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Dáil Éireann debate -
Wednesday, 5 Dec 2001

Vol. 545 No. 5

Written Answers. - Hospital Services.

Bernard J. Durkan

Question:

51 Mr. Durkan asked the Minister for Health and Children when his latest health plans will have direct benefit to the consumer in terms of delivery of service in such areas as ready access to chemotherapy, hip replacement, heart operations, orthodontic services and eye surgery in view of the situation in these disciplines; and if he will make a statement on the matter. [30871/01]

The new health strategy, which I launched recently, will provide a framework for the reform of the acute hospital system and the improved access for public patients. It includes a plan covering the actions required to address the issue of waiting lists and particularly waiting times.

The targets set out in the strategy are that by the end of 2002 no adult will wait longer than 12 months and no child will wait longer than six months for treatment, by the end of 2003 no adult will wait longer than six months and no child will wait longer than three months for treatment and by the end of 2004 no public patients will wait longer than three months for treatment. A new dedicated treatment purchase fund will be used for the purpose of purchasing treatments for public patients either in the private sector or, if necessary, abroad.

Considerable progress has already been made in reducing waiting times. During the period June 2000 to June 2001 the number of adults waiting for cardiac surgery for more than 12 months decreased by 68%, the number waiting for ophthalmology services for more than 12 months decreased by 38% and the number waiting for orthopaedic services for more than 12 months decreased by 16%. During the same period the number of children waiting for cardiac surgery for more than six months deceased by 85%, the number waiting for ophthalmology services for more than six months decreased by 31% and the number waiting for ENT services for more than six months decreased by 25%.

The single most important limiting factor for admission to hospital is bed availability. In this context a comprehensive review of bed capacity needs has been conducted in both the acute and non-acute sectors. The review, which has informed the new health strategy, has focused primarily on the emerging need to increase bed capacity and to have a strategic framework in place in terms of the number of additional beds required in the short, medium and long-terms. The overall target of the new strategy is that an additional 650 beds will be in place by the end of 2002 with an extra 3,000 beds provided over the period to 2011.

The strategy outlines further measures which are designed to address the issues of capacity and efficiency in the delivery of services. A strategic partnership will be developed with the private sector in providing services for public patients and a national hospital agency will be set up to plan the configuration of hospital services. I am confident that these measures will result in a more accessible and equitable hospital system for public patients.

With regard to orthodontic services, I have initiated a range of measures to substantially increase the capacity of the orthodontic services and reduce the waiting times for orthodontic treatment. Structural changes are being introduced into the orthodontic service. 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.

Agreement has now been reached at the Health Service Employers Agency on the creation of the specialist in orthodontics grade in the orthodontic service. In addition, six dentists from the Eastern Regional Health Authority, North-Eastern Health Board and South-Eastern Health Board commenced their training in October last for specialist in orthodontics qualifications. Furthermore, three dentists from the Western Health Board and North-Eastern Health Board are already in specialist training for orthodontics and this brings the total number of dentists in such training to nine. Discussions on providing an additional training course to commence in 2002 are also under way.
My Department has funded the appointment of a director of specialist training for the Irish committee for specialist training in dentistry through the Post-Graduate Medical and Dental Board. The director has taken up duty and will play a pivotal role in assisting the different agencies involved in dental specialist training programmes. In addition, my Department has also funded the recruitment of a professor in orthodontics at Cork University Dental School to facilitate the development of an approved training programme leading to specialist qualifications in orthodontics. Applications for the post were invited when it was advertised on 19 October last. Capital funding of approximately £1 million or 1.269 million was also provided to the orthodontics unit there for its refurbishment to an appropriate standard. My Department would welcome proposals for a specialist training programme from this university and the consultant orthodontists of the Southern Health Board and neighbouring boards.
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 or 6.729 million has been approved for orthodontic services this year, of which £3.7 million or 4.698 million is to fund an initiative on orthodontic waiting lists. This is enabling health boards to recruit additional staff.
The orthodontic initiative is beginning to impact on the public orthodontic service. At the end of the September 2001 quarter, there were 16,107 patients in orthodontic treatment, an increase of over 580 patients in treatment when compared with the previous quarter. I am confident that the capacity of the public orthodontic service, in terms of the numbers in orthodontic treatment, will increase further as health boards continue to make progress with implementing their proposals under the initiative.
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