Vol. 534 No. 1
35 Mr. Ring asked the Minister for Health and Children the position with regard to the waiting list initiative; when it will impact on the waiting list for orthodontic treatment; and if he will make a statement on the matter. [9843/01]
The waiting list initiative provides dedicated funding for a number of specified procedures in participating health board and voluntary hospitals. Orthodontic treatment is not one of the specified procedures and, therefore, does not attract waiting list initiative funding.
The provision of orthodontic services is a matter for the health boards in the first instance. I accept that the waiting times for orthodontic treatment are unacceptably long. Following recommendations in the Moran report, Review of Orthodontic Services, structural changes are being introduced in orthodontic services. These structural changes include the creation of the grade of specialist in orthodontics, the development of specialist training programmes and the creation of a grade of auxiliary dental worker to work in the orthodontic area.
However, it will be some time before these structural changes impact significantly on service levels. Consequently, last year I asked health boards to develop proposals to make an immediate significant impact on their waiting lists. Additional funding of £5.3 million has been provided for orthodontic services this year, of which £3.7 million is to fund an initiative on orthodontic waiting lists. This will enable health boards to recruit additional staff and engage the services of private practitioners to treat patients.
The principal elements of this initiative are the recruitment of three additional consultant orthodontists, six orthodontic specialists, three area managers, 12 nursing and nine administrative staff in the Eastern Regional Health Authority, ERHA, area. In addition, a six surgery facility at Loughlinstown and a five surgery unit at St. James's Hospital are currently being equipped. A further regional orthodontic unit is being planned for the James Connolly Memorial Hospital.
As part of the orthodontic initiative, the Department also approved a proposal from the ERHA for a grant-in-aid scheme. Under the scheme, patients who meet the criteria laid down for non-urgent routine treatment will be given the option of availing of treatment from a private orthodontic practitioner. A grant of 50% of the board's overall estimated cost of treatment would be paid. Parents could also avail of income tax relief on the balance where appropriate. A grant of 100% of the board's estimated cost of treatment would be paid in respect of medical card holders. The scheme will operate on a pilot basis in the Northern Area Health Board for 12 months. A working group has been examining this proposal and hopes to finalise it in the coming weeks.
Additional Information.Validation of waiting lists is currently in progress. Agreement has been reached between the ERHA and the Dublin Dental Hospital on the training of specialists to work in orthodontics. Four dentists will commence training in 2001. The initiative in the ERHA will enable an additional 3,000 patients on the assessment waiting list to commence treatment.
The Southern Health Board's proposals include the recruitment of two additional consultant orthodontists, the commissioning of four additional orthodontic chairs in the orthodontic unit in St. Finbarr's Hospital, the development of new orthodontic units in Tralee and north Cork and the validation of waiting lists. These proposals will double the capacity of the orthodontic services and reduce waiting times to under 12 months in the Southern Health Board.
The proposals from the Midland, Mid-Western, North Eastern, North Western, South Eastern and Western Health Boards include the use of private orthodontists, the training of three specialists in orthodontics in the Dublin Dental Hospital to commence in October 2001 and the recruitment of three additional orthodontic specialists, one senior clinical dental surgeon, four dental surgery assistants and three administrative staff. Additional sessions by health board staff and validation of waiting lists are also proposed.
The impact of the initiative in these health boards will enable an additional 2,500 patients, approximately, to commence treatment. The chief executive officer of the Western Health Board has informed me that up to the end of February 2001, 35 patients have been referred for treatment by the board to private orthodontists under the initiative.
Overall, this initiative will have a significant impact on orthodontic waiting lists. The health boards have advised me that the ultimate effect will be to increase the numbers in treatment by 5,500 per annum and significantly reduce waiting times for treatment. In the longer term, this initiative – combined with the structural changes being introduced – will, I am convinced, secure the delivery of an effective orthodontic service.
I am delighted the Minister has taken on board my suggestion in relation to grant aid. I am surprised it is only happening on a pilot basis; it should be a national scheme. Is the Minister aware that children do not want to go to school because they are embarrassed to face their colleagues? Their parents are upset and waiting time for treatment is causing distress in many homes. Is the Minister aware that the waiting list has increased nationally? The situation is getting worse instead of better. Will the Minister consider introducing a two year scheme to pay the private sector direct grants to take people off the waiting lists? After two years the other initiative can fall into place. In the short-term, however, it will not resolve the problem. Will the Minister consider allowing people to get the work done privately by paying them a grant to that end?
I gave this issue a great deal of time last year. Deputy Ring and Deputies from all sides of the House have tabled questions over a long period of time on the unacceptably long waiting lists in orthodontics. Certain health boards have come back with suggestions for their areas. The Western and Midland Health Boards, for example, will use private practitioners in their initiatives. With regard to the pilot project I announced for the Dublin area, it is important to let that work. I am anxious that it should be piloted as quickly as possible and I am somewhat concerned that it has taken about three months to get it off the ground. There is a working party dealing with it.
One must be careful, with regard to the type of scheme one announces, about quality in the first instance and second, that public funding be ring- fenced for those most in need in terms of both clinical need and socioeconomic disadvantage. I have an open mind on the matter. I will evaluate the situation, particularly the implementation over the coming months of the various action plans put forward by the health boards. Later in the year I will seek an account of how the plans have worked in practice. If I do not see some progress by then, I will return to the drawing board and take on board some of the views put forward by the Deputy.
It is bad enough for a parent to receive a letter from the health board stating that the waiting list has increased to four years, which is unacceptable. Further in the letter – I will not name the person concerned – it is pointed out that the person will not get tooth decay or gum disease as a result of being on the waiting list and that the treatment can be done into late adulthood. That is insulting. The Minister should send a directive to the health boards that there should not be smart aleck replies from their officials. If they wish to tell people there is a four year waiting list, that is sufficient. There is no need for smart aleck replies in relation to tooth decay. The treatment might not be done in adulthood; the people will probably be old and grey by the time it is done. Will the Minister direct the health boards to stop these insulting replies being sent to parents who are waiting four years for treatment?
I have not seen the reply—
I have it with me.
I do not think the officials concerned were being deliberately insulting.
I call it insulting.
I hope the motivation was not to insult the public.
Will the Minister deal with it?
I need additional information on it. In fairness, officials are right to give factual information to the public and the health boards endeavour to do that.
If they want jobs in RTE or in comics, they should get such jobs. If they want to work in the health boards, they should be compassionate.
I did not realise the Deputy had that view of RTE.
