Dáil Éireann debate -
Wednesday, 24 Apr 2002

Vol. 552 No. 4

Written Answers. - Orthodontic Service.

Brendan Howlin

Question:

62 Mr. Howlin asked the Minister for Health and Children if his attention has been drawn to the recent report from the Oireachtas Joint Committee on Health and Children calling for specific measures to cut orthodontic waiting lists; if he intends to implement the recommendations contained in the report; and if he will make a statement on the matter. [12550/02]

Minister for Health and Children (Mr. Martin)

The report of the Joint Oireachtas Committee on Health and Children's examination of the orthodontic service is a comprehensive document and contains 31 wide-ranging recommendations that are being considered as a matter of priority by my Department and the health boards.

My Department, in its submission to the joint committee, acknowledged that the extent of the waiting list and waiting time for orthodontic assessment and treatment is unacceptable and is a matter of serious concern. The prevailing situation is compounded by the fact that orthodontic services are restricted due to the limited availability of trained specialist clinical staff to assess and treat patients. This shortage has resulted from, among other things, divisions within the orthodontic community that have triggered difficulties and resistance in agreeing arrangements for training programmes.

I note that the joint committee has recognised the divisions within the profession and their impact on the extent of the waiting list and time for orthodontic assessment and treatment. In addition, the committee identified enhanced training opportunities as an important element in improved delivery of orthodontic services. Notwithstanding the difficulties in agreeing training programmes in a minority of health board areas, I am pleased to advise the Deputy that there has been significant progress in this area.

In October last year, six dentists from the Eastern Regional Health Authority, the North-Eastern Health Board and the South-Eastern Health Board commenced their training for specialist in orthodontics qualifications. Furthermore, three dentists from the Western Health Board and the 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. They are 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 Postgraduate 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. 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.

These measures will complement the other structural changes being introduced into the orthodontic service, namely, the creation of the grade of specialist in orthodontics and the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area. The Dental Council has already established a register of dental specialists with a division of orthodontics. In addition, 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. The grade of orthodontic therapist will act as a support to the consultant orthodontist, specialists and other dentists working in the orthodontic unit thus enabling a greater volume of treatment.

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.

These measures that I have taken have already positively impacted on the orthodontic services. The chief executive officers of the health boards have 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 above measures continue to take effect.