Written Answers. - Orthodontic Service.
Breeda Moynihan-Cronin
Question:
323
Mrs. B. Moynihan-Cronin
asked the
Minister for Health and Children
the number of people awaiting orthodontic treatment in County Kerry; the average length of waiting time; and if he will make a statement on the matter.
[7957/02]
Breeda Moynihan-Cronin
Question:
324
Mrs. B. Moynihan-Cronin
asked the
Minister for Health and Children
the terms of the scheme whereby he proposes to send public orthodontic patients to private specialists to alleviate the public waiting lists; the funding he has allocated to this initiative; and if he will make a statement on the matter.
[7958/02]
Breeda Moynihan-Cronin
Question:
325
Mrs. B. Moynihan-Cronin
asked the
Minister for Health and Children
the progress which has been made on the implementation of the Moran report on orthodontic services; and if he will make a statement on the matter.
[7959/02]
I propose to take Questions Nos. 323 to 325, inclusive, together.
The provision of orthodontic treatment to eligible persons is the statutory responsibility of the health boards in the first instance. 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 known as the Moran Report was to ensure equity in the provision of orthodontic treatment throughout the health boards and as a consequence, structural changes are being introduced into the orthodontic service.
The Moran report recommended that the current policy of having a consultant-led service be continued and that each health board have a consultant orthodontist. I am pleased to advise the Deputy that the orthodontic service of each health board is now consultant-led with the Eastern Regional Health Authority recruiting two additional consultants; this brings the current complement in the authority to three.
In addition, the recommendations of the Moran review group were that appropriately trained, qualified and registered specialist orthodontists be employed in regional orthodontic units to ensure the continuation of a high quality service and that the regional orthodontic units be involved with the dental schools in the training of specialists. These recommendations are being implemented as follows.
The Dental Council has established a register of dental specialists with a division of orthodontics. Agreement has been reached at the Health Service Employers Agency on the introduction of the grade of specialist in orthodontics into the public service. This agreement resulted from complex and time-consuming negotiations and its introduction will have a tremendous impact on the future delivery of orthodontics. In October last year, six dentists from the Eastern Regional Health Authority, North Eastern Health Board and South Eastern Health Board commenced their training 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. The general objective of these training programmes is to educate dentists to become specialists in orthodontics with a broad academic background and experience in different clinical treatment methods. This is made possible by co-operation between health boards, consultants and dental teaching institutions. 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.
Equally, the Moran review group recommended that auxiliaries be employed in the regional orthodontic units of the health boards. In order to enable the achievement of greater caseloads, the Dental Council has been approached concerning the creation of a scheme for the recognition of auxiliary dental workers in orthodontics. This grade, to be known as orthodontic therapist, will act as a support to the consultant orthodontists, specialists and other dentists working in the orthodontic units thus enabling a greater volume of treatment.
The Moran report advised that the health board dental surgeon refer appropriate patients for assessment at regional orthodontic units through the principal dental surgeon and that orthodontic services should fall within the ambit of responsibility of the acute hospitals manager in each health board. Both of these recommendations have been implemented and the development of information technology systems in the regional orthodontic units, which was put forward by the Moran review group, is under way.
I am cognisant that these structural changes may take some time to impact on waiting lists and, therefore, in the short term, I have funded an orthodontic initiative to ease current pressures on the system. This initiative has enabled health boards to,inter alia, recruit additional staff. In addition, last year my Department approved a proposal from the Mid-Western Health Board to engage the services of private specialist orthodontic practitioners to treat patients under the initiative. The proposal provides for a scale of fees for various items of treatment up to a ceiling of €2,920 per case and for various control and monitoring mechanisms. 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. Funding for such arrangements is also being considered.
The Southern Health Board was allocated an additional €1.191 million last year for orthodontic services of which €1.032 million was for its orthodontic initiative. Under the initiative, the board propose to recruit an additional two consultant orthodontists, develop new orthodontic units in Tralee and the northside of Cork city and commission four additional orthodontic chairs at the orthodontic unit in St. Finbarr's Hospital, Cork. The chief executive officer of the board has informed me that the Local Appointments Commission has recommended a candidate for one of the two consultant orthodontist positions and the board has offered the post to him. The recruitment process for the second position in the board will shortly recommence.
My Department does not routinely collect orthodontic waiting list data for County Kerry. My Department has, therefore, asked the chief executive officer of the Southern Health Board to investigate the position for the Deputy and reply to her directly. However, the chief executive officer has informed me of the following information in relation to its treatment waiting list at the end of the December 2001 quarter:
|
Category A
|
WaitingTime(months)
|
CategoryB
|
WaitingTime(months)
|
|
Southern Health Board
|
Nil
|
NoWaitingTime
|
4,575
|
48
|
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.
Finally, the chief executive officer of the board has informed that at the end of the December 2001 quarter, there were 2,300 patients in orthodontic treatment in the board. Nationally, the chief executive officers of the health boards have informed me that at the end of the same quarter, there were 17,295 patients in orthodontic treatment in the 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 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 waiting times for treatment in the Southern Health Board.
