Written answers

Tuesday, 6 July 2010

Department of Health and Children

Health Services

10:00 am

Photo of Jack WallJack Wall (Kildare South, Labour)
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Question 165: To ask the Minister for Health and Children the position regarding an application for dental treatment in respect of a person (details supplied); if the person is entitled to treatment under the medical card; and if she will make a statement on the matter. [29210/10]

Photo of Mary HarneyMary Harney (Dublin Mid West, Independent)
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As this is a service matter it has been referred to the HSE for direct reply.

Photo of Seán SherlockSeán Sherlock (Cork East, Labour)
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Question 166: To ask the Minister for Health and Children if she has given direction to the Health Service Executive on the conditions that constitutes a clinical emergency with regard to the provision of dentures under the dental treatment services scheme in view of the fact that applications are being returned to dental practices on the basis that the HSE has given no direction to the principal dental surgeons as to what constitutes an emergency; and if she will make a statement on the matter. [29250/10]

Photo of Denis NaughtenDenis Naughten (Roscommon-South Leitrim, Fine Gael)
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Question 203: To ask the Minister for Health and Children if she will withdraw the Health Service Executive circular of 26 April 2010 regarding the dental treatment services scheme in view of its impact on medical card holders; and if she will make a statement on the matter. [29378/10]

Photo of Michael D'ArcyMichael D'Arcy (Wexford, Fine Gael)
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Question 278: To ask the Minister for Health and Children if she has advised principal dental surgeons and contracting dentists of the circumstances under which approval may be given for emergency dentures. [29849/10]

Photo of Michael D'ArcyMichael D'Arcy (Wexford, Fine Gael)
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Question 280: To ask the Minister for Health and Children if she will ensure that the claims processing staff in the primary care reimbursement service have been apprised of the new arrangements. [29851/10]

Photo of Michael D'ArcyMichael D'Arcy (Wexford, Fine Gael)
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Question 281: To ask the Minister for Health and Children her views on whether the criteria imposed by the Health Service Executive in the recent circular to dentists are clinically and administratively clear and unambiguous; and if she has ensured that operational guidelines have been issued to the principal dental surgeons. [29852/10]

Photo of Michael D'ArcyMichael D'Arcy (Wexford, Fine Gael)
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Question 284: To ask the Minister for Health and Children her views on whether it is an appropriate use of medical consultants time to dictate letters requesting approval for dental treatments which are necessary for patients requiring urgent medical treatments. [29855/10]

Photo of Michael D'ArcyMichael D'Arcy (Wexford, Fine Gael)
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Question 286: To ask the Minister for Health and Children the specific arrangements in place for routine dental treatment for medical card patients, who have entitlements under the provisions of the Health Acts, since May 2010. [29857/10]

Photo of Mary HarneyMary Harney (Dublin Mid West, Independent)
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I propose to take Questions Nos. 166, 203, 278, 280, 281, 284 and 286 together.

The Government's decision to limit the funding available to the Dental Treatment Services Scheme (DTSS) was made in view of the current position of the public finances and the 60% increase in expenditure in the DTSS over the past five years. The Health Service Executive (HSE) has introduced measures to contain DTSS expenditure at the 2008 level of approximately €63 million. There are no plans to reverse these changes.

Under the new measures the range of treatments available are being prioritised. These measures have been introduced to protect access to emergency dental care for medical card holders and to safeguard services for children and special needs groups. Services for high-risk patients and those requiring exceptional care continue to be available. The remaining care provision is subject to prior approval, which will be required from a clinician in the HSE, who will prioritise for:

High risk and exceptional patients,

Those requiring emergency care, and

Patients who are considered to have greater clinical urgency and/or necessity in receiving care.

Where prior approval is required for the treatment, the HSE Principal Dental Surgeons will apply their professional judgment to determine, in the circumstances, whether or not there is a clinical emergency, and whether or not treatment should therefore be approved.

I have given no direction to the HSE concerning what constitutes a clinical emergency. In the DTSS an emergency is determined by the treating clinician, the contracted General Dental Practitioner, in agreement with the local HSE Principal Dental Surgeon, or a delegate who is also a clinician. Where a patient requires dental treatment in advance of urgent medical treatment, this must be communicated to the HSE Principal Dental Surgeon. The manner in which this approval is sought has not changed and is a matter for those involved in the process.

The staff of the Primary Care Reimbursement Service of the HSE are aware of the changes and are implementing them. The HSE will continue to engage with dental professionals to ensure clarity and consistency in implementing these changes. The HSE will also monitor the ongoing effect of these changes from a clinical and budgetary perspective. The dental and oral health services currently provided through the HSE Public Dental Service will not be affected by these changes to the DTSS.

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