Politicians are ‘asleep’ to the mounting oral health crisis

As summer turned to autumn, the number of dentists in Ireland who had left the Dental Treatment Services Scheme (DTSS), under which adults qualifying for a Medical Card can access a range of services and treatments, passed 100. The milestone marked three months since the country’s previous Health Minister, Simon Harris, promised to provide appropriate personal protective equipment (PPE), which has still to materialise.

The Health Protection Surveillance Centre (HPSC) advised dentists that regular dentistry wear would be sufficient to protect them from the coronavirus. The Irish Dental Association, representing around 2,000 dentists, estimates that the average cost of PPE per treatment is €14 per appointment in a three-surgery practice, which has made it “unviable” for many dentists to provide for medical card holders.

The Health Service Executive (HSE) concedes that the scheme needs “to be revised in order to align it with modern evidence on oral health needs and provision of dental services”. But it has assured the current Health Minister, Stephen Donnelly, that card holders will not be left without a service. The majority of the 106 who, by September, had indicated their intention to leave the scheme, had still to complete their three-month notice period – during which patients could be referred to an alternative practice.

Ruairí Ó Murchú, Teachta Dála for Louth, highlighted the situation in his constituency where some people in residential settings were told that their dental practices would no longer be providing ‘new’ care for medical card holders. The practices told these patients that treatment can be pursued under Louth Community Care, but Mr Ó Murchú said he understood that they are not taking patients unless it is an emergency.

This subsequently confirmed by the HSE, who told him: “The HSE dental service is also facing major backlogs, as a result of service restrictions during the height of COVID-19, and reduced capacity currently, due to new work processes, enhanced infection prevention and control measures, and redeployment of some dental staff. If any of the patients you are representing are experiencing pain, and have difficulty accessing treatment, the HSE dental service can arrange for them to be seen as an emergency.”

This issue has been flagged to them for months and still, there is no resolution in sight

Mr Ó Murchú said medical card holders, particularly those with disabilities, were facing the “dreadful choice of having to either forgo treatment or face the burden of having to pay for dental treatment out of the €203 disability allowance they receive each week”. The HSE statement, he said, acknowledged that there had been a withdrawal of dentists from the DTSS.

Apparently, it was the Department of Health’s intention to “revise” the DTSS and “engage” with the Irish Dental Association. However, there seems to be little urgency about this and, in the meantime, medical card holders, including those with disabilities, were facing worry and concern in relation to their dental care.

“While the HSE says it will facilitate patients moving to another dentist, there is no guarantee that the dentists will be local and there could be an added travel burden for those with disabilities,” noted Mr Ó Murchú. “The Government is asleep on this issue – it has been flagged to them for months – and still, there is no resolution in sight. In the short term, the Government needs to engage with dentists and provide an interim solution, so people are not left without care.”

Mr Ó Murchú is spot on; the Government needs to wake up.