The delivery of orthodontic services is a matter for the chief executive officers of the health boards in the first instance. I understand that the chief executive officers have established a review group on the public orthodontic service which is considering the recommendations of the Joint Committee on Health and Children in the context of the historical development of the service and the national health strategy. I understand the review group is made up of senior administrative and clinical personnel within the health boards, including the senior consultant orthodontist to which the Deputy refers. The work of this group will inform the development of an orthodontic action plan, which was one of the recommendations of the joint committee.
My Department is continuing to support the development of the public orthodontic services. In line with at least five of the recommendations of the joint committee, my Department expects to fund 11 dentists this year for internationally recognised specialist in orthodontics qualifications at training programmes in Ireland and the UK. These 11 trainees are in addition to the six dentists who commenced their training last year at the Dublin Dental School and one dentist whose specialist training is nearing completion in Northern Ireland. This is an aggregate of 18 public service dentists currently in training for internationally recognised specialist in orthodontics qualifications.
These training programmes are made possible by co-operation between the health boards, the majority of consultant orthodontists and the dental teaching institutions. Recently, two dentists that had been sponsored for such specialist training have qualified and taken up duty in the Western Health Board. 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. The chief executive officer of the board has informed me that Cork University Dental School is in discussion with an interested candidate for the post, 18 months on from the post being sanctioned. Capital funding of approximately €1.269 million was provided to the orthodontics unit there for its refurbishment to an appropriate standard.
Other recommendations of the joint Oireachtas committee are also being acted upon. The grade of specialist in orthodontics has been created in the health board orthodontic service. The number of specialists in orthodontics posts for the health boards is being finalised, using the estimated number of children eligible for orthodontic treatment under the 1985 guidelines; these national manpower requirements will feed into an orthodontic action plan. Health boards are initiating reviews of their assessment waiting lists as recommended. The committee also stated that it would support a public-private mix of staff and facilities that would lead to a continuous reduction in the number awaiting treatment.
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.
Additional information.The committee referred to the need to employ orthodontic auxiliaries in the public orthodontic service in order to increase caseloads. A scheme for the creation of this grade – to be known as orthodontic therapist – is being finalised by the Dental Council in conjunction with officials from my Department.
The number of patients in orthodontic treatment has begun to increase as the measures that I have taken to improve orthodontic services begin to take effect. The chief executive officers of the health boards have informed me that at the quarter ending June 2002 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.
The Joint Committee on Health and Children has rightly drawn attention to the fact that the co-operation of all regional consultants is required for an efficient service to be delivered in all health boards. I strongly agree with the committee's view that the interests of children are paramount and must take precedence over all other interests. My Department stands ready to support increased co-operation among the relevant stakeholders. I strongly urge those involved – whether through their representation on the review group established by the chief executive officers or through a separate mediation procedure – to strive for that increased fuller co-operation.
