asked the Minister for Health if his attention has been drawn to the fact that the guidelines issued by his Department in relation to orthodontic treatment for children restrict treatment to those with very severe defects only; that up to two-thirds of patients who require treatment do not meet these requirements; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Questions. - Orthodontic Treatment for Children.
14.
The guidelines issued by my Department to the health boards in relation to the provision of specialist orthodontic treatment are based on the principle that the more severe cases must get priority. The priorities are clearly defined in the guidelines and every category of need is recognised and catered for according to its degree of priority. Therefore, it is not true to say that only those with very severe defects are catered for.
Is the Minister aware that, according to the principal dental surgeons operating the scheme, two-thirds of applicants are not eligible under the guidelines? Is he also aware that false hopes are raised by calling people for examination and that two out of every three who are called are subsequently not treated? Will he provide the resources to enable all who need orthodontic care to be treated properly?
If what Deputy Howlin says is correct, it is an indictment of his own colleague who in 1985 supervised the issuing of the guidelines.
He tried to recruit orthodontists.
Without much success.
If the Deputy wishes, I can read the guidelines into the record. So far as I am concerned, they are very clear, reasonably flexible and ensure that those who need treatment get it as quickly as possible.
Will the Minister accept that two out of three people who need orthodontic care are not receiving it? What plans has he to provide care for all those in need in terms of resources? We are not talking about the guidelines in isolation, we are talking about the number of orthodontists needed to provide a service. What plans has the Minister to provide orthodontic care for those people?
I have no difficulty in accepting that the standard of dental services available across the board is not up to the standard to which we all aspire and desire. However, the Minister and I are totally committed to improving that situation. A sum of £300,000 is provided in the Supplementary Estimate and in the context of the Estimate for 1990 the Minister is doing his utmost to ensure that extra funding will be made available. We are reasonably optimistic and we hope to improve the situation in regard to the dental service as quickly as possible.
Will the Minister confirm that there are 24,000 children on the waiting list for orthodontic treatment and that the list is so long that their eligibility ceases when they leave school? Does the Minister have any proposals to establish a new post of orthodontic specialist to deal with the backlog?
I cannot confirm that there are 24,000 on the waiting list. I was not asked that question and I do not have the information. However, I accept that there is a pretty long waiting list but we are committed to reducing it as quickly as possible, taking into account the available resources.
What about the specialist position?
Will the Minister agree that children who require orthodontic treatment are very conscious of their condition? The dentists employed by the health board continually say how restricted they are because of the guidelines introduced by the Department. Will the Minister agree that his colleague, Deputy Dennehy, has been very vocal in highlighting this problem in the Southern Health Board over the last three or four years? He has said that the guidelines must be changed and, in the light of that——
The Deputy has made his point.
I appreciate the Deputy's remarks but orthodontists in the public service feel that priority must be given to people who have impediments as a result of the need for proper orthodontic treatment. Cosmetic orthodontics is a secondary consideration. Taking into account the guidelines laid down, the resources available and the professional judgment of the orthodontists, we are doing the best we can. I am confident that with the 500 extra cases which will be treated and the commitment we have to improving the situation in the new year, we can reduce the waiting list and provide a better service.
Will the Minister accept that £300,000 is totally inadequate and will barely touch the tip of the iceberg? Will he indicate how the 500 priority cases will be selected from the 24,000 people on the waiting list? How will the treatment be spread across the health board regions? Who will determine who will get treatment?
I do not accept that the sum of £300,000 is inadequate because it is a commitment by the Minister, the Government, the Department and myself to improve the situation. The 500 cases have already been decided on by the orthodontists within the health board areas and by the chief dental surgeons and their teams. The 50 most severe cases have been selected by them and sent forward to the Department. The resources will be made available and I hope that the 500 cases will be treated between now and Christmas.