Written Answers. - Orthodontic Service.

Breeda Moynihan-Cronin

Question:

200 Ms B. Moynihan-Cronin asked the Minister for Health and Children the number of patients awaiting orthodontic treatment in County Kerry; the number waiting in categories A and B; the average waiting time for treatment; and if he will make a statement on the matter. [22061/02]

Breeda Moynihan-Cronin

Question:

204 Ms B. Moynihan-Cronin asked the Minister for Health and Children if he will report on the progress in the implementation of the Moran report on orthodontic services here; and if he will make a statement on the matter. [22065/02]

I propose to take Questions Nos. 200 and 204 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.

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.

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.

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. 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. This year, my Department expects to fund an additional eleven dentists from various health boards for specialist in orthodontics qualifications at training programmes in Ireland and at two separate universities in the United Kingdom. Furthermore, the specialist training in orthodontics of another dentist is nearing completion. This is an aggregate of 18 public service dentists currently in training for specialist in orthodontics qualifications.
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 is playing 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.
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. This scheme is presently being finalised in conjunction with the Dental Council.
The Moran report advised that the health board dental surgeons 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.
However, 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. 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, from which the Southern Health Board was allocated an additional €1.191 million for orthodontic services including €1.032 million for its orthodontic initiative. 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 Southern Health Board was allocated an additional €0.720 million from the fund to treat cases in this way.
My Department does not routinely collect orthodontic waiting list data specifically 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.
Finally, the chief executive officer of the Southern Health Board has informed me that at the end of the June 2002 quarter, there were 2,932 patients in orthodontic treatment in the board. This is an increase of 632 patients when compared with the end of December 2001 quarter. I am confident that when fully implemented the initiatives that I have outlined, 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.