PATIENTS WITH MEDICAL cards should be given vouchers of up to €500 for dental care, according to a report published today.

The research paper prepared by Ciaran O’Neill, Professor of Health Economics at Queens University Belfast, recommends a “credit or voucher” scheme to replace the medical card model currently in place.

Difficulties with the fee structure have seen a raft of dentists exiting the medical card scheme and the Irish Dental Association says it nears “total collapse”.

The group says there are now believed to be just 750 dentists treating medical card patients, which is less than half the number of Dental Treatment Service Scheme contracts held by dentists up to two years ago.  

This amounts to one dentist per 2,000 medical card patients and some parts of the country are left with few dentists available for medical card holders.

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

“This scheme would provide coverage for commonly required services at levels of reimbursement that reflect the cost of care,” Professor O’Neill says in the report.

“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.”

Fintan Hourihan, CEO of the Irish Dental Association, said: “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,” Hourihan said.

The dentists’ association says a new model needs to be introduced 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,” Hourihan added. 

Dentists also say the current system limits the number of preventative treatments allowed, such as fillings to save a tooth, while permitting an unlimited number of extractions.