asked the Minister for Health the numbers on the waiting list for orthodontic treatment in each of the health board areas; and the progress made in employing extra orthodontists.
Ceisteanna—Questions. Oral Answers. - Orthodontic Treatment.
6.
The following are the numbers on the waiting lists for orthodontic treatment in each health board:
|
Eastern |
1,200 |
|
Midland |
2,300 |
|
Mid-Western |
620 |
|
North-Eastern |
1,500 |
|
North-Western |
300 |
|
South-Eastern |
1,350 |
|
Southern |
1,000 |
|
Western |
2,550 |
Comparisons between one health board and another on the basis of these figures would not be valid because the criteria employed in compiling waiting lists vary between the different health boards.
Five posts of consultant orthodontist in the health boards were advertised by the Local Appointments Commission in October 1983 and applications received are being processed by the commission at present.
I understand that, despite advertising in the past, there has been difficulty in getting suitable candidates for these positions. From the Minister's reply am I to understand — I am concerned more directly with the Eastern Health Board area — that suitably qualified candidates are applying for the vacancies in the Eastern Health Board area and does he anticipate the making of an appointment in the near future?
As I said, five posts have been advertised, one for the Eastern Health Board and the person appointed there will serve also the North-Eastern and perhaps the Midland Health Boards. Therefore, I presume that if a suitable candidate makes application there will be an appointment in that area.
The Minister of State has not said exactly whether a candidate suitable for that area has applied. I understand that the difficulty in the past has been that even when sanction was given — which was slow in coming and I appreciate that this problem has gone back to many holders of the office——
A question.
Even where sanction was given for appointment it proved extremely difficult to get a suitable person.
A question.
I ask the Minister of State whether the possibility of having to go so far perhaps as to offer training to a suitable candidate who might then be obliged to serve on the health board is still under consideration as a possible way around the difficulty of recruitment. Can the Minister of State assure me that no difficulty exists, that an appointment can be made and that suitable candidates have applied for the Eastern Health Board area?
I am aware of the difficulty in filling these positions in the past. I am not at liberty to say at the moment whether suitable candidates have applied and I would not be the one to determine who is a suitable candidate.
Could the Minister of State tell us why the Minister decided to advertise for only five orthodontists for five health board areas and leave three health board areas without their own orthodontists? Would he accept that it is totally unrealistic to expect that one orthodontist for the Eastern Health Board area, which is far and away the largest health board area, will be able to work for the North-Eastern and Midland Health Board areas also as he himself has stated? Does he think that the patients in the Ceann Comhairle's and my constituency in Cavan will have the facility, that the man or woman will have the time to look after the needs of the people in that area?
I would be less than honest if I did not say that I am not fully satisfied with the position in relation to children awaiting orthodontic treatment, but a move is being made in a certain direction. Whereas the Deputy may be critical of the fact that only five positions have been advertised, certainly it is a move in a direction. That, plus the fact that the Department are in negotiation at the moment with private orthodontists with a view to getting agreement on a price structure with them so that they will participate in the scheme also. If that occurs this big problem will be alleviated.
Will the Minister agree that the figures he has given us clearly indicate that the service we have in regard to orthodontistry is an indictment of the dental orthodontic service, that literally it does not exist and we would be better if we did not pretend we have such a service? In fact, we do not have such a service and we have people waiting for a long time for such treatment.
The Deputy is making a speech on the information he has received from the Minister.
People are on those lists waiting in false hope to be seen. It is doubtful if they will be seen let alone treated.
This is a good speech but it is not a question.
Will the Minister agree that many young girls — we are all concerned more about the beauty of young girls rather than males — who need treatment urgently will be condemned to going around for the rest of their lives with goofy teeth because this dental service does not exist? Something should be done urgently to remedy the problem. The Minister should disband the system or do something more radical.
I am not altogether satisfied with the situation that exists. A move is being made in a certain direction with a view to alleviating the problem. I should like to remind the Deputy that this problem did not arise overnight.
Is the Minister in a position to tell the House the waiting period? The Minister told the House how many are waiting in the different health board areas for orthodontic treatment, but I should like to know the average waiting time for such treatment. Will the Minister repeat the figure he gave for the Eastern Health Board area?
That is a separate question. I do not have that information but I will answer such a question if the Deputy puts one on the Order Paper.
The Minister could not be expected to have that information.
Some people have to wait for up to four years for orthodontic treatment.
I will not confirm or deny that.
The Minister cannot deny that statement because it is true.
7.
asked the Minister for Health if he will consider subsidising private practitioners to supply orthodontic treatment for medical card holders and eligible children until such time as the State is able to provide a complete service.
Health boards already avail of the services of orthodontists in private practice to provide treatments for eligible persons.
Will the Minister expand on that reply because it is a practice I am not familiar with? In the course of his reply to the last question the Minister indicated that he was negotiating the type of scheme I had in mind. The Minister said he was involved in discussions with private orthodontists and I welcome that. Will the Minister develop on that?
Health boards already avail of the services of orthodontists who are in private practice to provide treatment for eligible persons. All the health boards avail of the services in providing orthodontic treatment for eligible persons. However, for more than two years private orthodontists have not been used except in a few extremely urgent cases to provide fixed appliances in orthodontic treatment. There are two types of appliances involved in this treatment, those that are fixed and those that are not. There is only a small problem with regard to some appliances but there is a bone of contention between the Department of Health and private orthodontists about the fixed appliances. The Department have failed to get agreement with the private orthodontists on a scale of fees for this type of work. Recently, when a scale of fees was accepted by both sides, the orthodontists indicated that they were not prepared to implement it unless they could be guaranteed that a specific sum of money would be made available by health boards for this type of treatment on an annual basis. Negotiations are in progress between the private orthodontists and the Department to try to iron out the problem.
How much money was paid to orthodontists on a private basis last year?
I do not have that information.
Does the Minister anticipate that this mechanism will lead to a reduction in the shocking figure on the waiting list? Will it be this mechanism rather than the employment of State orthodontists that will ease the problem?
It will be a combination of the two. If we got a combination of the two things working in the way we would like to have them, it is possible that the waiting list would be drastically reduced in a short time.