asked the Minister for Health if he will state, in view of the long waiting period for orthodontic treatment for school children and the high cost of private treatment, the steps he is taking to provide treatment for children within a reasonable period of time.
Ceisteanna—Questions. Oral Answers. - Orthodontic Treatment.
11.
Five full-time posts of consultant orthodontist for the health boards have been approved and are with the Local Appointments Commission for filling. Applications for the posts were invited recently.
The health boards will continue to have a certain amount of orthodontic treatment, particularly of the more complicated cases involving the use of fixed appliances, provided on their behalf by orthodontists in private practice. The absence of an agreed scale of fees has caused a hold up in the issue of authorisations to proceed with this type of treatment in recent years. However, agreement is expected to be reached very soon between the Department and the private orthodontists on a special scale of fees for this treatment when provided for health board patients.
Both these measures should lead to a considerable reduction in the present waiting time for orthodontic treatment for school children.
Do I take it that if the health boards produce five names the Minister will agree to appoint them? Will those people be appointed immediately they are selected?
There was considerable difficulty in this regard. Five posts were agreed — one for the Eastern Health Board area to serve the North Eastern and Midland Health Boards, one for the Southern Health Board, also to serve part of the Mid-Western Health Board area and one for the Western Health Board also to serve part of the mid-west area; then one for the north west and one for the south eastern area. The qualifications for the post have been agreed with the Local Appointments Commission. Negotiations with the Dental Association and the Local Government and Public Services Union have been finalised regarding salary and conditions of service for the posts.
We wrote to the health boards late in December 1982, indicating that there was now no objection to the filling of the posts being proceeded with. The position is that all the posts have been cleared in all respects by my Department. They are now with the Local Appointments Commission for filling and applications for the posts I think will be invited with the next few weeks.
Why are orthodontists being appointed to five health boards only? Why are three health boards being left without their own orthodontist?
For the very simple reason that last week I answered eight or nine questions and today I have answered another half a dozen questions and that so far we have spent £11 million. I might say to the Deputy that the expenditure on that alone is well over £100,000.
Would the Minister not accept that it would be more economical, say, in the North Eastern Health Board to appoint their own orthodontist rather than use the consultancy service as they are doing at present, and that indeed by so doing he might well save money?
For the simple reason that the North Eastern Health Board like every other health board, wants to have a consultant obstetrician-paedetrician in every small hospital, and they want to have an orthodontist in every clinic in every area.
But they are using a consultancy orthodontist service at present.
But in revenue costs that amounts to £100,000.
Does the Minister begrudge those services?
I do not begrudge anybody anything except that people must pay for it.
Is the Minister aware that in the Midland Health Board there is a very considerable waiting list for orthodontic treatment? Do I take it from what the Minister said in an earlier reply to Deputy De Rossa here today that he commenced discussions on this matter in December 1982 and that now, practically a year later, there has been no movement in the availability of orthodontic treatment for young people? Is the Minister aware also that this is the type of treatment which, if not given when needed, will lead later to irreparable damage?
I do not dispute in any way what the Deputy says. I am saying that within my Department's expenditure, of necessity, I am not in a position to spend a great deal of money. But I would point out that the filling of the five posts will do two things: firstly, it will reduce the waiting list very considerably and, secondly, reduce the need for health boards to use the service of orthodontists in private practice, which is also a very good thing——
When will that commence?
It will not eliminate it entirely because there will still be need to use private orthodontists in the most complicated cases, for example, the fixing or insertion of fixed appliances. A number of them specialise in this area and five new men coming in cannot do all of that work. But I can assure the Deputy that, in terms of reducing the waiting list, that constitutes a major measure.