Seán Connick (Wexford, Fianna Fail)

On behalf of the Minister for Health and Children, I am happy to have the opportunity to address the issue raised by the Senator. I thank him for his kind words at the beginning of his contribution. We worked together on the South-East Regional Authority and I look forward to working with him in the interests of the people of south east over the coming period.

The dental treatment service scheme, DTSS, was set up in 1994 after negotiations between the health boards - now the HSE - and the Irish Dental Association. The financial aspects of the scheme are administered by the primary care reimbursement service on behalf of the HSE and it is monitored at local level by principal dental surgeons. The two objectives of the scheme are to improve the oral health of adult medical card holders and to provide dental services to adult medical card holders in a cost effective and equitable manner.

The scheme provides a range of basic dental treatments to adults who are medical card holders. The service is offered by 1,419 dentists nationwide who hold a contract with the HSE. The dental treatment is free to the patients, and dentists working under the DTSS are reimbursed on a fee per item basis. The dental treatments provided under the scheme are split into two categories which are known as above and below the line treatments. Above the line treatment currently includes main treatment items such as examinations, fillings, and extractions. These treatments can be carried out immediately by a participating DTSS dentist. Below the line require prior approval from a HSE principal dental surgeon before they can be carried out by a dentist. They include amputation of roots, protracted periodontal treatment and the provision of dentures.

Expenditure on the scheme was approximately €85 million in 2009, which was a substantial increase from the 2008 figure of €63.4 million. Over the past five years expenditure on the scheme has increased by approximately 60%. In view of this increased expenditure and the current position of the public finances, and recognising that health expenditure represents 27% of total public expenditure and is, therefore, of central importance in any strategy to achieve public expenditure savings, it was necessary to consider options to reduce the level of expenditure in the DTSS. This reduction in expenditure reflects the imperative to achieve overall reductions in public expenditure while providing essential health services to patients and the public.

The HSE has been requested to examine this issue and forward proposals to the Department that contain DTSS expenditure at the 2008 level. The executive has developed proposals aimed at containing DTSS expenditure, which the Minister for Health and Children is considering. However, it is important to note that no final decisions have yet been taken on the changes to be made to the DTSS.