I propose to take Questions Nos. 285 and 286 together.
As the Deputy is aware, the provision of dental treatment to patients with special needs is the statutory responsibility of the health boards in the first instance. The question of recruitment of staff, whether medical or dental, and decisions on ensuring a sufficient availability of appropriately trained staff is also a matter for the health boards.
The Deputy may also be aware that the level of dental caries has declined in all socio-economic groups in Ireland. However, it is recognised that children from socially disadvantaged groups and those with disabilities suffer disproportionately from the effects of oral disease. Important steps have already been taken to focus greater attention on developing dental services for people with special needs.
There is significant research under way examining the oral health needs of persons with disabilities. This research is part of the national survey of adult and children's dental health being carried out by health boards, University College Cork and the Department of Health and Children. The outcome of this research will be used in the formulation of a new strategy for the dental services. Ultimately, it will have a major impact on the evolution of dental services in the future.
In 1994, the dental health action plan was agreed which allowed for the reorientation of the dental services towards the provision of structured care for special needs patients. In this regard, health boards have restructured their dental services to give greater recognition to those involved in delivering dental services to persons with special needs.
A grade of senior dental surgeon in special needs duties has been created. The remit of the senior dental surgeon in special needs includes the identification of specific target groups in the community who may have difficulty in gaining access to or accepting oral health care or who may be at greater risk from dental disease or oral dysfunction than the majority of the population. Such target groups include the medically compromised and those with physical and intellectual disabilities. In addition, the senior dental surgeon in special needs is responsible for the prioritisation of the oral health needs of these groups and the supervising of the ongoing training needs of dental staff working with people with special needs.
My Department recognises the importance that leadership in the area of special needs dentistry can bring to the future direction and development of this area. I am pleased to advise the Deputy that the Department has funded the appointment of a professor of special care dentistry at the Dublin Dental School and Trinity College Dublin. A professor for this post has been appointed and is playing a very important role in developing education, training and research in the arena of special care dentistry.
A number of boards refer patients who are medically compromised and who need complex care to specialist dental units in Cork University Hospital and Our Lady's Hospital for Sick Children, Crumlin. In this way, the health boards ensure the welfare and safety of these patients. The Dublin Dental School and Hospital act as a national resource for health board and general practice dentists for the referral of patients who require specialist treatments that dentists cannot provide. The school and hospital have service agreements with a range of agencies to provide specialist care services and these play an important role in specialist-consultant training programmes, as well as delivering specialist care for patients. At the Cork Dental School and Hospital, senior staff including specialists in paediatric dentistry provide an important consultant service within their area of specialisation.
The health strategy 2003 envisages a health system that is accessible and fair and that empowers the community to achieve its full oral health potential. Embracing this vision means participating in a system that is equitable, people-centred and responsive to the needs of the individual. These equity and people-centred visions foster a culture of removing barriers to health care for people with disabilities. The strategy declared that "A special needs based approach will be taken to developing dental services over the next five to seven years". Consequently, greater attention will be focused on developing dental services for people with special needs at national and regional level over the next four to six years. Ultimately, building on steps already taken in this important area will be a priority.