The Supreme Court has dismissed an appeal by dentists Martin Reid and James Turner over the Health Service Executive’s decision to fund only emergency dental treatment for medical card holders under a 2010 circular.
The court held that the dentists were bound by the 1999 revision of their contract and that its budget provision gave the HSE broad authority to withdraw funding from particular forms of treatment. It found no error in the High Court judgment, which had ruled there was no breach of contract and dismissed the dentists’ action.
The dentists had provided treatment under the Dental Treatment Services Scheme. Before the circular, routine treatments were eligible for reimbursement. Circular No. 008/10, issued on 26 April 2010, said the scheme’s 2010 expenditure was limited to €63 million and prioritised emergency care, including treatment for pain and sepsis. Some additional care could be considered in exceptional or high-risk cases. The circular restricted or suspended payment for a range of routine treatments.
The dentists argued that the contract did not permit the HSE to make such a major unilateral change. They also disputed that the 1999 revision applied to them. The HSE argued that the revision acknowledged health boards’ right to take whatever measures were necessary to live within budget and statutory obligations.
In a judgment delivered by Mr Justice Charleton on 3 March 2016, the court concluded that the dentists had accepted the revised terms through their participation in the scheme over the following years. It said the 1999 budget clause replaced an earlier, narrower provision and could not be treated as merely introductory or ignored. Read in the context of the contract and the 1999 exchange of letters, the clause gave the funding party wide discretion to withdraw funding for types of treatment.
The judgment addressed which treatments were eligible for reimbursement under the contract. A separate reduction in fees under the Financial Emergency Measures in the Public Interest Act 2009 was mentioned in the appeal but was not part of it. The court dismissed the appeal; it did not make a new order about the circular’s operation in the judgment’s stated result.