HSE rationing of dental care for medical card holders is primitive penny-pinching that will harm a nation’s health
IT’S A busy place, that zone popularly referred to as under the radar, and our Government has been proficient in operating there since the fiscal crisis they created went from bad to desperate. Hide behind layers of financial gobbledegook and then lob missiles at a careworn public when the time is right.
On April 28th, all dentists operating the Dental Treatment Services Scheme received a letter from the HSE to the effect that dental treatments to medical card holders are to be rationed. From April 29th. That is one day’s notice to all private dental practices in the State and to their patients.
“The HSE will provide emergency dental care to eligible patients with a focus on relief of pain and sepsis. Additional care will be considered in exceptional or high-risk cases.”
So that’s it then. With this letter the Government has reinforced its systematic dismantling of State involvement in the provision of dental care. Firstly, after the budget in December 2009, we had the severe haircut (I’m using banking parlance as it seems to be the only thing our Government understands at present) on PRSI provision of dental treatment, treatment that the public had already paid for via their pay-related insurance contributions.
And now adult medical card holders are to be severely restricted in their access to dental care. Medical card patients will be allowed one oral examination, two emergency fillings and emergency extractions only. Denture repairs and prosthetics will only be provided in emergency situations. The HSE has claimed in the past that as dental treatment is a demand-led service, it cannot afford to continue to supply treatment to everyone. The cost to the HSE is too high. That might be something to do with the chronic unemployment situation and the consequent number of people eligible for medical cards.
When I contacted the HSE yesterday, staff answering the phones were themselves taken aback at the speed and depth of the cutbacks. They had been informed of the development five minutes before and their managers were “in a meeting about the decision”. The cuts were effective from April 29th and any patients who had already started their treatment by close of business on April 28th would be covered under the old arrangements.
Meanwhile, what do those working in surgeries tell their patients? Is this a temporary arrangement? The girl in the HSE office didn’t know. She was expecting a deluge of calls as soon as word got above that radar.
So if you are unemployed or elderly or your business has gone wallop and you need teeth treated and can’t afford dentures, well, that’s just too bad. Unless you are in pain and it’s an emergency you won’t get free treatment. It seems dental care is to become a luxury; those who can afford it will have gleaming gnashers and the rest of the population can go to a painful, gummy, dental hell.
It’s a gobsmacking decision when considering the amount the HSE hopes to save; in and around €30 million. For such small beer, taken in the context of the jaw-dropping funds allocated to propping up bankrupt institutions, the Government seems perfectly willing to return Irish oral health to the Middle Ages. According to one dental surgeon, it is a basic, primitive decision that will reverse the overall health of the nation.
The level of infection in gum tissue can directly affect the major organs of the body and the decision of the HSE to abolish prophylactic treatment in particular (that’s a scale and polish to you and me) will have repercussions for the population.
I know a bit about this because my husband is a dentist. This is what he says: “It’s a shortsighted, knee-jerk reaction to save money. The people who are most affected by this decision are barely able to afford to live at the moment, not to mention being asked to cough up for minimum maintenance. What do I do if a patient presents requiring an amount of restorative work? Do I pick which two teeth to fill, which to save and which to pull.
“It’s horrendous for the patient involved. The irony of it all is that the HSE will end up spending more money on subsequent health problems relating to this than they will ever save in the short term. And are we supposed to whip out teeth, with no guarantee of a denture for the patient? We can’t do that to our patients.”
Yesterday morning in the surgery, patients were unsurprised at the decision and despondent, having become somewhat bitter and inured to hard news as this deep recession rumbles on. Some did express shock at the hastiness of the implementation of this latest diktat from on high. One elderly gentleman mentions public demonstrations in France and Greece and wonders why the Irish public are like lambs to the slaughter.
“Look at the guys in the banks who broke the country. They are still on huge wages. We see the elite, the bankers, politicians and corporate moguls walking around untouched.”
This man feels there is a tipping point and public anger is beginning to bubble over. How many more cuts are the weakest sections of the population supposed to take?
“Free dentures in old age when you have worked all your life should hardly be considered a luxury, should it? Not in 2010.”