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Irish dental service system prevents dentists from providing adequate care

Irish dentists are dissatisfied with the dental care they can provide under the Dental Treatment Services Scheme. (Photograph: nelen/Shutterstock)

Tue. 5 June 2018

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DUBLIN, Ireland: A recent survey conducted by the Irish Dental Association (IDA) has found that the majority of dentists have no confidence in the Dental Treatment Services Scheme (DTSS) and are dissatisfied with the level of care they are allowed to provide under it. The DTSS gives Irish citizens who fall below a certain income tax threshold access to free or reduced-rate dental treatment. Based on the results of the survey, the IDA has called for immediate resumption of contract talks.

Over 440 dentists, all members of the IDA, completed the survey, which was undertaken in the first two weeks of May. According to the results, 90 per cent said they are dissatisfied with the level of care they can provide under the scheme, while 96 per cent stated the scheme prevents them from providing the same standard of care as for private patients.

The survey also found that 97 per cent of dentists lack confidence in the DTSS. Thirty-eight per cent of the surveyed dentists said they had been refused approval to provide treatment for exceptional or high-risk patients owing to lack of funding. Because of these circumstances, three out of four of the respondents would like to leave the scheme within the next five years.

“I am opting out of the DTSS scheme. I will suffer short term for this, but not as much as my poor patients. I just can’t do it any longer,” said one surveyed dentist. Another claimed, “It is an unethical scheme. It provides the illusion of care.”

In 2010, the Health Service Executive (HSE) imposed unilateral cuts to the scheme without informing or consulting patients, dentists or the IDA. From that point on, the only treatments available to patients were an annual oral examination, two fillings per annum and unlimited extractions. According to CEO of the IDA Fintan Hourihan, these changes have led to a 41 per cent increase in the number of surgical extractions and a 12 per cent rise in routine extractions.

Since 2010, the number of patients eligible for dental care has risen to 1,340,412—an increase of 24 per cent. Despite this, the number of treatments funded by the HSE has fallen by 24 per cent.

“We are calling on the Minister for Health [Simon Harris] to resume contract talks as a matter of urgency and to extend to dentists the same terms and conditions which have been offered to public servants and other health professionals who have seen Financial Emergency Measures in the Public Interest pay cuts reversed in full. There must also be a commitment in the forthcoming budget for multi-annual funding towards a new scheme which focuses on prevention rather than treatment. Until that is in place the costs of poor dental health will continue to be borne by the most disadvantaged in society,” Hourihan concluded.

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