Vol. 539 No. 3
9 Mr. Durkan asked the Minister for Health and Children the number of children who have received orthodontic treatment in the past four years; the number on waiting lists who have not received treatment; when those patients now on the waiting lists will receive treatment, if at all; and if he will make a statement on the matter. [19306/01]
The provision of orthodontic treatment is the responsibility of the health boards in the first instance. The chief executive officers of the health boards have informed me that between 1998 and the end of the March quarter 2001, a total of 6,880 patients had their orthodontic treatment completed. This total excludes figures for 1998 and 1999 for the North Eastern and North Western Health Boards. The chief executive officer of the North Western Health Board has informed me that the number of completed treatments in 2000 is also not available.
In addition, this total excludes the number of completed treatments in the Eastern Regional Health Authority and the Southern Health Board which are developing their computerised patient management systems. However, the chief execu tive officer of the ERHA has informed me that 1,436 patients were discharged from the authority's waiting lists since June 2000.
The chief executive officers of the Midland, Mid-Western, North Eastern, North Western, South Eastern and Western Health Boards have further informed me that a total of 9,615 patients between their boards were receiving orthodontic treatment at the end of the March quarter 2001. There are 31,743 people awaiting orthodontic assessment and treatment at the end of this quarter.
I recognise that waiting times for orthodontic treatment are unacceptably long. At the invitation of my Department, a group representative of health board management and consultant orthodontists reviewed the orthodontic services. The objective of this review was to ensure equity in the provision of orthodontic treatment throughout the health boards. Following this review structural changes are being introduced in the orthodontic services. These 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, I asked health boards to develop proposals to make an immediate significant impact on their waiting lists. An additional investment of £5.3 million has been approved 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 orthodontists to treat patients.
Additional information.
In the Eastern Regional Health Authority, two additional consultant orthodontists have been appointed and the recruitment of a fourth consultant orthodontist for the Northern Area Health Board is in train. Two orthodontic specialists have been recruited and the recruitment process for three managers to manage the orthodontic services in the three area health boards has been completed; two of the managers will commence duty in July and the third will take up duty next August. A six surgery facility at the Loughlinstown regional orthodontic unit has been developed and is being equipped. The equipping of an additional five surgery unit at the St. James's Hospital orthodontic unit is being completed. The Northern Area Health Board is progressing plans for the development of a new regional orthodontic unit to be located on the grounds of James Connolly Memorial Hospital. Agreement has been reached between the ERHA and the Dublin Dental Hospital on the training of specialists to work in orthodontics and four dentists will commence training in 2001. Validation of waiting lists is in progress. The initiative in the ERHA will enable an additional 3,000 patients on the assessment waiting lists to commence treatment.
The Southern Health Board's proposals include the development of new orthodontic units in Tralee and north Cork and the recruitment of two additional consultant orthodontists – both positions were advertised last week. The board also proposes to commission four additional orthodontic chairs in the orthodontic unit in St. Finbarr's Hospital and validate 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 two 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.
Overall, this initiative will have a significant impact on orthodontic waiting lists. The health boards have advised me that the ultimate effect of their proposals when fully implemented, will be to increase the numbers in treatment by 5,500 per annum and significantly reduce waiting times for treatment. The outcome of this initiative in conjunction with the structural changes will be carefully monitored to assess the impact on waiting lists and determine what further resources, if any, are required. It is not possible to put a timescale on this.
Is the Minister appalled by these extraordinary waiting list figures? There are 31,000 children on waiting lists. Given the length of the waiting lists and the likelihood of other patients joining them, what is the possibility of providing treatment for the majority of these children while at school? What advice can the Minister offer children on these waiting lists, some of whom are waiting eight years? What advice has he to offer them by way of remedy?
As a result of additional investment this year in the ERHA area, two additional consultants have been appointed and a fourth consultant orthodontist is being recruited. Two orthodontic specialists have been recruited and the process for recruiting three managers for the orthodontic services in the three area health boards has been completed. Many other measures have been put in place as a result of this year's investment. The ERHA hopes these measures will result in the commencement of treatment for an additional 3,000 patients currently on assessment waiting lists.
The Southern Health Board is the other area in which there are long waiting lists. The board has been involved in the development of two new orthodontic units in Tralee and north Cork and advertisements were placed last week for the recruitment of two additional consultant orthodontists. The board's proposals will double the capacity of the orthodontic service in the area and reduce waiting times to under 12 months.
We have also received proposals from the Midland, Mid-Western, North Eastern, North Western, South Eastern and Western Health Boards to include the use of private orthodontists. The boards are happy that if they can secure the additional capacity, they will reduce waiting lists.
A number of Deputies are offering. If they ask a brief question, I will try to facilitate them. However, if they do not do so, I will have to call the Minister.
Why is the Western Health Board unable to recruit permanent orthodontists?
Has the Minister any plans to extend the pilot scheme in the ERHA area under which parents who pay for private orthodontic treatment for their children receive a 50% refund of the cost, and a 100% refund if they have a medical card? This scheme is reducing waiting lists in the ERHA area. Why can it not be extended to other health board areas in which many parents are paying for private treatment?
I thought the Minister might have addressed my Question No. 31 which deals with the same issue. There is now a waiting list for a waiting list. Why is the Minister reluctant to give direct grant aid to parents? This problem would be solved if parents could arrange for their children to be treated privately. If these people have a medical card, they should be refunded directly. If they do not have a medical card, they should be given an allowance. Will the Minister consider sending children to Northern Ireland or England for treatment? The situation is getting worse and the figures have gone up by 3,000 in a few months.
Please, Deputy.
The Minister must take drastic action as we are dealing with children. I do not wish to get into a row, but there is a serious problem. The Minister should ignore his officials and make a decision.
Why are figures not available for the North Western Health Board? Will the Minister consider a tax write-off for parents who pay for private orthodontic treatment?
I will allow the Minister a minute and a half.
A tax write-off is available. The pilot scheme to which Deputy McCormack referred has not taken off in the north Dublin area.
We know that.
I have sanctioned the scheme as I received optimistic vibes that it was possible.
The Minister should give the scheme to the north-east and we will use it.
As the scheme has not taken off, I am not in a position to advocate its extension.
It has not taken off because the Minister announced it without preparation.
The Minister to continue without interruption.
No, I did not announce it. I announced the sanctioning and provided money because the health board came to me and said it had a bright idea. I am always open to bright ideas which I will fund.
The Western Health Board has had ongoing difficulties recruiting an additional consultant. That is a matter for the Western Health Board but I have continually urged the board, and have provided the resources, to facilitate that recruitment. There have been difficulties within the orthodontic sector – I will say no more than that at this stage – which have not helped the overall delivery of services. There has been much discord within and between boards and individuals which has had a detrimental impact on achieving significant results.
Last year I called in the health boards to initiative this matter. I assure Deputy Ring that I will seek a full evaluation in July, and I am not ruling anything out in terms of what he has suggested.
Good.
Last year, we tried much of what people had put to us. We have now told all the health boards that they can enlist private orthodontists to do the work and thus reduce waiting lists. In consultation with my Cabinet colleagues I will consider what remains to be done if this initiative does not produce results.
