Will the Minister ensure that pensioners and families with children on income support are encouraged and the monies made available for all to attend 6 month check-ups as recommended to keep teeth in good condition

2.5   Deputy J.A. Martin of St. Helier of the Minister for Social Security regarding payments within the Income Support system for dental treatment:

Given that the Minister recently advised in a response to a written question that special payments were available within the income support system for dental treatment to relieve pain or to deal with essential remedial work, will the Minister ensure that pensioners and families with children on income support are encouraged and the monies made available for all to attend 6 month check-ups as recommended to keep teeth in good condition?

Senator P.F. Routier (The Minister for Social Security):

Existing schemes already provide support for regular dental costs for pensioners and children. The over-65 health scheme covers the majority of the cost of the annual dental check-ups for pensioners together with the costs of further treatment. This scheme is available to households that do not pay income tax, so that would be people with income support and with savings below £20,000 for a single person and £30,000 for a couple. Pensioners applying for income support are strongly encouraged to join this scheme which also provides assistance with optical and chiropody costs and I would urge any Member who is aware of any pensioner who does have a need for dental check- ups to ask them to apply for the over-65 scheme. For all primary school age children, the school dental service provides check-ups and treatment free of charge. This includes visits to every primary school to check children's teeth. Once children move to secondary school they can join the Jersey Dental Fitness Scheme. Those eligible are between the ages of 11 and 18, or if they are in fulltime education, up to 21.

1. Deputy J.A. Martin:

I asked the question; was income support going to encourage people on low incomes, pensioners and children to go to the dentist regularly, every 6 months. He has told me about all other schemes, this does not encourage people on the low income support to go. They all cost money, some are upfront and while he is answering, can he, later today, inform me how many people over 65 are taking up the dental scheme?

Senator P.F. Routier:

I have the figures for the dental scheme here because the I am very aware of how valuable people do feel that that scheme is to them. The current numbers in the scheme at March of this year are 2,796 members and with regard to the comment that there is an upfront payment, we have arranged with people who are in that scheme, and with Westfield, that income support can get over that problem that used to exist with having the upfront payment. So I believe that anybody who is in income support, they are pointed in the direction and assisted to ensure that they do have regular check-ups. The Deputy specifically asked about 6 months as being the recommended time for people to have check-ups. That does vary according to various organisations and dentists. Some say, depending on the person's clinical health, that it would be 6 months or even 3 months or even a year or 2 years. It really depends on the person's own dental health that that needs to be dealt with on those circumstances. So I do believe that the systems that we have in place do provide the appropriate amount of support to people to enable them to have their dental check-ups and good dental health, and I would encourage any Member to point any member of the public to the Westfield scheme or to the other services for the children in secondary school.

2. Deputy C.J. Scott Warr en of St. Saviour :

Could the Minister confirm that a special payment or loan would usually be given to those people who are not retired who are under the required maximum income band to help meet their dental payments, and would he look across the department to see that there is a if the answer is yes that this is happening?

Senator P.F. Routier:

Yes, I can confirm that we already do help people with dental costs. In fact, that is one of the largest costs within the existing special payments which are made, and we are doing that on a fairly

regular basis. I can assure Members that the department is fully aware that anybody coming with

exceptional dental costs which are not cosmetic but are needed dental work the funds will be found to support them to have that work.

3. Deputy R.G. Le Hérissier of St. Saviour :

Would the Minister not accept that the root of the problem is the general high cost of dental care on this Island and to crown it all [Members: Oh!] by giving away prescription money £2, which involves a £30 visit to the doctor to get a free prescription. He has totally misapplied his sense of priority.

Senator P.F. Routier:

The Deputy is trying to extract an answer out of me. [Laughter]  Certainly, the mechanism of helping to support people with dental costs does need to be looked at and obviously under New Directions, when that comes forward we will be looking at ways of trying to help people to deal

with all their medical needs and dental costs and chiropody are areas which hopefully will come

into the play with regard to coming forward with New Directions and for use of the health fund as described.

4. Deputy G.P. Southern :

Is the Minister aware of any occasions on which requests for help with dental bills have been turned down and if not, will he investigate this particular situation?

Senator P.F. Routier:

I am aware of requests being turned down for dental costs when somebody has been to the dentist

without prior knowledge of the department. People have just gone and had cosmetic work carried out without any recourse to the department to see if it would be possible for support, and also there has been people who have gone to the dentist without, as I say, prior knowledge, and so in those circumstances they have been refused support. I would urge any member of the public who does require dental work to contact the department and if they are within the income support system that they speak to the department first before they speak to the dentist, and the dentist will advise us, and we have a good relationship with the dentists and we can help to support people with those costs.

5. Deputy G.P. Southern :

Will the Minister agree to publish details and circumstances in which these cases were turned down, without breaking anonymity?

Senator P.F. Routier:

I think that would be quite difficult to do because there are very few cases and it would be very obvious that those people, it would be them that would be talked about because there are so very, very few cases. So I would decline to publish those.  [Approbation]

Deputy G.P. Southern :

Surely, only those who already know about the circumstances would be those who could identify an individual. I do not believe it is impossible to produce the circumstances without identifying the individual. I do not believe it is not possible to do that without identifying the individual.

6. Deputy C.J. Scott Warr en:

Could the Minister clarify that it always has to be prior request to Social Security if payment because obviously someone does not normally know necessarily the amount of the cost of a dental bill, that he would always have to get prior the okay prior to treatment from your department and how does this compare with the old system where Connétable s would have helped out somebody with a loan or maybe helped with the cost before income support?

Senator P.F. Routier:

My understanding is under the welfare system that the Connétable s always used to require an estimate and, in certain circumstances before the work was carried out, and that is a similar procedure which we are continuing with. Because dentists do need to there is a general view that dental charges are expensive and they are. So we have to be as careful with States public money as the public are with their own about choosing which dentist to go to and what treatment they have. I would hope that you would endorse that process.

7. Deputy J.A. Martin:

Yes, that is really why I started asking these questions. My concern is we are missing children between 11 and 16. They have to be medically dental fit to go on the scheme and the question, the Minister has already said, they do not extend special payments to costs already incurred. Now, 6 monthly check-ups which obviously now the Minister for Social Security thinks is not probably right for some people, but even as far back when I was a child I was told, and given, every dentist I

have been to, 6 months but, as I say, obviously the Minister for Social Security may know better.

Now, my question is, for these children to go for a check-up it is round about - to make them

dentally fit - the check-up plus an x-ray or 2, you do not get much change out of about £60, £70. Now people are out there and they are not taking the children between 11 and 16 and they are not going to the scheme, and will the Minister stop fluffing about and decide to do something under the new income support scheme and not just follow what the Constables did before?

Senator P.F. Routier:

The comments about whether it was me just having a view on whether 6 months was an appropriate length of time for check-ups; I just quote from the National Institute of Health and Clinical Excellence. The question is: "When should my next dental check-up be?" It says on their website: "The time to your next check-up could be as short as 3 months or as long as 2 years, or up to a year if you are under 18. Generally speaking, the lower your risk of dental problems the longer the gap before your next check-up. This may vary at times of life depending on the conditions of your teeth and gums." So it is not something which I have just dreamt up about 6 months not being an appropriate time. The issue with regard to children moving from the free dental service to the dental scheme; when children are leaving the free dental service which is available to them in primary school, the dental service at the hospital will provide and ensure the hygiene is an appropriate level to go into the scheme. Parents can ensure that when they leave the free dental service, that their children's teeth are suitable to join the dental scheme. That is the way it works, and I will ensure that anybody who is moving from the free service into the dental scheme that they do get their children's teeth checked before they leave the free service so they are able to move into the scheme. If there is a child who has additional costs to get their teeth into a satisfactory situation with regard to getting on to the dental scheme, the income support system will accept an application for funds to cover that cost, to get them to be dentally fit. I hope that answers the question.

8. Deputy P.V.F. Le Claire:

Would the Minister explain the rationale behind a free dental scheme for primary schoolchildren and a qualifying scheme for children passing from primary to secondary school, and what the cost of the free scheme is and what, if he knows or if he could inform us at a future time, would be the cost of continuing that scheme through into secondary education?

Senator P.F. Routier:

I think that question would be better answered by the Minister for Health and Social Services who provides that scheme. I really do not have the information with regard to that.