Jimmy Deenihan
Question:108 Mr. Deenihan asked the Minister for Health and Children the position regarding reducing the waiting list for orthodontic treatment in the County Kerry region; and if he will make a statement on the matter. [24578/00]
Other Questions. - Orthodontic Service.
David Stanton
Question:197 Mr. Stanton asked the Minister for Health and Children the number currently awaiting assessment and treatment respectively at the orthodontic clinic in St. Finbarr's Hospital, Cork and at the associated outreach clinics; the measures that are being put into effect to deal with these waiting lists; and if he will make a statement on the matter. [24576/00]
I propose to take Questions Nos. 108 and 197 together.
The provision of orthodontic treatment and the maintenance of orthodontic waiting lists in the Southern Health Board region is the responsibility of the board. According to returns submitted to my Department the numbers on orthodontic waiting lists maintained by the Southern Health Board, at the end of September last, were as follows: assessment 5,000; treatment 4,364. However, the board points out that it is currently in the process of validating the waiting lists and therefore feels these numbers are subject to revision.
This year I made an additional £0.25 million available to the Southern Health Board for the further development of its orthodontic services. This funding has enabled the board to undertake a number of initiatives as follows: opening of four additional dental chairs in the orthodontic unit at St. Finbarr's Hospital which will bring the total number of chairs there to ten – this will substantially increase the capacity of the unit; upgrading the computer system in order to provide accurate and timely information and speed up the processing of appointments.
I have also undertaken to provide additional funding of £0.1 million to the Dental School next year to assist the school in the recruitment of a professor in orthodontics to facilitate the development of an approved training programme leading to specialist qualifications in orthodontics which will be open to health board dentists working in the regional orthodontic units.
The geographical distribution of children on the waiting list will only be accurately known on completion of the waiting list validation. The board will then be better situated to evaluate the service needs of the Kerry area.
At my invitation the board has submitted proposals to my Department to significantly reduce orthodontic waiting lists as part of my proposed initiative on orthodontic waiting lists. The board's proposals include: the appointment of an additional consultant orthodontist based in St. Finbarr's Hospital; the appointment of an orthodontist with specialist qualifications based in Tralee; development of a new orthodontic unit in Tralee; the recruitment of four additional dental teams with secretarial and radiographer support in the Cork unit; the recruitment of two additional dental teams and secretarial and radiographer support for the Kerry area.
I will respond shortly to the board on these proposals.
Despite the fact that the Minister does not have the figures there are 1,073 young people awaiting orthodontic treatment in Kerry. Will he accept for a county the size of Kerry that such a waiting list in unacceptable? It is unacceptable that teenagers should have to wait three and a half years for a basic service. Can the Minister give a time frame for the appointment of a specialist orthodontist for Kerry to alleviate the growing waiting list?
I agree with the Deputy's concerns about the orthodontic service in the Southern Health Board area. There have been difficulties there over several years which have allowed the build-up of the back log currently being experienced. I asked the board to present proposals to me. I made it clear to the board and to every other health board that I wanted realistic proposals which would have a measurable impact in as short a time as possible on the waiting lists and on the waiting times in particular. The health board has made a substantial proposal. I have, more or less, considered the various submissions made and I hope in the next few weeks to be in a position to make a definitive response.
Is the Minister aware there are 10,000 patients awaiting assessment in the clinic in Cork? Is he aware that the consultant orthodontist has said the service is in danger of collapse? Will he agree there are parents whose children are suffering needlessly because of the lack of a response from his Department on this issue? Is there empire building going on in the Department where this is concerned? Will the Minister intervene in a hands-on fashion? There are parents who, having waited for years, are told their child's problem is not bad enough to warrant treatment. They have to pay thousands of pounds for this treatment which should be provided by the State.
I am taking a hands-on approach to the orthodontic service and particularly in respect of the difficulties in the Southern Health Board area and in the ERHA. Let us be straight, it is not all about funding. There are very strange relationships between key players in the provision of orthodontic services and the patient and the punter has suffered as a result. I will not stand for that. I will make alternative arrangements that will ensure we build up the capacity and that people get the service to which they are entitled.
Referring to the Minister's previous reply, will he confirm that he will appoint a specialist orthodontist in Kerry to serve five days a week to reduce the waiting list fivefold? The current consultant orthodontist visits Kerry one day per week. A permanent specialist orthodontist in Tralee would reduce the waiting list fivefold and would rectify the problem. Will he confirm that he will make such an appointment – as one decent Kerryman to a Corkman?
The Deputy was not too decent to some of our players in the past and we paid dearly for it. Yes, I will do that.
What was the Minister's response to the fact that a senior orthodontist in the Southern Health Board felt obliged to write a letter to the editor of the Irish Examiner outlining his grave disquiet at the service in the region? In relation to promised reviews will they include a review of the classification of patients? We are all aware of dozens of constituents whose parents consider they should receive orthodontic treatment. They are refused placement on the list on the basis that the treatment is cosmetic rather than medical. Will the reviews take that into account?
New guidelines which emanated from the Moran report in terms of the classification of people who may be treated or go on the waiting list are being considered by the boards. I have been advised that those guidelines will involve a broadening of the spectrum of people who will be entitled to treatment. I am aware of the concerns. I caution that we will have to be realistic, given the size of the existing lists. They are the priority. Obviously we will have to prioritise the treatments in order of the acute nature of the conditions, in other words, those in greatest need will have to get the service more quickly. I do not want to comment on individuals or individuals writing to newspapers. That is not appropriate. It would not be appropriate use of the House for the debate in which I would like to engage. It is not all about the responsibility of Government or health boards. Everyone has a collective role. There has been a lack of consensus between the key players both within that health board and in other health boards as to how best the orthodontic service should develop. There have been many rows and much conflict about training and accreditation. Meanwhile Rome was burning, in terms of the lack of movement on the list.
Is there a grade at which orthodontists can be employed by health boards? Is his Department refusing to sanction the appointment of orthodontists who are not consultants? Why was it that dentists who were working under the supervision of the consultant orthodontist in Cork to do this work were stopped from doing so by his Department?
That did not happen. That is not accurate. There was a training accreditation issue that emerged before my time.
Was it changed?
It was not changed. There is a big history and the issue is not black and white. One of the reasons we are appointing a professor of orthodontics to the dental school is that that issue had been raised by the individual consultant and others concerned. As soon as I had given sanction to the health board a difficulty arose, but I have no criticism of that. Everyone involved has to genuinely engage in a consensus approach and unfortunately the people are poles apart. I cannot hang around for people to mend their past conflicts. Hopefully, we will bring to a conclusion discussions with the HSEA on conditions and so on for specialist orthodontists who will be employed and will help to reduce the waiting lists.