the significant benefits that accrue from the scheme and that its abolition would eventually double the cost to the State. Her research also shows that the return on investment is extremely beneficial and that the benefits outweigh the cost of the scheme by a multiple of between two and 2.6. This means the return on investment is roughly 2.5 times the cost to public finances.

The abolition of the DTBS would result in a deterioration of the dental health of citizens. It would intensify the divide between those who can afford dental care and those who are indebted to the many advantages the scheme has to offer. It would also contribute to a lengthening of waiting lists in many areas, while in others people would forgo seeking private insurance, leading to a lack of work for dentists. Furthermore, the ESRI has found that there is a markedly lower attendance rate at dental clinics among lower income groups, a situation which will only be exacerbated by the abolition of the DTBS. Its abolition would be hugely unfair. It would be akin to paying house insurance for years and then being told cover was being withdrawn. If the McCarthy report recommendations proceed, despite the many years of significant contributions by hard working individuals, they will be deprived of the benefits provided under the scheme.

The main aim of Government intervention, as well as the goal of the dental benefit scheme, is to improve overall dental health of the population and allow access to everyone to oral examinations and basic treatments. I request, on behalf of the Irish Dental Association - I acknowledge the excellent material I received from its chief executive, Mr. Fintan Hourihan - and those who have participated in and benefited from the scheme - ordinary citizens - that it remain active and be left intact.

I was recently in a popular shop, Past Times, a shop into which I like to call frequently to indulge my taste for nostalgia. I looked at an old compilation journal of sports magazines for young people. I find it interesting to look at old photographs, including old sports photographs. People now look different. Often in old photographs we can see that people in past generations suffered from poor health. Sometimes the effect of illnesses such as TB is visible in people's faces and often one notices that people had poor teeth. We have moved on so much in terms of the overall health of the population and it is visible that people now enjoy better dental health. I would hate to think we would take regressive steps and return to a situation where we would see increasing numbers with inferior dental health. I hope the Government sees the value in the scheme and recognises the good it does for the population. I also hope it recognises better dental health is one of the many benefits we enjoy as a result of improved health care and that the scheme should be left intact.