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IrelandDentists say government's new oral health policy will be 'catastrophic' for adults and children in lower income areas

11:25  15 may  2019
11:25  15 may  2019 Source:   thejournal.ie

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The Irish Dental Association says policy will be ‘ catastrophic ’ for adults and children in lower income areas .

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Dentists say government's new oral health policy will be 'catastrophic' for adults and children in lower income areas © Catalyst Images A dentist with a model of teeth

DENTISTS HAVE SLAMMED the government’s new oral health policy stating that key aspects of the public dental service are now to be privatised.

Last month, Health Minister Simon Harris announced the new scheme of dental care for Irish children under the age of six, as well as packages of care for children from birth to 16 years of age.

Fintan Hourihan, chief executive of the Irish Dental Association, is set to tell the Oireachtas Health Committee today, that not only will the new policy fail, but it will be “catastrophic for patients in lower socio-economic areas with high treatment needs”.

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The association, which represents 2,000 dentists nationwide, said it was – the not consulted on the new oral health policy, despite being the practitioners that will have to roll it out.

The new policy for the care and treatment of children and adults is “seriously flawed, economically unviable and operationally unworkable”, states the chief executive.

Dentists say government's new oral health policy will be 'catastrophic' for adults and children in lower income areas © Catalyst Images A toothbrush

Under the changes, contracted local dental practices will replace the existing Public Dental Service (PDS) school programme.

Currently, the PDS provides emergency treatment to all children under 16 years of age and routine dental examinations for school children at certain periods.

Children are examined and given a grade depending on how quickly the child needs treatment. The child is then referred to a local HSE dental clinic to receive treatment.

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Children ’ s Oral Health Guide. Children ’ s Dental Products. Although the NHS dental system is still subsidised by the government , most adults have to pay a fee for checkups and treatments. Only children who have a certain degree of malocclusion will be granted orthodontic treatment on the NHS.

Dentists not consulted on new plan

Hourihan will tell the committee today that it is “incomprehensible to our members in both the HSE public dental service and private practice that key aspects of the public dental service are now to be privatised”.

He states in his opening statement to the committee that the association’s members are concerned moving from a targeted, risk based model to a demand led model will pose risks in relation to the continuity of care and the provision of emergency care for children.

He added that dentists “fear that the public dental service will ultimately prove to be a dumping ground when the unworkable model proposed, which our members believe is based on a failed and discredited NHS experiment, inevitably collapses”.

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Public service dentists employed by the HSE play a critical, complementary

role in providing expert care primarily for children and special care children and adults, he says.

“Regrettably, based on our members’ analysis of the plan, it seems certain that oral health inequalities will increase rather than reduce with the plan’s proposals in regard to the provision of dental care and treatment,” says Hourihan.

He adds that this is “the inevitable consequence of moving from a targeted approach where HSE public dental surgeons directly target children at key age ranges of their development for dental services including, but not limited to, prevention, restorative care and referral to secondary services where eligible”.

This approach enables those who do not attend to be identified and followed up.

Dentists say government's new oral health policy will be 'catastrophic' for adults and children in lower income areas © Catalyst Images Girl at the dentist

The policy’s proposal is to redirect this service into general practice where identifying risk will be dependent on attendance by the very groups who are both least likely to attend but also have the worst oral health and the greatest treatment need.However, the policy’s focus on prevention needs to be counter-balanced by the fact that prevention going forward cannot fix the significant amount of untreated oral diseases that are already present today.

Hourihan adds that dentists have long been calling for the replacement of the “unfit for purpose” medical card scheme, but the declaration from the Department of Health over

the years is that this couldn’t happen until the publication of a new oral health policy.

“This has been used as an excuse also for the delayed publication of new legislation to update and amend the Dentists Act of 1985.

“The publication of the oral health policy now clears the pitch and allows all parties to engage without delay in long overdue discussions on the state contracts and also the need for new legislation,” he says.

Dentists say government's new oral health policy will be 'catastrophic' for adults and children in lower income areas © Catalyst Images Girl at the dentist

Moving towards privatisation

Highlighting the “most glaring weakness” in the policy is the proposal to extend limited “free dental care” to under 6s and eventually to under-16s.

“However, the plan offers no evidence to justify taking care and treatment of children from the HSE public dental service,” he says, adding:

It may seem easy to suggest taking work from the HSE public dental service when it has been hollowed out and left to crumble over the past decade.

The association also notes there is no mention made to the current crisis in arranging dental care for children who require to be treated under general anaesthetic. Hourihan states up to 10,000 children a year are undergoing painful operations because routine screenings are no longer taking place and issues are not being identified in time.

In addition, the new government policy offers nothing to the 60% of adults who do not have access to free or subsidised dental care other than very limited PRSI dental benefits, he adds, and questions why there no support or funding towards the cost of dental treatment provided to those adults.

No change in tax relief

Hourihan also questions why there is no change in the tax relief for those adults, adding that the provisions for adults represents “little more than repackaging of the existing suite of treatments which were savagely cut in 2009, a decision which everyone described as shameful at the time”.

Currently, there is 20% tax relief only for a limited number of dental procedures.

Hourihan adds that dentists first reaction to news of the new scheme was “disbelief and anger” at how few dentists in practice – within general practice, specialist practice or within the HSE – were consulted in the preparation of this new policy even though they are the ones it is hoped will deliver 95% of dental care in future.

“Therefore, we respectfully submit that this is not the last word on oral health in Ireland.

The association regards this as a starting point for a badly needed discussion on oral health,” he states.

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