I thank you, a Leas-Cheann Comhairle, for allowing this matter to be raised. I regret having to table this Adjournment request and the Minister of State come here to reply. It is, if one likes, a drastic challenge to the Adjournment debate structure in that the question is clear, but the answer has probably been drafted long before the Minister of State stands up to give her reply.
The position regarding orthodontics and the public orthodontic service is nothing short of a national scandal. The Joint Committee on Health and Children has been dealing with this matter for a period of time and done a great deal of work under the chairmanship of Deputy Batt O'Keeffe of the main Government party. There has been a failure on the part of successive Governments and Ministers to deal with the problem. Parent X may go to see the Minister of State, Deputy Hanafin, who I am glad to see here, to say his or her child has a problem with his or her teeth which he or she regards as orthodontic. The child is assessed and if put on a list in the public service, may well wait for five to six years in the Western Health Board area before treatment is delivered. It is completely unethical and immoral to put children on lists for orthodontic treatment in the sure knowledge that they will never be called or that their parents will be forced to pay through the private sector. I am appalled at the failure of this and previous Ministers to take on the Dublin and Cork Dental Schools and their failure to recog nise, and be shielded from, the reality of the powerful cabal operating here preventing the provision of an effective public orthodontic service.
A number of guidelines are being bandied about in terms of the criteria laid down for eligibility for children. When we had no public orthodontic service guidelines were laid down in 1985 by the Department of Health which were accepted. In a reply in November and again last week the Minister pointed out that the health board consultants recommended a number of changes in the interim which was followed by a recommendation known as the Moran report from the chief executive officers of the health boards based on a system of IOTN, index of orthodontic treatment need.
I would like the Minister of State to tell the House which of these guidelines is now in operation. Are we talking solely about the 1985 guidelines? The Minister said in reply that the consultant orthodontists sent a report to him. He did not say whether he accepted it, but that his Department was writing to the health boards about changes. He did not say either whether the Moran report index is being used to any extent.
I quoted at the joint committee minutes of a meeting held between the Irish consultant orthodontists group and the Orthodontic Society of Ireland held in Dublin on 18 September 2000. The minutes are very clear in that they show that the private sector would be largely eliminated if an indexing system was introduced that was defensible both on a constitutional and legal basis because otherwise the hospital service would be overwhelmed with patients it would never be able to treat. That is taken from the minutes of a group meeting in September 2000 in terms of the relationship between the Orthodontic Society of Ireland and the ICOG.
I recognise private practice and the work it does, but the Minister of State represents the Government. There are hundreds of thousands of mothers, fathers and children who are not receiving this service and there is great confusion about eligibility and the guidelines being used. Will the Minister of State explain whether the 1985 guidelines alone are now being used? If not, has the Minister accepted the consultant orthodontists recommendations of interim changes? Are these the guidelines being used? While the study is being carried out by the Department, are there elements of the IOTN or Moran index being used? Whatever is going on, thousands of children are being eliminated from orthodontic waiting lists and waiting times have increased. This is grossly unethical, unfair and immoral.
The Minister said to me in the House, I think in November, if there was one other thing he would do during his remaining period in office it would be that he would sort this matter out. If nothing else happens between now and the time the Taoiseach goes to the country, the Government and the Minister should zero in on this scandal and sort it out once and for all.