Statutory responsibility for the provision of orthodontic treatment to eligible persons rests with the health boards in the first instance. Entitlement to 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. Patients assessed as category A have severe malocclusions and should receive urgent orthodontic care; patients assessed as category B have less severe problems and are placed on orthodontic treatment waiting lists.
The number of cases treated is dependent on the level of resources available in terms of qualified staff in the area and this is reflected in the treatment waiting list. In fact, the provision of orthodontic services is severely restricted due to the limited availability of trained specialist clinical staff to assess and treat patients. Consequently, a category C waiting list may not be maintained in some health boards.
However, I have taken a number of measures to address this shortage of specialists and so increase the treatment capacity of the orthodontic service. The grade of specialist in orthodontics has been created in the health board orthodontic service. In 2003, my Department and the health boards funded 13 dentists from various health boards for specialist in orthodontics qualifications at training programmes in Ireland and at three separate universities in the United Kingdom. These 13 trainees for the public orthodontic service are additional to the six dentists who commenced their training in 2001. Thus, there is an aggregate of 19 dentists in specialist training for orthodontics. 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.
Furthermore, the commitment of the Department to training development is manifested in the funding provided to both the training of specialist clinical staff and the recruitment of a professor in orthodontics for the Cork Dental School. This appointment at the school will facilitate the development of an approved training programme leading to specialist qualification in orthodontics. The chief executive officer of the Southern Health Board has reported that the professor commenced duty on 1 December 2003. In recognition of the importance of this post at the Cork Dental School, my Department has given approval in principle to a proposal from the school to further substantially improve the training facilities there for orthodontics. This project should see the construction of a large orthodontic unit and support facilities and it will ultimately support an enhanced teaching and treatment service to the wider region under the leadership of the professor of orthodontics.
The chief executive officer of the South Eastern Health Board has informed me that at the end of the December quarter 2003, there were 2,249 children receiving orthodontic treatment from the health board. This means that there are over three times as many children getting orthodontic treatment from the board as there are children waiting to be treated. As responsibility for the provision of orthodontic treatment to eligible persons in County Kilkenny rests with the South Eastern Health Board, my Department has asked the chief executive officer to investigate the matter raised by the Deputy and to reply to him directly.