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Dáil Éireann debate -
Tuesday, 22 Feb 1994

Vol. 439 No. 2

Adjournment Debate. - South Tipperary Orthodontic Service.

A Cheann Comhairle, I wish to thank you for allowing me to raise the matter of the enormous dissatisfaction with the orthodontic service in South Tipperary. This is not due to the staffing in the county clinic in Clonmel but rather to the restructuring of the scheme by the South Eastern Health Board. Parents are at the point of desperation, not knowing if or when orthodontic treatment will be available to their children.

This is the second time in the past three years that I have raised this issue in this House and the numbers worried about the delay in obtaining orthodontic treatment continue to increase. I have had no success in getting information about when orthodontic treatment will be available to particular students. This is frustrating for me but exasperating for the parents, who rightly feel obligated to have their children's teeth treated. Children often suffer severe embarrassment and sometimes personality problems because of protruding or crooked teeth. This can hinder a young person's overall development and interfere with school performance.

I have given details of just one girl in South Tipperary who has been on the waiting list for four years. She is now in fifth year and she and her parents are desperately worried about whether she will receive orthodontic treatment before she completes second level education. She is just one of many in this situation. This is unacceptable and unfair. When I contacted the health board in regard to this student I could not get any information as to when treatment would be available.

The last time I raised this in the House I was told that the delay was due to the lack of an X-ray machine. That has been provided, but now there seems to be some other problem. I cannot understand why there is no information about how many are on the waiting list and whether a student will be seen in three months, in six months or within a year. The health board should be able to give some idea of when the service will be available and that would relieve parents of some of the frustration. Because of the lack of any guarantee from the clinic that orthodontic treatment will be provided, I have seen parents who cannot afford to do so resort to trying to provide private treatment, and we all know how expensive such treatment is. It is unfair that any parent should be put in such a situation. I cannot understand why we cannot be told how many are on the waiting list, where a student is placed on the waiting list and when the treatment will be available. The lack of information is totally frustrating. The problem is compounded by the fact that I, as a public representative, cannot get the information either.

I look forward to the Minister's reply in the hope that he can give some explanation. Most important, a directive should issue to health boards to tell people how long they must wait for this service. Above all, I hope the Minister can give me an assurance that the orthodontic service for people on the waiting list in South Tipperary will be up and running and that there will be some cut in the waiting time over the next year.

Responsibility for the provision of orthodontic treatment to persons from the South Tipperary area is a matter for the South Eastern Health Board. I have obtained information from the South Eastern Health Board regarding this case. The board have informed me that an appointment will issue to this person next week to attend the regional orthodontic unit to begin treatment within the next two months.

Children requiring attention are categorised according to the severity of their condition. The most urgent cases, or category 1 — for example, cleft palate — are treated immediately. Other categories are dealt with in order of severity and in the order in which they are placed on the waiting list. Category 2 cases can have a severe functional handicap such as a marked overbite or overjet relationship of the teeth and jaws, while category 3 cases are non-handicapping and have a lesser need for treatment.

Orthodontic treatment can take from 18 months to two years to complete and according as treatments are completed new cases are brought into treatment.

For the past few years special additional allocations have been provided to the South Eastern Health Board specifically for the development of their orthodontic services. A full time consultant orthodontist has been employed by the South Eastern Health Board since 1992. Facilities for the consultant orthodontist have been provided at Waterford Regional Hospital and will come on stream in April this year. Part of the consultant orthodontist's role will be to train health board dental surgeons to sub consultant-secondary care level and in this way significant improvements can be made in the number of treatments carried out. To this end, initially, two dental surgeons will be working with the consultant orthodontist on secondary care cases in the Waterford Regional Hospital facilities. This will result in more cases receiving treatment. Additional dental surgeons will be appointed to the orthodontic team as resources allow over the Programme for Government. In addition, health board dentists work in each community care area carrying out simple orthodontic work under the supervision of the consultant orthodontist.

The Minister is committed to the development of the health board orthodontic services as outlined in the Programme for Government. As part of an overall development of the dental services it is the Minister's intention to provide additional resources to the health boards to develop their primary and secondary care orthodontic services. In 1993 the Minister provided £85,000 to the South Eastern Health Board for developments in the orthodontic services and he will be providing additional moneys this year for the further development of the services through the employment and training of health dental surgeons to carry out orthodontic work at secondary and primary care levels under the direction of the consultant orthodontist.

In regard to the Deputy's request, I am somewhat surprised at the lack of communication from the South-Eastern Health Board in regard to people on waiting lists etc. I will communicate tomorrow with the chief executive officer of the health board and request that performance be improved in relation to communicating that type of information.

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