The Irish Dental Association (IDA) has warned that the medical card scheme is near total collapse, with there currently being just one dentist per 2,000 medical card patients.
The warning comes following the publication of an independently commissioned research paper by Professor of Health Economics at Queens University Belfast, Professor Ciaran O’Neill, which has suggested that a credit or voucher scheme would "remove perversities in the current system".
According to the research paper, a new system would also help rebuild relations between the public, providers, and Government.
The model set out in the research paper is a credit or voucher scheme that provides an entitlement of a given value for a specified period of time to cover a given range of services and care.
The IDA pointed out that reimbursement levels to dentists were reduced following the financial crisis of 2008 and treatments available to medical cardholders were suspended or available in emergency cases only. This has not changed in the 13 years since.
Between 2015-2020 there was a 31 per cent decline in the number of dentists holding Dental Treatment Service Scheme (DTSS) contracts, with there now being just 750 dentists treating medical card patients.
'Rapid exodus'
Fintan Hourihan, CEO of the IDA, said: “What this paper shows is that an entirely new scheme is required, and the model set out by Professor O’Neill deserves serious consideration by all parties to the current scheme.
“The spend on the medical card scheme in 2021 was €39.6 million and a far cry from the €86 million spend in 2009.
“Despite the suggestion of an extra €10 million being made available this year, it is not nearly enough to solve the underlying problems associated with the scheme or have any substantial impact on the rapid exodus of dentists from it.
“Without any meaningful plan or roadmap to reform coming from Government, it is becoming increasingly difficult to see how the medical card scheme can survive, which means more and more of our most vulnerable patients will lose out on important access to dental care.
“Ultimately, a new model has to move away from a system which allows restrictions to be placed by the state on treatments which are covered.
“A new scheme will only succeed if it attracts sufficient numbers of dentists as a professionally appropriate and economically viable alternative, and, most importantly, it has the confidence of the patients it is designed to serve.
“While we remain deeply frustrated, we invite the Government to engage with us to explore new ways of improving access to dental care, including this proposal from Professor O’Neill.
“Ultimately, patients, Government and dentists require a more sustainable solution that ensures access to care for those who need it most.”
