Mary Hanafin (Dún Laoghaire, Fianna Fail)

I thank the Senator for raising this issue. As mentioned, the PRSI scheme goes towards dental benefits but also towards optical benefits. However, its main use is that people can qualify for unemployment assistance and other benefits, the most valuable of all being a pension. The DTBS is a PRSI-based scheme that provides assistance in the provision of dental treatment for those who satisfy the qualifying conditions and their dependent spouses. Eligible customers receive assistance towards the provision of services such as annual examinations and biannual scaling and polishing and a grant towards the cost of fillings. To be eligible to benefit from the scheme, a person must have paid a certain number of PRSI contributions.

The scheme is one of a number through which the State supports or directly provides dental care. The Senator was right when he mentioned the improvements made in recent years in the standard of dental care and oral hygiene. The scheme sits alongside the provision by the Department of Health and Children of dental care under the medical card scheme for customers on low incomes.

The qualifying PRSI conditions vary with age. For the majority of customers, those aged between 25 and 66 years, the requirement is a minimum of 260 qualifying contributions paid, plus 39 paid or credited in the governing contribution year, which for this year would be 2007. Slightly different rules apply to those under 25 years and over 66 years. Anyone qualified at aged 60 years retains his or her entitlement for life. Pay related social insurance is a contribution towards much more than dental treatment. It also covers other entitlements such as pensions, disability, invalidity and unemployment benefits, etc.

The dental treatment benefit scheme operates on the following basis. Any insured person or a dentist on his or her behalf must check with the Department if he or she is qualified to receive treatment. This can be done by telephone, fax, e-mail or completion of a claim form. Once approval has been given, either verbally or in writing, treatment may be provided by a contracting dentist. Treatment must begin within three months of approval being given and be completed within nine months. Once treatment has been completed, the dentist submits a final application form detailing the treatments provided and the customer's confirmation that treatment has been completed. Payment is then processed and issued directly to the dentist concerned. More than 675,000 applications, relating to 1,450,000 treatments were received in 2008 and an increased number of applications are expected by year end. The scheme cost €60 million in 2008 with more than €13.5 million expended on examinations, €16.2 million on cleaning teeth and gum treatments and €17.5 million on fillings.

The dental treatment benefit scheme is paid from the social insurance fund, SIF. Although the fund has operated a surplus since 1996, this position began to change last year when expenditure had to be partially funded from the accumulated surplus. Expenditure continued to exceed PRSI and investment income to the fund this year and it is expected that the accumulated surplus will be completely exhausted in the first half of 2010. It is estimated that the Exchequer will be required to subvent the fund by around €1.2 billion next year.

The expenditure pressures on the fund will continue in the future. In the short term there are increased demands on jobseekers benefit, estimated at €1.7 billion in 2010, and on insolvency and redundancy payments, estimated at €318 million next year. The progressive aging of the population is another factor leading to increasing expenditure on the State pension contributory and transition. It is estimated that there will be only two workers for every pensioner in 2050 compared to six for every pensioner now.

The McCarthy report of the special group on public service numbers and expenditure programmes specifically refers to the scheme and took the view that given the other pressures on the social insurance fund continuation of the scheme is no longer affordable.

Dúirt an Seanadóir as Gaeilge ag tús a chuid óráid go raibh sé ag súil go ndeirfinn leis go díreach cad a bheadh san cháinfhaisnéis amárach. Tuigfidh sé go maith nach mbeadh mé in ann é sin a dhéanamh agus aon cinneadh san cháinfhaisnéis a bhaineann leis an scéim seo nó le scéimeanna eile, fógrófar é amárach.