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Tooth hurts Medical card patients should get vouchers as dentists abandon HSE scheme, report says

There has been an exodus of dentists participating in the free scheme – with just 750 dentists now left to treat medical card holders, and no service in some areas, due to HSE fees.

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Dentists are in demand (Rui Vieira/PA)

Dentists are in demand (Rui Vieira/PA)

Dentists are in demand (Rui Vieira/PA)

Medical card holders should be given a voucher or credit worth between €100 and €500 for dental care by the HSE, according to a new plan published today.

The independently commissioned research paper by Ciaran O’Neill, Professor of Health Economics at Queens University Belfast, recommends a “credit or voucher” scheme.

There has been an exodus of dentists participating in the free scheme – with just 750 dentists now left to treat medical card holders, and no service in some areas, due to HSE fees.

Fintan Hourihan, head of the Irish Dental Association (IDA) which commissioned the research, said: “There is currently one dentist per 2,000 medical card patients. This cannot be allowed to continue.

“It is incumbent on the Government and HSE to reform this scheme urgently and the model set out by Professor O’Neill deserves serious consideration by all parties to the current scheme.”

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There has been an exodus of dentists participating in the free scheme

There has been an exodus of dentists participating in the free scheme

There has been an exodus of dentists participating in the free scheme


The research paper, Dental Credit Scheme, suggests a voucher for €100 towards dental care would cost around €108m a year. Vouchers of a higher value, between €200 and €500, would cost the HSE €93m and €232.5m.

The report says the scheme “would provide coverage for commonly required services at levels of reimbursement that reflect the cost of care.

"It would afford a degree of clinical autonomy that would remove perversities in the current system and help rebuild relations between the public, providers, and Government.”

President-elect of the IDA and Chair of the GP Committee, Dr Caroline Robins, said: “Dentists want an entirely new scheme that reflects modern dental practice and care, one that allows vulnerable groups to access routine dental care in their community.

"We have never understood the rationale behind a scheme that restricts the number of preventative treatments allowed, such as fillings to save a tooth, while permitting an unlimited number of extractions.

“There are now believed to be just 750 dentists treating medical card patients, which is less than half the number of contracts held by dentists up to two years ago.

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"To put it in context, that is one dentist per 2,000 medical card patients and parts of the country where there is just one dentist covering an entire town or region.”

Mr Hourihan said: “The spend on the medical card scheme in 2021 was €39.6m and a far cry from the €86m spend in 2009.

“Despite the suggestion of an extra €10m 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.”

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