asked the Minister for Health when it is hoped to make the necessary finance available to the North-Western Health Board to provide a proper dental service.
31.
Ceisteanna—Questions. Oral Answers. - Dental Services.
7.
asked the Minister for Health if he will allocate funds to health boards in order to provide a dental service for adults where no such service exists.
I propose to take Questions Nos. 7 and 31 together.
It is a matter for the health boards to allocate as they see fit the funds available to them between the different services they provide. The ad hoc dental scheme whereby adults are referred for dental treatment by private practitioners has been suspended in the Mid-Western, Southern and Western Health Boards and curtailed in the North-Eastern and North-Western Health Boards. However, the dental staff of these health boards provide dental treatment for eligible adults in priority groups such as expectant and nursing mothers, the handicapped and the elderly. Emergency treatment for the alleviation of pain is available to all eligible adults in all health boards, but eligible adults who require routine dental treatment but do not belong to a priority grouping are placed on a waiting list for treatment when resources become available.
Is the Minister aware that the budgetary cut-backs to the North-Western Health Board amount to more than £3 million and because of that the board find it difficult to provide a proper dental service? Is the Minister aware that 3,575 children are awaiting treatment in Sligo and Leitrim, that the children have been tested and identified as needing treatment but cannot get it because of the long waiting list and the shortage of dentists? Is the Minister aware that 56 adults urgently need treatment and that 181 are waiting for orthodontic treatment in Sligo and Leitrim? Those figures are frightening as, I am sure, the Minister will agree.
I must make the point that during my period of office there has been a substantial increase in the number of adults in the Deputy's health board area who have received treatment.
In 1982, 5,962 received treatment and that figure rose to 7,893 in 1985. I accept that the waiting list of 1,800 is still substantial, but the volume of work is increasing all the time, particularly in that health board area.
I am sure that if I added the figures for Donegal to the figures for Sligo/Leitrim which I quoted the picture would be even worse. What does the Minister propose to do about the 3,575 children who are awaiting treatment and the 181 who need urgent orthodontio treatment? I am aware, from representations I have made, that the waiting list is very long, particularly for orthodontic treatment.
If we can get a consultant orthodontist to take up a post in the Deputy's health board area on the basis of a public service salary and pension — I must stress the word "pension"——
What about facilities?
——we will willingly provide the resources. We have not been able to do so. In relation to the Eastern Health Board area, we had to combine such a post with an academic post to enhance the position in order to tempt an applicant to take the job.
The salary, and the pension, are not the issues; facilities are also important.
Does the Minister know, or is he concerned that the poorest people in the country cannot receive a dental service unless they are in the priority group he referred to, that they are handicapped or awaiting major surgery? Is he aware that the ordinary adult who needs a filling can go on a waiting list in the sure knowledge that he will never be attended to? Is he aware that in many community care areas such people are not put on a waiting list because nobody will suggest that they should? Is it not dishonest to put people who are waiting for a filling in a waiting list knowing that they will never be attended to? The Minister may tell Deputy Brennan that more people are being attended to in the North-Western Health Board area, but I wonder if he is aware of the extent of the problem. I met a woman last week who was on her way to the credit union, or the bank to borrow money to pay for treatment for her children because she could not get it under the health services. Many genuine cases are not being attended to because the facilities are not there due to lack of funding.
I find it very strange that health boards, including the Deputy's, could spend £10.5 million last year on travelling expenses and cut back on the dental scheme. That is the kind of priority which I call into public question. I have provided for the Deputy's health board area and all the other areas a full scale scheme of consultant orthodontists——
I am not talking about orthodontists.
A great deal of the work on the waiting lists is orthodontic work. On the ad hoc side, the general dental side, I am very much opposed to the policy of health boards not to take on full time dental officers. Health boards have been endeavouring to farm out this work on an ad hoc basis to private practitioners. It would be far better and less costly to have a proper dental staff for the treatment of adult patients considering the high fees charged by private practitioners. The number of dental officers has not fallen, generally speaking, but the demand has increased because everybody is far more conscious these days of the need for dental care. I hope the health boards will review their decisions on expenditure, particularly in regard to the ad hoc schemes. In the Western Health Board and elsewhere they have taken up the post of consultant orthodontist and there has been remarkable progress made with the waiting lists, which have been slack. It is a matter for the health boards.
The money is being allocated and there has been no reduction.
If the health boards find themselves unable to provide the service because of lack of funding, and the Minister must accept that there has been a real decrease in the moneys allocated to health boards since he came to office, will the Minister increase the funding? He referred to travelling expenses. Surely the Minister will accept that travelling expenses for public health nurses is a necessary part of the service. Health boards cut by 10 per cent the travelling expenses of public health nurses when the Minister told them there must be a shift to community care. If health boards find that they cannot provide a dental service without curtailing other essential services, will he allocate funds to them to ensure that the poorest in the land will be provided with a proper dental service?
The Minister gave a rather shocking figure of £10.5 million for travelling expenses. What proportion of that went on official travel rather than for members of the boards?
Lest there be any public misapprehension about it, I would stress that the proportion for members of health boards is fractional. However, there is a question to be asked about why thousands of people delivering the health services throughout the country crisscross county boundaries, sometimes three times a day, day after day——
Will the Minister stop trying to get away from the question? Will he provide money so that health boards can provide dental and other essential services?
I will not answer in the afirmative. I am saying simply that within the existing framework the health boards have enough money to provide an extremely good dental service.
Would the Minister have a heart and move into a higher gear? There are 30 questions for oral reply, we are at Question No. 7 and there are 55 minutes gone. Some of us put a lot of work into these questions and they will never be reached. There is not even an attempt being made to reach these questions. It is a disgrace.