Michael Ring
Question:106 Mr. Ring asked the Minister for Health and Children if he will contract private orthodontists to provide treatment for children in view of the large waiting lists for treatment nationally. [24520/00]
Priority Questions. - Orthodontic Service.
The provision of orthodontic services is the statutory responsibility of the health boards. At present, there are significant waiting lists and waiting times for the provision of orthodontic treatment. There are currently more than 18,000 children on the assessment waiting lists and 12,000 on the treatment waiting lists, with a waiting time for treatment of between two and five years. However, treatment of the most severe cases commences straight away.
Following a review of the orthodontic services carried out by health boards in 1998 – the Moran report – structural changes are being introduced in the orthodontic services. A grade of specialist in orthodontics will be introduced following completion of negotiations under the Health Service Employers Agency. Efforts are being made to progress with the relevant authorities the putting in place of training programmes for dentists working in the regional units to allow them to reach specialist level. My Department has approached the Dental Council concerning the recognition of a new grade of auxiliary dental worker in orthodontics. I hope these structural changes, when fully on stream, will allow target service levels to be achieved.
In the meantime, I have been considering a special initiative on the orthodontic waiting lists. Under this initiative, it would be open to health boards to contract the services of private orthodontists at approved rates. The effect of the initiative would be to increase the numbers in treatment and significantly reduce waiting times.
Is the Minister aware that some children in need of orthodontic treatment do not want to attend school or socialise with other children? This is a national scandal. I question the Minister's figures because there were 24,000 people on the waiting lists in October 1999.
The Government and the health boards have failed to resolve this crisis. Will the Government consider providing direct grant aid to families to allow them to obtain private orthodontic treatment for their children? It is not acceptable that children will not go out to play and are constantly crying because they are self-conscious.
We have listened to the Minister speaking about various reports and initiatives, yet nothing has happened and the situation in the health services is deteriorating. Earlier, Deputy Mitchell spoke about waiting lists to get on to waiting lists for orthodontic treatment. There are problems with staff. A number of years ago the Department looked to Sweden for staff, and now the situation is getting worse. Would the Government consider giving grant aid to parents to deal with the problem, at least until the waiting lists are dealt with?
I am not considering giving grants to parents or families to procure orthodontic services. However, I will shortly announce a special initiative for the orthodontic waiting list. I am not happy with the length of the waiting lists, but they have existed for a long time and we have had many difficulties in certain health boards, including in terms of personnel, which have exacerbated the situation. Additional investment is also required.
The Deputy's question spoke about whether health boards could contract private orthodontists. Some health boards are doing that and that option will be available to health boards throughout the country. It is important that we build up public sector capacity in the orthodontic service, which means an increase in the number of specialists. Doing that has been delayed in terms of discussions with the Health Services Employers' Agency and working out a deal. It will result in more consultant appointments in certain health boards. We have already approved a significant plan for the ERHA area and are doing the same in the Southern Health Board area, the areas with the largest orthodontic waiting lists.
I am determined that over the next 12 months there will be a very significant reduction in the waiting times for children awaiting these services.
What has been tried in the past has not worked. In the Western Health Board area the waiting list time has increased from two to five years. In four years the numbers on the list have increased from 1,376 to 4,500. It is a serious crisis and we need thinkers, real action and a commitment from the Minister. I also ask the Minister to stop the wits in the health boards telling parents that people in need of the orthodontic service can be treated up to the age of 75. That is a disgraceful answer which I and parents find insulting. The Minister should write to the chief executive officers of all the health boards to ask them to stop giving that outrageous and ridiculous answer.
Will the Minister tell us what he will do about this very serious problem?
I have made clear what I will do and that I do not propose to take the route suggested by the Deputy.
I suggested a grant.
I do not propose to take that route.
That is a pity.
It would be haphazard and would constitute a scatter-gun approach. We must build up expertise in the orthodontic units in each health board area in a structured way. We cannot go down a road which would ultimately undermine the capacity of the public sector to do the business properly over the medium term.
I suggest a grant until the waiting lists have been dealt with.
There is no argument about the need to reduce waiting lists.