Vol. 508 No. 2
8 Mr. Timmins asked the Minister for Health and Children if no first time patients have received orthodontic treatment in the Eastern Health Board area since April 1999; and if he will make a statement on the matter. [18224/99]
53 Mr. Timmins asked the Minister for Health and Children if he has satisfied himself that children have access to orthodontic treatment in the Eastern Health Board area; and if he will make a statement on the matter. [18223/99]
I propose to take Questions Nos. 8 and 53 together.
The orthodontic services in the Eastern Health Board area are being developed in accordance with the dental health action plan. The action plan provides for the development by each health board of a consultant-led orthodontic service. A consultant-led service ensures a service of high quality and high service levels.
Is the question being taken with another question?
My apologies. It is being taken with Question No. 53.
Due to the high cost of fixed appliance orthodontic therapy, health boards can only provide this treatment where a child has a handicapping orthodontic condition. Children are assessed, therefore, in accordance with guidelines drawn up by my Department to ensure that resources are used to best advantage and for those most affected or handicapped.
Following the appointment by the board of a consultant orthodontist in September 1996, a regional orthodontic unit, appropriately staffed and equipped, was established by the board on the campus of St. James's Hospital. A number of dentists with appropriate support staff were assigned to work in orthodontics under the direction, training and supervision of the consultant. Using this combined approach it has been possible to treat a large number of patients under the supervision of the consultant.
Since 1996 the board has made significant inroads in orthodontic waiting lists. The category one waiting list has been reduced from 681 patients to 83 patients and the category two list from 10,676 to 7,736. My Department is currently considering submissions from the board for the development of two further regional orthodontic units, one in north Dublin and another in south east Dublin.
I understand that some difficulties have been experienced at the regional orthodontic unit this year which have led to a unilateral decision by the consultant to cease the commencement of new treatments. These difficulties are of a sensitive nature and are being addressed by the board with the consultant and her representatives. The board envisages that they will be resolved in the short-term.
Will the Minister confirm, as the question states, that there have been no new appointments since April 1999? Is the Minister in a position to indicate how many children are currently awaiting orthodontic assessment as distinct from treatment in the Eastern Health Board area?
It is a separate question. I do not have the information available to me at present but I will get it for the Deputy if possible. It is not in the supplementary information available to me now.
I thank the Minister for his reply. Does the Minister have any idea when the ongoing dispute may be solved? The Minister mentioned that the category two waiting list is 7,000. Can the Minister indicate how long it will take to clear this list?
Those figures mean the waiting list has been reduced by two years but the average waiting list is still three years and ten months despite that reduction. The situation was horrific before that.
Does the Minister know when the dispute will be solved?
The advice I have from the board is that discussions are ongoing at present between the two parties and they will be resolved in the short-term. That is the information I have and I hope that will be the case.
Will the Minister indicate whether any discussions have taken place between the Minister and consultant orthodontists on the Moran commission regarding the future of orthodontics in the public health service? Why is the Cork dental school no longer recognised for training? Why is no dental postgraduate qualification in orthodontics—
Deputy, the questions relate to the Eastern Health Board.
Will the Minister deal with other health boards?
No, I cannot allow a question to be broadened to that extent. They relate specifically to the Eastern Health Board.
I must not be helpful.
Will the Minister put money into the training of public dental officers and orthodontists to ensure a qualification in orthodontics can be achieved in the State? In many areas there are no formal training arrangements and the whole area is a total mess. Will the Minister personally intervene in this area and try to sort it out? There are major disputes in all areas and empire building is going on in some places. This area needs the Minister's personal intervention. Will he personally intervene now? Is the Minister aware that 9,000 people are awaiting treatment in the Southern Health Board area?
The questions refer to the Eastern Health Board.
If the Deputy tables a question, I will give him a considered reply.
The Minister has no answer. It is a mess.
There is no question.
The Deputy should put down a question.
It is a mess.
If the Deputy takes the time to put down a question, I will give him a reply.
I put down a question yesterday. It is a total mess.
Why is the Deputy taking up the time of other Deputies who put down questions?
It is a total mess.
(Carlow-Kilkenny): Will the Minister consider doing something about the salaries of orthodontists working in public health boards? The situation in Carlow-Kilkenny has fallen behind. I was on the health board—
The Deputy should proceed by way of a separate question.
(Carlow-Kilkenny): I accept that, a Cheann Comhairle, but I know you share my concern for Carlow-Kilkenny.
That does not enable the Chair to relax the Standing Orders.
(Carlow-Kilkenny): You cannot ask questions so I am doing it for you. One cannot recruit orthodontists because they make so much in private practice. There will be an ongoing problem if something is not done regarding their salaries.
The strength of feeling expressed by previous speakers indicates how much concern exists about the mess the orthodontic service is in at present throughout the country and particularly in the Eastern Health Board area where there is an ongoing dispute. I ask the Minister to personally intervene because it cannot be allowed to continue. The rate of pay on offer is a major factor. The Eastern Health Board had considerable trouble recruiting one orthodontist, which is totally inadequate for the size of the area. I ask the Minister to start taking charge of this area which is in a mess at present. It needs radical reform and funding as a matter of urgency, particularly in the Eastern Health Board area. Will the Minister give an undertaking to review pay scales because the current pay scale available for a consultant orthodontist is not attractive enough to encourage somebody to work in the public sector?
Pay scales are the subject of another question.
I can only note the Deputy's opinion in relation to that matter. Regarding resolving the issue which has caused problems over the last few months, the Department is informed that the matter should be resolved very shortly. That is the position.
Does the Minister agree that a three year and ten months average waiting time for a child to have orthodontic care is scandalously inadequate? Will the Minister indicate when he anticipates this waiting time period will be reduced? What is the Minister's objective in terms of the time he believes children should wait before they receive orthodontic treatment which has been assessed as necessary?
As I stated earlier, under the previous Administration the waiting time was five years and ten months. It is now three years and ten months. Perhaps if I stay in office longer, it will be much better in two years.
The Minister has been in office for two and a half years.
The waiting time has reduced by two years. That is the answer to the Deputy's question.
The service in the Eastern Health Board is grinding to a halt.
All facts are friendly.
I call Question No. 9.
There is a two year waiting list for assessments at this stage. People are not being given appointments so the real waiting list is disguised.
Question No. 9.
I know the Deputy has difficulty accepting waiting list figures but he has been proved wrong on every occasion so far.
