Dáil Éireann debate -
Tuesday, 11 Mar 2003

Vol. 563 No. 1

Written Answers - Orthodontic Service.

James Breen

Question:

432 Mr. J. Breen asked the Minister for Health and Children if the difficulties that have arisen between his Department, consultant orthodontists and the chief dental officer will be brought to a speedy conclusion in the interest of the large number waiting for treatment; and if he will make a statement on the matter. [7289/03]

Minister for Health and Children (Mr. Martin)

As the Deputy is aware, the delivery of orthodontic services is a matter for the chief executive officers of the health boards in the first instance.

In its report on the orthodontic service, the Oireachtas Joint Committee on Health and Children has – quite 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 have no doubt that the absence of agreement has led to a lower increase in treatment numbers and a lower reduction in waiting lists than would otherwise be the case. 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.

The chief executive officers established a review group on the public orthodontic service that considered the recommendations of the Oireachtas joint committee in the context both of the historical development of the service and of the national health strategy. The chairperson of this group has informed me that the group was established on 23 April 2002 with the following terms of reference: to review and report on progress to date on the recommendations set out in the Moran report; to consider the recommendations in the February 2002 report of the Oireachtas Joint Committee on Health and Children; and to make revised recommendations and prepare and cost an action plan in the context of the approach set out in the national health strategy, Quality and Fairness – a Health System for You.

I understand that the review group comprised senior administrative and clinical personnel from the health boards. The chairman of the group has informed me that its report will be submitted to me in the near future.

In line with the recommendations of the joint committee, my Department and the health boards are funding 13 dentists this year for internationally recognised specialist in orthodontics qualifications at training programmes in Ireland and the UK. These 13 trainees 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 20 public service dentists currently in training for internationally recognised specialist in orthodontics qualifications. Two dentists that had been sponsored for such specialist training qualified last year and took up duty with 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.

Other recommendations of the Oireachtas joint committee are also being acted upon. In particular the grade of specialist in orthodontics has been created in the health board orthodontic service; the number of specialist 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 have initiated 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; the committee referred to the need to employ orthodontic auxiliaries in the public orthodontic service in order to increase caseloads. I have approved a scheme submitted by the Dental Council for the creation of this grade to be known as orthodontic therapist.

Finally, the chief executive officers of the health boards-authority have informed me that, at the end of the December 2002 quarter, there were 20,151 patients receiving orthodontic treatment in the public orthodontic service. This is an increase of approximately 2,856 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 impact further on the service.