Written Answers. - Orthodontic Service.
Bernard J. Durkan
Question:
424
Mr. Durkan
asked the
Minister for Health and Children
the progress which has been made to provide orthodontic treatment to those who are diagnosed as being eligible and in need of such treatment by private professionals, notwithstanding the contrary view expressed by health board professionals; and if he will make a statement on the matter.
[3757/03]
As the Deputy is aware, the provision of orthodontic treatment to eligible persons is the 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.
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. This year, my Department and the health boards are funding thirteen dentists from various health boards – including the Eastern Regional Health Authority – for specialist in orthodontics qualifications at training programmes in Ireland and at two separate universities in the United Kingdom. These 13 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. Thus there is an aggregate of 20 public service dentists currently in training for specialist in orthodontics qualifications. Additional funding of €0.64 million and €0.894 million was provided for these training programmes in 2002 and 2003 respectively. 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.
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 in 2001, of which €4.698 million was to fund an initiative on orthodontic waiting lists. Under the initiative, the ERHA was allocated €2.044 million. This enabled the authority to recruit additional staff, including two consultant orthodontists, and to develop new treatment facilities at Loughlinstown and at the regional orthodontic unit located at St. James's Hospital. My Department has also funded a six-chair orthodontic suite for the Northern Area Health Board, expected to be operational in spring 2003.
In June 2002, 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 ERHA received €1.815 million from the fund for the treatment of cases in this way. Finally, the chief executive officers of the health boards have informed me that at the end of the September 2002 quarter, there were 18,511 patients receiving orthodontic treatment in the public orthodontic service. This is an increase of approximately 1,216 patients in orthodontic treatment when compared with the number of patients receiving treatment in December 2001. I expect that the number of patients receiving orthodontic treatment in the public orthodontic service will continue to increase as the measures that I have taken have a further impact on the service.
