Ceisteanna—Questions. Oral Answers. - Dental Services.


asked the Minister for Health further to his reply to Parliamentary Question No. 13 of 2 November 1988 if orthodontic treatment will be provided for persons (details supplied) in County Cavan; and if his attention has been drawn to the fact that in all these cases treatment has been recommended by their respective family doctors.

The North Eastern Health Board have indicated that the question of assessment and the provision of orthodontic treatment for eligible persons is a matter for the dental and/or orthodontic personnel working for and on behalf of the health board. The position in relation to the three cases mentioned by the Deputy is as follows:—

Case number one has recently been reviewed as part of the on-going review of all cases seeking orthondontic treatment by the North Eastern Health Board and has been placed on the waiting list for assessment by a consultant orthodontist.

Case number two has been assessed as requiring fixed appliance orthodontic treatment, a type of treatment which the North Eastern Health Board is not in a position to provide at the present time.

Case number three is high up on the board's waiting list for orthodontic treatment and it is expected that treatment will commence within the next few months.

Arrangements are being made at present between the North Eastern Health Board and the Dublin Dental Hospital for the post-graduate training in orthodontics of a dental surgeon sponsored by the health board. Under this arrangement a certain amount of orthodontic treatment will be provided in the Dublin Dental Hospital specifically for North Eastern Health Board patients. This should lead to a considerable improvement in the availability of orthodontic treatment for North Eastern Health Board patients.

Before I heard the Minister's reply I had intended to say that there was a crisis with regard to orthodontic treatment in Cavan County Clinic. Having heard the reply, I am convinced there is a real crisis. The second part of the reply indicates that the health boards are not in a position to carry out the treatment which is urgently needed in the second case. This applies to the treatment in all three cases. These are three of not less than 50 cases which have been brought to my attention from a total of 1,500 cases on the waiting list. Obviously there is a very serious problem. I have been making this point for the past 12 or 18 months. The problem arises from the fact that an orthodontist is available for only one half day per month.

The Deputy has made his point.

In fairness to the children and to their parents who have shown great patience during the past seven years——

I have given the Deputy a lot of latitude.

——what action will the Minister take now that we have the full facts?

I accept that the Deputy has been complaining over the past 12 months, but I have been complaining for 12 years about this problem. It is not a new problem and it has not always been a question of funding. An advertisement was placed by the health boards about three years ago seeking five orthodontists but only one post was filled. Orthodontists were not available to fill the other posts. That has been part of the problem. The health board are sponsoring a post-graduate dentist to train in orthodontics in the Dublin Dental Hospital and facilities will be available in that hospital for specialist treatment for patients from the North Eastern Health Board area. This will go a long way towards alleviating the most difficult problems.

In relation to orthodontics, the Minister always refers to the five posts which were advertised. Would he consider changing from consultant posts to specialist posts, requiring four years post-graduate training instead of seven? There is an acute shortage of consultants. Would the Minister consider readvertising the posts on a specialist basis? He might then be able to fill them.

As a result of the very important review carried out by my colleague, the Minister of State, we are looking at all areas of the service to see how it can be improved. I am not sure that we would have it within our power to change the length of training. I think it would be a matter for another authority. We are looking at various ways and means of ensuring that an increased level of orthodontic treatment is available.

The Minister has indicated long term solutions. In the immediate short term would the Minister not allow private practitioners to deal with the cases I have raised today? The situation is so critical that I must make another suggestion, although I am reluctant to do so. There is no difficulty in having treatment in Northern Ireland. Would the Minister be prepared to look to Northern Ireland for help in this crisis?

Certainly I will undertake to bring up the three cases with the North Eastern Health Board to see if they are in an position to provide an alternative. I am satisfied that the arrangement with the Dublin Dental Hospital will alleviate the situation in the North Eastern Health Board area.