Vol. 522 No. 3
11 Mr. Durkan asked the Minister for Health and Children if his attention has been drawn to inadequacies in the orthodontic service; if sufficient efforts are being made to ensure early attention to children and young adults on the waiting lists; if the problem of sufficient numbers of consultants has been resolved; and if he will make a statement on the matter. [18420/00]
167 Mr. Durkan asked the Minister for Health and Children the reason reasonable progress has not been made in regard to the provision of orthodontic treatment, in view of the fact that this issue has caused serious concerns for at least ten years; and if he will make a statement on the matter. [18752/00]
I propose to take Questions Nos. 11 and 167 together.
I am aware of the difficulties in the orthodontic services. There has been considerable investment over the past few years under the dental health action plan in the setting up by the health boards of orthodontic services. All boards, with the exception of the Midland Health Board, have a consultant-led service in place. The Midland Health Board provides orthodontic services by arrangements with private orthodontists. Nevertheless, despite these developments in the service, waiting times for treatment are in some instances unacceptably high.
I am continuing to develop the orthodontic services in accordance with the dental health action plan. This year I am making an additional £1.45 million available to the health boards on an ongoing basis for the further development of their orthodontic services.
The Moran report, made to the chief executive officers of the health boards on the future development of orthodontic services, has been under discussion between my Department and representatives of the chief executive officers. Some interested parties have also commented on the report. A number of recommendations in the report are being implemented as part of the dental health action plan. My Department has issued a comprehensive response to the various recommendations in the report.
The report, in conjunction with my Department's response, provides an agreed framework for progressing various issues in relation to the orthodontic services. In particular, there is agreement on the recommendation that specialist orthodontists appropriately trained, qualified and registered be employed in the orthodontic services. The Dental Council has agreed to set up a specialist register. This issue is now being advanced with the staff association at the Health Service Employers Agency. The creation of the grade of specialist orthodontist will considerably enhance the service provision and help to retain trained staff in the services by providing them with a suitable career structure.
My Department recently gave approval for two additional posts of consultant orthodontist in the Eastern Regional Health Authority area. The authority is in the process of filling these posts in conjunction with the Local Appointments Commission. The filling of these posts, combined with the setting up of two new regional orthodontic units at Loughlinstown and Beaumont hospitals, should help to significantly reduce the current waiting times for treatment in the area of the Eastern Regional Health Authority. I have indicated approval of additional funding of £100,000 per annum to Cork Dental School to support the appointment to the school of a professor in orthodontics so that priority can be given to the provision of specialist training programmes in orthodontics for health board dentists in the orthodontic units. In addition, I have invited the Southern Health Board to consider the appointment of an additional consultant orthodontist.
I have also recently asked health boards to submit proposals to me as to how waiting lists and waiting times for orthodontic treatment in their areas might be further reduced. Proposals from some boards are still awaited. I hope to respond to all boards on their proposals by end July.
Does the Minister agree the orthodontic service is a catastrophe and that there has been total inaction? The Minister should ask why the additional resources have not reduced the lists but rather increased them. Why has the Moran report not been implemented in full? Why has the Midland Health Board, which employs private orthodontists, one of the shortest waiting lists and times? Why are private orthodontists not used to reduce the four and a half year waiting list in the Western Health Board area? The Minister has not contacted that board to find out what additional resources it needs.
I have contacted the Western Health Board.
The Minister mentioned the Southern Health Board and the Eastern Regional Health Authority. The situation is chaotic.
I contacted all health boards. I agree that health boards should use private orthodontists if they wish. I have told them to do so and I will provide the resources to reduce the lists. The lists are too long. The Deputy is correct that this is not just an issue of resources. There have been particular problems with orthodontic services over a number of years. Patients are suffering and I am not prepared to stand for that. We had useful discussions with the health boards. We held discussions with the ERHA and the Southern Health Board because of the particularly long waiting lists in those areas and because they have particular difficulties.
The waiting time in the Western Health Board area is four and a half years.
That is why I invited all health boards, particularly the ERHA and the Southern Health Board, to provide me with action plans we will resource. I met the ERHA team. It is appointing additional consultants and assured me there will be a significant improvement in waiting times and waiting lists by the end of the year. We put the same issue to the Southern Health Board and invited all health boards to come back to us with their plans.
The Minister's one minute has concluded.
I want to announce my response to those plans by the end of July.
I accept the Minister is concerned about this issue, but is he aware of the woeful long waiting times in Dublin and the ERHA area? Is he aware, for example, that young people who are patently in need of urgent attention are not accessing treatment? Some young patients received orthodontic treatment and had retainers and braces fitted. In some cases these devices should have been removed but they have not been, so the treatment is now causing problems. Will the Minister ensure these people are attended to in some way? It does not matter how they are attended to as long as they are attended to. Otherwise, the actual treatment is doing damage to their teeth.
Will the Minister further ensure that when people obtain an appointment date, and that is a rare enough occurrence, they do not receive a telephone call from the health board on the day of the appointment to the effect that the appointment is cancelled until further notice? This is unacceptable and disgraceful. I am glad the Minister is taking this issue seriously, but he needs to tend to the reality of the matter.
Four other Deputies are offering. I will allow a brief supplementary from each Deputy and a final reply from the Minister.
A Leas-Cheann Comhairle, I think the Minister wishes to reply.
I have no problem if the Minister wishes to reply. That is fine and we will move on to the next question.
A Leas-Cheann Comhairle, do you wish me to answer all the questions together?
Is it the Minister's view that lists are increasing because people are becoming more concerned about dental health and cosmetic issues in terms of how they look?
(Carlow-Kilkenny): Will the Minister carefully consider the position in Carlow-Kilkenny and the South Eastern Health Board area? This is not a question of local politics, this area has had problems with orthodontic services since I was a member of the health board, and that is many years ago. We are receiving large numbers of telephone calls on this issue from frustrated parents.
Does the Minister agree that after three years in office, orthodontic services nationally have been scandalously neglected by the Government? Does he also agree it is unacceptable that 20,000 children nationwide are waiting for assessment? Does he further agree that 14,000 children nationwide are waiting for treatment and that the average waiting time is approximately four and a half years? Does he acknowledge that neither he nor the Government can wash their hands of responsibility for this disaster having been in office for three years?
Does the Minister consider it acceptable that children in the Western Health Board area are being moved down rather than up the list because of the lack of resources and staff? When will he ensure equality of treatment between health boards? Children in the Western Health Board area are getting a raw deal compared to those in other health board areas because long waiting lists mean the Western Health Board deals with only the more severe cases. What is the Minister doing to resolve this?
I am aware of the issue raised by Deputy McManus. I recently met the ERHA's orthodontic team and we have sanctioned the appointment of two additional consultant posts as well as other additional measures. The ERHA estimates it could significantly reduce the lists by Christmas. I will raise the issue of young people who have already received treatment with the ERHA's orthodontic team to see if we can facilitate it in its plan.
Deputy Gormley asked why lists are increasing. I do not think this is due to cosmetic reasons alone. However, this is a sensitive issue for young people. Some people are of the view that too many people are looking for too many services. I do not accept that view and we should not turn away customers. We should respond to the very real needs of young people in terms of their social and psychological development. That is the approach I am taking to this issue.
Lists have been increasing for a long time and not just in the past three years. This has more to do with issues in the orthodontic and dental fields than many other issues. I will say no more than that at this stage. We have run out of time and neither I nor the Oireachtas can tolerate this situation any longer.
Deputy Browne raised the situation in the South Eastern Health Board area. We have asked all health boards to come back to us with proposals and we will announce our response to them. Deputy Naughten mentioned the Western Health Board area. It is clear from all Deputies that this is an issue in all health board areas.
The problem is worse in the Western Health Board area. The situation is a sham.
I asked the chief executive officers for their plans in this regard during my first meeting with them.
The Minister has presided over this situation for three years.
I ask the Minister to conclude.
I ask Deputy Shatter to reflect on what he said. Perhaps if the Oireachtas adopted a unified stance for once and stopped trying to—
The Minister has been in office for three years.
The Opposition said the same when the Deputy's party was on this side of the House. The issues can be resolved elsewhere.
The situation is a sham and a disgrace.
People should speak to their respective health boards, sort out the problem once and for all and stop pussing footing around.
That concludes Question Time.
Written Answers follow Adjournment Debate.
