Phil Hogan (Carlow-Kilkenny, Fine Gael)
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Question 120: To ask the Minister for Health and Children the definition of high risk in regard to medical card patients who require treatment of gum disease and if so, if appropriate clinical expertise was used; if the definition has been communicated to all principal dental surgeons and the dental treatment service scheme contractors involved; and if she will make a statement on the matter. [30863/10]

Mary 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.

Phil Hogan (Carlow-Kilkenny, Fine Gael)
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Question 121: To ask the Minister for Health and Children if she has ensured that the Health Service Executive have principal dental surgeons in place in all areas to deal with the new approvals process and questions that arise daily as a result of the new arrangements; if not, the reason for same; and if she will make a statement on the matter. [30865/10]

Mary 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.

Phil Hogan (Carlow-Kilkenny, Fine Gael)
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Question 122: 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; and if she will make a statement on the matter. [30866/10]

Phil Hogan (Carlow-Kilkenny, Fine Gael)
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Question 124: To ask the Minister for Health and Children if she has ensured that the claims processing staff in the primary care reimbursement section have been appraised on the new arrangements; and if she will make a statement on the matter. [30868/10]

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 131: To ask the Minister for Health and Children the position regarding the implementation of the Health Service Executive circular 008/10 of 26 April 2010 to dentists who are cutting back services to medical card patients; if she has sought an explanation from the HSE of their definition of emergency dental procedures to which many treatments are to be confined; and if she will make a statement on the matter. [30883/10]

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 132: To ask the Minister for Health and Children if she will reverse the cuts to dental services for medical card holders. [30884/10]

Phil Hogan (Carlow-Kilkenny, Fine Gael)
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Question 137: 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 clinical and administratively clear and unambiguous; and if the operational guidelines have been issued to the principal dental surgeons; and if she will make a statement on the matter. [30899/10]

Phil Hogan (Carlow-Kilkenny, Fine Gael)
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Question 141: 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; and if she will make a statement on the matter. [30905/10]

Phil Hogan (Carlow-Kilkenny, Fine Gael)
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Question 144: To ask the Minister for Health and Children the specific arrangements that she has ensured are in place for routine dental treatment for medical card patients who have entitlements under the provisions of the Health Acts since May 2010; and if she will make a statement on the matter. [30908/10]

Michael McGrath (Cork South Central, Fianna Fail)
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Question 204: To ask the Minister for Health and Children the steps she is taking to ensure there is a reasonable service for medical card holders in need of dental treatment; and if she will make a statement on the matter. [31363/10]

Mary Harney (Dublin Mid West, Independent)
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I propose to take Questions Nos. 122, 124, 131, 132, 137, 141, 144 and 204 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.

Phil Hogan (Carlow-Kilkenny, Fine Gael)
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Question 123: To ask the Minister for Health and Children the steps she has taken to advise general medical practitioners of the new circumstances pertaining to the dental treatment services scheme which would impact on patients health; and if she will make a statement on the matter. [30867/10]

Mary 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.