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THE HEALTH Service Executive (HSE) has been severely criticised for its failure to manage its own public dental service that provides free dental care for children, people with disabilities and older people in care. The criticisms are contained in a new report on the service. The Public Dental Service (PDS) has a budget of €60 million for 2009 and services are provided by 200 dentists, working as HSE employees.
The Department of Health appointed Dr Paul Batchelor, a London-based oral care consultant to write an Analysis and Evaluation of the Public Dental Service of the Health Service Executive , a copy of which has been seen by The Irish Times .
The evaluation report found “little evidence among senior levels of the HSE of a serious engagement to understand the operation of the PDS with a view to actively managing that part of the organisation, providing encouragement and knowledgeable direction. This lack of leadership at a national level is having a demoralising effect on the providers of the service.” It also found that “the most important factor inhibiting the introduction of improvement is the lack of clinical [dental] leadership in the PDS”.
The ‘dental fraud’ saga continues….
THE HSE and the Irish Dental Association (IDA) have strongly rejected reports that in excess of 10 per cent of the €85 million budget spent on a dental scheme may be paid to dentists making fraudulent and inappropriate claims. The scheme is known as the Dental Treatment Services Scheme (DTSS).
Fintan Hourihan, the chief executive of the IDA, which represents dentists, said the assertion was “misleading and unfair” while Paddy Burke, of the HSE’s Primary Care Reimbursement Scheme which makes these payments, said he was “satisfied that there is a sophisticated set of controls in place to prevent fraudulent payments”.
The €8 million-plus estimate was contained in unpublished documents on probity commissioned by the Department of Health and internal department documentation as recently as last June. Their contents were reported in last week’s Healthplus. The Department of Health has since posted the report, entitled the 2009 Report on Probity Assurance within the Dental Care Sector on its website. (more…)
Below and above are a series of articles by me that appeared in the Irish Times health supplement on 20 and 27 October 2009 on fraudulent and inappropriate claims by dentists participating in the free public dental scheme for adults who are medical card holders.
The unpublished Department of Health and HSE documents warn that in excess of 10% of the €85 million allocated to this scheme is inappropriate. They also indicate that this abuse may not be confined to just one scheme and is happening across other demand led schemes where the HSE contracts services from professionals.
If you have information on any such inappropriate practice or payments I am very interested in hearing from you. Please get in touch….
Dental Treatment Services Scheme: Under the Dental Treatment Services Scheme (DTSS), adults who are medical card holders are entitled to free dental care. Treatment is free to the patient, and privately practising dentists who take part in this scheme claim back the cost of services provided from the Primary Care Reimbursement Scheme (PCRS) in the HSE on a fee-for-service basis.
In August 2009, just over one million people were entitled to the DTSS. Its budget in 2009 is €85 million. As it is a demand-led scheme, it is impossible to accurately estimate the numbers who will avail of the scheme and the cost of it. These have increased significantly since 2008 as more adults are entitled to this scheme, due to the increasing number of medical card holders.
Dental Treatment Benefit Scheme: The Dental Treatment Benefit Scheme (DTBS) contributes to the cost of dental care for about two million working people who pay PRSI contributions, their spouses and dependants. All PRSI contributors are entitled to an examination and a clean free each year, while other treatments are subsidised.
Last year, 1.5 million treatments were provided under this scheme. Dentists who practise privately are paid a fee for this service by the Department of Social and Family Affairs, which runs this scheme. Its budget for 2009 is €68 million.
Public Dental Scheme:
The Public Dental Scheme (PDS) provides free dental care for children, adults with special needs and people in long-term residential care. About 200 dentists work for the PDS as salaried HSE employees.
The PDS operates a screening programme for all children attending national schools in 2nd, 4th and 6th classes. This programme provides preventive and other treatments when required. The budget for the PDS for 2009 is €60 million.
Private dental care:
Many people pay each time they get treated by a dentist. The vast majority of dentists in Ireland operate as self-employed private practitioners. Patients pay the full cost of care at fees agreed with the dentist. Tax relief may be available for fees associated with some types of specialist dental care.
Tue, Oct 20, 2009
© 2009 The Irish Times