Dáil Éireann debate -
Thursday, 7 Mar 2002

Vol. 550 No. 2

Written Answers. - Orthodontic Service.

Michael Noonan

Question:

286 Mr. Noonan asked the Minister for Health and Children if his attention has been drawn to the waiting lists that exist for orthodontic treat ment in the Mid-Western Health Board region; his views on whether these waiting lists are now out of control; if his attention has further been drawn to the case of a person (details supplied) in County Tipperary; and if he will make a statement on the matter. [7769/02]

Minister for Health and Children (Mr. Martin):

The provision of orthodontic treatment to eligible persons in the Mid-Western Health Board is the statutory responsibility of that board in the first instance.

I am aware of the unacceptable waiting list for orthodontic treatment in the MWHB but I note that some improvements have been made in relation to the treatment waiting list. For example, between June 2001 and December 2001, the treatment waiting list in the board has been reduced by 427. I have taken a number of measures to increase the capacity of the orthodontic service nationally.

Structural changes are being introduced into the orthodontic service such as the creation of the grade of specialist in orthodontics, the development of specialist training programmes and the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area. Six dentists from the Eastern Regional Health Authority, North-Eastern Health Board and South-Eastern Health Board commenced their training last October for specialist in orthodontics qualifications. My Department has provided €0.541 million in 2002 for specialist in orthodontics training. 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 this year 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. Capital funding of approximately €1.27 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 orthodontist of the Mid-Western Health Board.

In the short term, I have funded an orthodontic initiative to ease current pressures on the system. Additional funding of €6.729 million was approved for orthodontic services last year of which €4.698 million was to fund an initiative on orthodontic waiting lists. This is enabling health boards to,inter alia, recruit additional staff. The MWHB has been allocated an additional €0.671 million in 2001 for orthodontic services of which €0.513 million was for the orthodontic initiative. Under the initiative, the board proposes to recruit additional staff and validate its orthodontic waiting lists. In addition, my Department approved a proposed scheme from the MWHB last year to engage the services of private specialist orthodontic practitioners to treat patients.

For this year, my Department is exploring with all health boards new arrangements for the treatment of patients, both by private specialist orthodontic practitioners and in out-of-hours sessions by health board orthodontists.

Moreover, the chief executive officer of the MWHB has informed that at the end of the December 2001 quarter, there were 1,593 patients in orthodontic treatment in the board. This is an increase of 185 patients in treatment in comparison with the corresponding figure at the end of the September 2001 quarter. I am confident that when fully implemented this initiative, combined with the structural changes to the orthodontic service, will significantly increase the number of patients in and reduce the waiting list for treatment in the board.

Finally, my Department has asked the chief executive officer to investigate the matter raised by the Deputy and to reply to him directly.

Jim O'Keeffe

Question:

287 Mr. J. O'Keeffe asked the Minister for Health and Children the number of children who are awaiting orthodontic treatment and assessment in each of the health board areas; and the waiting time for assessment and treatment in respect of each health board area. [7785/02]

Minister for Health and Children (Mr. Martin):

The provision of orthodontic treatment to eligible persons is the statutory responsibility of the health boards in the first instance.

Structural changes are being introduced into the orthodontic service such as the creation of the grade of specialist in orthodontics, the development of specialist training programmes and the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area. Six dentists from the Eastern Regional Health Authority, North-Eastern Health Board and South-Eastern Health Board commenced their training last October for specialist in orthodontics qualifi cations. My Department has provided €0.541 million in 2002 for specialist in orthodontics training. 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 this year 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. Capital funding of approximately €1.27 million was also provided to the orthodontics unit there for its refurbishment to an appropriate standard.

In the short term, I have funded an orthodontic initiative to ease current pressures on the system. Additional funding of €6.729 million was approved for orthodontic services last year of which €4.698 million was to fund an initiative on orthodontic waiting lists. This is enabling health boards to recruit additional staff and engage the services of private specialist orthodontic practitioners to treat patients. An additional six-surgery facility and five-surgery facility at the Loughlinstown regional orthodontic unit and the St. James's Hospital regional orthodontic unit, respectively, have also been developed under the initiative. My Department is exploring with boards every possibility to expand the level of services in the short term such as the use of private specialist orthodontic practitioners and the treatment of patients in out-of-hours sessions by health board orthodontists. My Department has also funded the development of new regional orthodontic units at Dundalk and Navan – both of which are operational – and the recruitment of a consultant orthodontist for the Midland Health Board who was appointed last year.

The chief executive officers of the health boards have informed me of the following information on their orthodontic waiting lists as at the end of the December 2001 quarter:

	Assessment Waiting List	Treatment Waiting List
Health Board		Average Waiting Time (Months)	Category A	Waiting time (Months)	Category B	Waiting time (Months)
ERHA	9,438	36	93	see*	965	see*
Midland	201	3	Nil	No Waiting Time	437	18
Mid-Western	3,596	24-36	Nil	No Waiting Time	1,005	24-36
North-Eastern	Nil	No Waiting Time	11	1.5-2	546	24-30
North-Western	1,300	9	276	13	1,879	39
South-Eastern	176	2-2.5	Nil	No Waiting Time	498	12

	Assessment Waiting List	Treatment Waiting List
Health Board		Average Waiting Time (Months)	Category A	Waiting time (Months)	Category B	Waiting time (Months)
Southern	5,657	According to Date of Birth. Currently January 1988	Nil	No Waiting Time	4,575	48
Western	509	9	Nil	No Waiting Time	1,605	42-48

*Average Waiting time between both categories is 18 months.

Patients in category A require immediate treatment and include those with congenital abnormalities of the jaws such as cleft lip and palate, and patients with major skeletal discrepancies between the sizes of the jaws. Patients in category B have less severe problems than category A patients and are placed on the orthodontic treatment waiting list.

These figures show that the number of patients awaiting assessment and treatment fell by 1,133 and 1,613 respectively between June and December 2001. The chief executive officers of the health boards have further informed me that at the end of the December 2001 quarter, there were 17,295 patients in orthodontic treatment in the health boards. This is an increase of 3,086 patients in orthodontic treatment when compared with the number of patients in treatment in May 1999. I expect that the number of patients in orthodontic treatment will continue to increase as the measures that I have taken to improve orthodontic services take effect. Finally, my Department has asked the chief executive officer to investigate the matter raised by the Deputy and to reply to him directly.

Question No. 288 answered with Question No. 256.