An improved scale of fees was offered last night to dentists providing treatment to medical card holders, but it is not yet clear if this will affect the withdrawal of services threatened for today. It is understood that the Department of Health has offered parity of payment with a similar scheme operated by the Department of Social, Community and Family Affairs for patients covered by PRSI.
However, in return the Department and the Health Service Employers' Agency are thought to be seeking new procedures which will ensure "probity and accountability", to guard against abuse of the system. There is also understood to be some back payment in the offer, as dental fees under the medical card system have fallen significantly behind those under the PRSI-funded scheme in recent years. In some cases the discrepancy is as much as £12 per item.
Negotiators for the Irish Dental Association are to present the new package to their executive council and are expected to respond to the HSEA tomorrow morning. It is not clear at this stage if the strike, due to begin today, will be called off, but the significant progress made in yesterday's talks has certainly made the possibility much greater.
Both sides agreed not to make any public statements when the talks concluded shortly after 8 p.m. at the HSEA headquarters.
More than one million adults with medical cards face the withdrawal of routine treatment for teeth and dentures if the strike goes ahead. If it does, then emergency treatment only will be provided to medical card holders. Children up to the age of 16 will not be affected by the dispute.
Emergency cover is defined by the IDA as the relief of pain, rather than restorative work. However, this could include fillings, the repair of dentures and the provision of prescriptions, if considered appropriate, as well as extractions.
The IDA members voted by 96 per cent to take strike action because of what they claim is inaction on the issue by the Department.
Besides the fact that fees can be as much as £12 lower for some procedures under the GMS medical card scheme than the PRSI scheme, the IDA is seeking to increase access by medical card holders to dental treatment. At present treatment must be approved by the local health board before an appointment can be made with a dentist.
There have also been delays in extending the scheme to medical card holders in the 35-65 age group. The IDA's general secretary, Mr Donal Atkins, said only 12.9 per cent of medical card holders received routine dental treatment last year.