Written Answers. - Orthodontic Service.
Michael Ring
Question:
371
Mr. Ring
asked the
Minister for Health and Children
the reason so many children with severe orthodontic problems are being denied treatment; and if he will make a statement on the matter.
[4571/03]
Michael Ring
Question:
372
Mr. Ring
asked the
Minister for Health and Children
the reason children in the Western Health Board area must wait a year before they can be assessed for orthodontic eligibility; and if he will make a statement on the matter.
[4572/03]
I propose to take Questions Nos. 371 and 372 together.
As the Deputy is aware, responsibility for the provision of orthodontic treatment to eligible persons lies with the health boards in the first instance. I am pleased to advise the Deputy that I have taken a number of measures to improve orthodontic services on a national basis, including those services provided in the Western Health Board area.
The grade of specialist in orthodontics has been created in the health board orthodontic service. This year, my Department and the health boards are funding thirteen dentists from various health boards – including two from the Western Health Board – for specialist in orthodontics qualifications at training programmes in Ireland and at two separate universities in the United Kingdom. These 13 trainees for the public orthodontic service are additional to the six dentists who commenced their training last year and one dentist whose specialist training is nearing completion. Thus, there is an aggregate of 20 dentists in specialist training for orthodontics. The creation of an auxiliary grade of orthodontic therapist is another structural measure being introduced in order to increase the number of orthodontic treatments.
In the short-term, additional funding of €6.729 million was approved for orthodontic services in 2001 of which €4.698 million was to fund an initiative on orthodontic waiting lists. The additional funding of €628,000 allocated to the Western Health Board in 2001 for orthodontic services, includes €533,000 for an orthodontic initiative in the board. The chief executive officer of the board has informed me that under the initiative, the board has,inter alia, recruited an additional specialist in orthodontics. Furthermore, two specialists in orthodontics who completed their training last year, have since taken up duty with the board. This brings the boards complement of specialists in orthodontics to three, with a further part time specialist employed by the board one day per week. In addition, the orthodontic department has one specialist trainee working in the department two days per week.
Last year, my Department provided additional funding of €5 million from the treatment purchase fund to health boards specifically for the purchase of orthodontic treatment. This funding is enabling boards to provide both additional sessions for existing staff and purchase treatment from private specialist orthodontic practitioners. Under the scheme, the Western Health Board received €465, 000 for the treatment of patients in this way.
The chief executive officer of the Western Health Board has informed me that the number of cases awaiting orthodontic assessment and treatment, as at 30 September 2002, were 599 and 1,066 respectively. This is a reduction of 539 on the treatment waiting list in comparison with the corresponding figure at the end of the December 2001 quarter. The chief executive officer has also informed me that the average waiting time for orthodontic assessment in the Western Health Board area at the end of September 2002 was nine months and that there were 1,403 patients receiving orthodontic treatment at that time.
Entitlement to secondary care orthodontic treatment is determined by reference to orthodontic guidelines, a set of objective clinical criteria applied by health board orthodontists when assessing children's priority of need for treatment. The orthodontic guidelines were issued by my Department in 1985 and are still in use. The orthodontic guidelines are used to ensure that orthodontic resources are prioritised for and applied equitably to the most severe cases. When a health board orthodontist decides that a child is in clinical need of orthodontic treatment in accordance with the criteria, he or she is then placed on a treatment waiting list. The guidelines are intended to enable health boards to identify in a consistent way those in greatest need and to commence timely treatment for them.
For children who are placed on a waiting list for treatment, the initiatives and structural changes that I have set out above will bring about an improvement in waiting times for treatment and positively impact on the future delivery of orthodontic services in the longer term.