Vol. 555 No. 2
120 Mr. Durkan asked the Minister for Health and Children his plans to address the increasingly serious problem of lack of services and facilities in respect of orthodontic treatment; and if he will make a statement on the matter. [18106/02]
350 Mr. Durkan asked the Minister for Health and Children the reason rigorous assessments have been carried out in an apparent attempt to eliminate patients from orthodontic waiting lists and where it is quite clear that second opinions from private orthodontists seriously conflict with the result of such assessments; and if he will make a statement on the matter. [18407/02]
I propose to take Questions Nos. 120 and 350 together.
The provision of orthodontic treatment to eligible persons is the statutory responsibility of the health boards in the first instance. Entitlement to secondary care orthodontic treatment is determined by reference to orthodontic guidelines, a set of objective clinical criteria applied by health board orthodontists when assessing children's priority of need for treatment. The orthodontic guidelines were issued by my Department in 1985 and are still in use. The orthodontic guidelines are used to ensure that orthodontic resources are prioritised for and applied equitably to the most severe cases. When a health board orthodontist decides that a child is in clinical need of orthodontic treatment in accordance with the criteria, he or she is then placed on a treatment waiting list.
The guidelines are intended to enable health boards to identify in a consistent way those in greatest need and to commence timely treatment for them. A child who has been assessed and comes within the guidelines will remain on the waiting list until treatment commences. It is widely recognised that decisions made in the private sector regarding orthodontic treatment are based primarily on subjective need and are not based on any evidence linking the orthodontic condition to any aspect of dental ill health. On the other hand decisions made in health boards are based on prioritised guidelines ensuring that cases are selected for treatment based on the objective severity of the condition.
I am pleased to advise the Deputy that I have taken a number of measures to improve orthodontic services on a national basis. The grade of specialist in orthodontics has been created in the health board orthodontic service. The introduction of this pivotal grade will have a tremendous impact on the future delivery of orthodontics in the public service: ultimately, it will address the issues of recruitment and retention of qualified clinical personnel in the service. This year, my Department expects to fund 11 dentists from various health boards for specialist in orthodontics qualifications at training programmes in Ireland and at two separate universities in the United Kingdom. These 11 trainees for the public orthodontic service are additional to the six dentists who commenced their training last year and one dentist whose specialist training is nearing completion. This is an aggregate of 18 public service dentists currently in training for specialist in orthodontics qualifications.
The training programmes concerned provide a broad academic background and experience in different clinical treatment methods and are made possible by co-operation between health boards, health board consultant orthodontists and dental teaching institutions. These measures will complement the other structural changes being introduced into the orthodontic service, including the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area. 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. Last June, my Department provided additional funding of €5 million from the treatment purchase fund to health boards specifically for the purchase of orthodontic treatment. This funding is enabling boards to provide both additional sessions for existing staff and purchase treatment from private specialist orthodontic practitioners. The chief executive officers of the health boards have further informed me that at the end of the June 2002 quarter, there were 19,055 patients in orthodontic treatment in the health boards. This is an increase of 1,760 patients in orthodontic treatment when compared with the number of patients in treatment in December 2001. 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.
