David Norris (Independent)

I have been approached by the dental profession from two angles. There has been a very considerable diminution of their income, and they feel that dentists who rely largely on the operation of this scheme will be put out of business. I am a little bit less sympathetic to them on that issue. However, I have had subsequent communication from them which indicates the benefit to society of the dental scheme. It is used very extensively, and it shows there is a clear need for it.

Out of 2 million insured persons in 2008, up to 400,000 availed of the free check up and the total cost to the State was €13.5 million. This is an oral examination and it is a pre-emptive method of assessing whether there will be further problems down the road, which will save on further costs and further pain. A total of 446,000 took advantage of the free scale and polish, but this will also be abolished. Some 500,000 fillings were paid for and the scheme provides for the State to pay the dentist €33.50 per filling and contributes a further 15% discount on patient fees for those earning less than €65,000. The ESRI has established that there is a markedly lower likelihood of people attending dental clinics if they come from lower income groups. This means the abolition of this particular scheme will disadvantage the most vulnerable. That is a pity.

There were 93,000 extractions paid for under the scheme, at cost of €3.3 million, which is not enormous. The scheme provides for the State to pay the dentist €26 and for those patients earning less than €65,000, the amount is capped at €14.15. This is now to be abolished. This will really cut people where it hurts. The provision of 91,000 dentures has largely but not exclusively been for elderly people. These are not cosmetic things, but are appliances which allow elderly people to masticate their food and assist in their digestion, their diet and general well being. Oral disease has a significant impact in terms of pain, suffering, impairment of function and reduced quality of life.

The dental association commissioned Dr. Brenda Gannon from NUIG to conduct a cost benefit analysis of the scheme. She is a reasonably independent minded person, even though the group commissioning the report had a vested interest. Her study shows that the return on the investment is very positive and that the benefits outweigh the cost of the scheme by a multiple of between 2 and 2.6. She presents evidence of improved dental health afforded by this scheme and she establishes the fact that there will be a considerable loss of tax revenue following any decision to abolish the scheme. The inevitable redundancy and ongoing welfare costs which would arise show significant extra costs. I am making, supported by factual data, three related points. A considerable number of citizens find this scheme to be of advantage. As the figures show, approximately 1.5 million people, an enormous number, availed of the various elements of the scheme in the past year. The proposal will result in 1.5 million people being substantially disadvantaged. The three legs of my argument are the large number of people involved, the human toll of the proposal in terms of pain, the prevention of dental decay and more serious conditions, extractions and so forth and the analysis done by a respected academic which shows that far from saving the State money, the measure may cost money. I respectfully ask the Minister to reply to them.