The Government has decided that the numbers employed across the public service must be reduced in order to meet fiscal and budgetary targets. In order to mitigate the impact on frontline services of the reduction in employment numbers, the priority is to reform how health services are delivered in order to ensure a more productive and cost effective health system. The Haddington Road Agreement provided the health service with over 5 million additional employee hours. These hours are being used to replace staff who have left, to allow for further employment reductions and to reduce spending on agency and overtime. Subject to approval by senior managers, arrangements are in place in the HSE to allow the recruitment of staff where it has been established that there is an urgent service requirement. In addition, the HSE continues to fill a significant number of development posts in line with service priorities identified by Government.
The HSE is aware of the need to address orthodontic waiting times and commissioned an independent national review of orthodontic services to give guidance as to what changes will be desirable. The review has now been completed. The key issue highlighted by the review, which has assessed services nationally, is that the Orthodontic Service should be fully integrated within the Primary Care Service. This is under consideration by the HSE to be implemented as part of the HSE's reform programme. In addition, an initiative to reduce waiting times through the provision of additional services is currently being explored by the HSE. In the Dublin North East area a pilot scheme, which will involve the use of orthodontic therapists, is being introduced. It is expected that these changes will have a positive impact on waiting times.