Dáil Éireann - Volume 372 - 30 April, 1987

Ceisteanna—Questions. Oral Answers. - Dental Services.

7. Mr. Crowley asked the Minister for Health if his attention has been drawn to the widespread dissatisfaction which exists regarding the inadequate level of dental services; the proposals, if any, he has to improve the services; and if he will make a statement on the matter.

Dr. O'Hanlon: I had been aware before assuming office that there is widespread dissatisfaction with regard to the level of dental services being provided. As Members are no doubt aware, it is a matter for the health boards to allocate available funds between the different services they provide as they see fit. However, in the letter of 2 April 1987 which informed health boards of their allocations for 1987 I urged that community care services should be protected and I expect that the health boards will do that.

Mr. Allen: In view of the disarray in the dental services in the health board regions, would the Minister consider setting up a strategy group to review the free dental services? What is the Minister's opinion on setting up a third party funding agency for dental services? I refer to an agency such as the VHI.

Dr. O'Hanlon: I am concerned and have been for a number of years at the level of dental service being provided. It is my intention in preparing the Estimates [732] for next year to look at the dental services to see what can be done to improve them. While a third party agency would not particularly affect the public dental service, I am examining the possibility of a comprehensive VHI scheme to cover dental services.

Mr. Allen: In view of the present allocation to the health boards and the extension of the service to spouses of insured workers, how does the Minister expect the health boards to provide a boarder service? Services to medical card holders and the physically and mentally handicapped are being curtailed because of cutbacks.

Dr. O'Hanlon: When our Government left office in 1982 there was an excellent dental service in operation, including the ad hoc service which allowed medical card holders to attend a private dentist. During the past four years that service has been removed completely from each of the health boards. We are concerned about the dental service and are looking at it in the context of what we can do next year. We asked the health boards to protect the community care services and I hope the dental service will be maintained and improved.

Mr. Stagg: At present medical card holders have to wait between one and two years for ordinary dental treatment and up to three years for specialist treatment. In the light of the very severe restrictions in the allocations to health boards, Will the Minister agree that unless further funding is provided they will not be able to provide the necessary dental services?

Dr. O'Hanlon: We have asked the health boards to protect the community care services.

Mr. Stagg: The Minister has not given them the money.

Dr. O'Hanlon: The allocations were made out in such a way that community [733] care services would be protected. I accept that the dental service is inadequate.

Mr. Stagg: Chaotic.

Dr. O'Hanlon: Chaotic is correct but we take no responsibility for the fact that the ad hoc dental service was abolished during the past four years. It was an excellent service.

Miss Flaherty: Is the Minister bringing it back?

Mr. Power: Is the Minister aware that any hope of corrective treatment in the Eastern Health Board area is so far off that in Kildare the damage is done long before anyone can hope to have the problem solved? There is a complete absence of orthodontic treatment.

Dr. O'Hanlon: I accept what Deputy Power says. I am very concerned about the very low and inadequate level of dental service available. We are looking at it in the context of next year's Estimates.

Mr. Allen: The Minister has admitted that the service is in chaos. What strategy review is taking place between him and the Minister for Education? On the one hand we have the dental service in disarray and we do not have the funds to carry out the services we are legally obliged to supply. On the other hand, we have an oversupply of dentists and we are spending £17.5 million on educating dentists whom we do not require. What review is taking place in this area?

Dr. O'Hanlon: Obviously certain factors help to maintain the teeth of children, one being flouridation which has made a major impact on the incidence of dental caries in the community. It is important that children be instructed in their homes and in schools on how to protect their teeth. It is not possible in the current year to allocate any extra money to the dental service to which the question refers.

[734] (Interruptions.)

Miss Flaherty: A Cheann Comhairle——

Mr. Desmond: May I ask the Minister a final question?

An Ceann Comhairle: I want to get off this question. I will seek to facilitate Deputy Flaherty as she knows full well but I want co-operation in putting brief questions so that I can get through a reasonable number of questions. All questions are important.

Mr. Desmond: Will the Minister assure us that the Government will transfer the £7 million allocated to the treatment benefit scheme in social welfare to the community care programme of his Department to increase the current provision of £13.3 million for 1987 in view of the fact that the treatment benefit extension is most unlikely to occur in 1987? When greater need exists under the health board care programme the money should be spent in that direction.

Dr. O'Hanlon: I can give the Deputy no such assurance because the scheme providing for the dependants of insured workers will be financed from the social insurance fund. I do not consider that it would be appropriate to transfer money from the social insurance fund directly to the fund for the health services.

An Ceann Comhairle: Deputy Mary Flaherty.

Mr. Desmond: Surely the Minister is giving us——

An Ceann Comhairle: I have called Deputy Flaherty.

Miss Flaherty: What steps does the Minister intend to take to ensure that this long overdue service will be made available to the wives of insured workers most of whom go without treatment to ensure that their children are looked after, that vested interests who do not [735] wish to offer services at a more modest level under this scheme will not be allowed to have their way and that the women of Ireland will get the service they have long awaited?

Dr. O'Hanlon: That is for the Minister of Social Welfare.

Mrs. Barnes: Wives' teeth are worse than anybody else's.

Mr. Desmond: Priority my eye.

Mrs. Barnes: Women are always the last priority.

Miss Flaherty: Insured husbands should give up their rights and let their wives have them.