Ceisteanna — Questions. Oral Answers. - Dental Services.

18.

asked the Minister for Health if he will make a statement on the current dental services available in this country; in particular, the plans he has to provide for an orthodontic service in the entire Eastern Health Board area; and if he will make a statement on the matter.

Last year, due to my concern about the level of health board dental services generally, I set up a small working group under the chairmanship of Deputy Terry Leyden, Minister of State at my Department, to review health board dental services and, where appropriate, to make recommendations for their improvement. The working group's report, which contains details of the current level of services available, was issued in December 1988 and I am arranging to have a copy of it sent on to the Deputy.

In regard to the orthodontic service in the Eastern Health Board, I recently agreed to the secondment of the deputy chief dental officer of my Department to the health board for a short time to review the board's arrangements for the delivery of dental services, including the orthodontic service and, where necessary, to make recommendations for their improvement. The deputy chief dental officer's final report is expected to be available shortly.

In the past two years the Eastern Health Board entered into arrangements with the Dublin Dental Hospital whereby the hospital provides a certain amount of orthodontic treatment on behalf of the health board. Under these arrangements the health board are funding a post of registrar in the orthodontic department of Dublin Dental Hospital and the hospital is assisting in the training of a number of health board dentists in advanced orthdontic techniques. These arrangements have led to a considerable improvement in the availability of orthodontic treatment for eligible persons in the Eastern Health Board.

The Minister's reply is extremely disappointing. I am not interested in receiving a copy of any report. We have received enough reports since the Minister took office. It is now time for action. Is the Minister aware that there are as many as 1,000 children in the Dublin area awaiting essential orthodontic treatment? Is the Minister aware that many of the parents of those children have contacted Members on all sides of the House seeking those services for their children before they move on to second level education? Is the Minister aware that there is virtually no orthodontic service available in the Dublin area? Will he, as a matter of urgency, ensure that sufficient people are appointed, be they ordinary dentists or whatever, to provide treatment for those children? I am sure there are people qualified to do that work in needy cases.

It appears that Deputy Harney only listened to the first half of my reply. I referred to Deputy Leyden's, the Minister of State's report which was circulated in December 1988.

What does the Minister intend doing about the recommendation in that report?

The report has been shelved.

I have pointed out that in the last two years the Eastern Health Board entered into arrangements with the Dublin Dental Hospital under which that hospital provides orthodontic treatment on behalf of the health board.

That is not working.

That is a new agreement. Under these arrangements the health board are funding a registrar post in the orthodontic department of the Dublin Dental Hospital. I should like to point out, and I am sure the Deputy can recall this, that my predecessor, Deputy Desmond, arranged that the Local Appointments Commission would appoint five orthodontists and that, following a competition, it was only possible to recruit one orthodontist.

Why was that?

The Minister should pay them properly.

The problem about orthodontists has been with us for a long time.

Will the Minister come clean and admit to the House that he has shelved the implementation of the Leyden report on the dental services? Will he further confirm that report concluded that health boards were breaking their statutory obligations under the 1970 Health Act to provide a dental service to the 1.9 million people who are medical card holders? Will the Minister accept that he has not done anything to rectify the situation? Is he aware that old age pensioners have to pay between £200 and £300 for dentures and that there is, effectively, no routine dental maintenance service for medical card holders.

I accept that the dental service is not what we would wish it to be. Indeed, long before I was elected to this House, the dental service was totally inadequate. At a time when there was plenty of money in the country there were no dentists available. The service is not what we want but there are 240 dentists working in the public dental service, it is untrue to say there is no service. I have referred to the arrangements which the Eastern Health Board have made and the arrangements that have been made with private orthodontists for the treatment of children in need.

The Minister is misleading the House.

Arising out of the Minister's admission that the dental service is totally inadequate, and the growing frustration on all sides of the House with the Minister who whenever a crisis emerges, responds by calling for reports or establishes committees but does not take action, what does he intend to do to make an adequate dental service available to our people? Is he suggesting that another report should be prepared or another committee established? We are all fedup listening to the Minister's——

The Deputy may not embark upon a speech.

——assertions that committees should be established and reports prepared when people must face life with deformed mouths.

This is not the time for speechmaking.

There is no dental service for pensioners.

Will the Minister indicate what he intends doing to alleviate what he has admitted to be a totally inadequate dental service?

The question refers to the orthodontic service in the Eastern Health Board area and I cannot allow an extension of that question.

In the first part of the question the Minister was asked to make a statement on the current dental services available in the country.

The question deals primarily with the Eastern Health Board.

That is wrong.

I have allowed some latitude in the matter.

The first part of the question clearly asks the Minister to make a statement on the current dental service in the country. The Minister has already made a statement and has told us that the service is inadequate.

Today is not the first day that I have said the service is totally inadequate.

What does the Minister intend to do about it?

I was a member of a health board for 16 years and it was inadequate then.

What does the Minister intend to do about the service? It has broken down.

(Interruptions.)

Order, please. May I appeal to the ingrained sense of fair play of Deputies?

The Minister has his backbenchers to support him.

I should like to tell Deputy Mitchell that I will not tolerate any more of his insolence. I am appealing to the sense of fair play of all Members in saying that when they ask questions they ought to listen to the replies.

What about fair play for those who are waiting four years for treatment?

Some time ago I asked the health boards for proposals and estimates of the funding requirements to clear the adult waiting lists over a three year period.

The Minister cut their allocation.

The last of the health boards has only recently responded to that request and we are presently examining the proposals of all eight health boards.

Will the Minister undertake to give the health boards more money?

Orthodontic care in the Eastern Health Board area is provided by the following means——

The Minister is totally oblivious to the position in the suburbs of Dublin where children have to wait four or five years for treatment.

It seems to me that certain Deputies are determined to shout down the Minister. That is not the type of procedure with which we should conform in the House.

In fairness, the Minister said that the dental service was always bad but the position is that thead hoc scheme that was in operation has been abolished.

This is Question Time and the Deputy should not make a speech.

We do not have a dental service. The Minister is presiding over the worst deterioration of the health services in the history of the State. Pensioners are being asked to pay between £200 or £300 for dentures.

(Interruptions.)

Deputy Yates should desist from making a speech. I am calling the next question.

With respect, the Chair should permit the Minister to conclude his reply.

The Minister has abolished the dental service for children between four and five years of age which means that it will be too late for them to obtain corrective treatment. The Minister is totally oblivious of the position in suburban Dublin.

What does the Minister intend to do about the waiting list of 24,000 for orthodontic services?

(Interruptions.)

If these tactics are going to continue at Question Time in future they will, as far as I am concerned, be very short-lived. I will not tolerate continued disorder in the House.

How else can we highlight this dreadful problem?

Deputy Mitchell was in Cabinet for five years but he did not do much.

Deputy Mitchell is primarily responsible for this disorder.

The Chair has already thrown out two Members.

I am surprised at Deputy Yates.

Some children will not receive orthodontic treatment.

I am calling on the Minister to reply to Question No. 20.

(Interruptions.)