Vol. 396 No. 5
7 Miss Flaherty asked the Minister for Health if he will outline the community care guidelines in relation to incontinence wear, with particular reference to persons (details supplied) in Dublin 22 who are suffering from spina bifida; and his views on whether the allowance is adequate for persons of limited income.
Spina Bifida is a prescribed long term illness. Children with this condition are supplied free of charge with a standard quantity (60 per month) of incontinence wear. In cases where there are exceptional circumstances the health board on the recommendation of the director of community care increases this allowance. I have asked the chief executive officer of the Eastern Health Board to reply directly as a matter of urgency to the Deputy as regards the provision of incontinence wear to the individuals instanced.
Is the Minister aware that over the last couple of years there has been a widespread practice within health boards to ration incontinence pads? Will he ensure that this practice ceases forthwith and that there will be a ready supply and flexibility in making them available to all patients who need them?
I cannot say that I will ask the health boards to cease rationing because it is reasonable that they should select a specific number of incontinence pads——
It is disgraceful.
It is reasonable that there should be a set number available to patients. However, where there are exceptional circumstances it is important that the board should be flexible and look at the matter sympathetically. I understand that the board do this. In relation to the question raised by Deputy Flaherty, as I said, I have written to the health board asking them to look at the case again and to reply directly to Deputy Flaherty.
The Minister's reply is totally unsatisfactory. I asked him to realise that this causes hardship to the families of different types of patients who require these incontinence pads. It is very humiliating for them and I ask him to reconsider this as a matter of urgency.
The Deputy has already made his point very effectively.
What the Deputy is asking is that there would be no rationing whatever, that they could get whatever they wanted. I accept that the health board have a responsibility in how they administer that but they should be flexible and ensure that there are sufficient pads for the needs of the patients.
Does the Minister appreciate that in relation to this matter, 60 per month is approximately two per day——
I did not comment on numbers at all.
——which is totally inadequate for an adult with this problem and that it is unreasonable to ration to that extent?
Question No. 9 please.
9 Mr. McCormack asked the Minister for Health when an orthodontist will be appointed for County Galway.
25 Mr. Taylor asked the Minister for Health the number of orthodontists required and for which there are vacancies in each of the health board areas; the date on which advertisements were placed or efforts were made by the Civil Service Commission to secure candidates to fill these vacancies; and if he will make a statement on the matter.
I propose to take Questions Nos. 9 and 25 together.
As a result of the report on the Working Party on Dental Services it was decided that 6 posts of consultant orthodontists would be created in order to fulfil the national requirement. Only one post, located in the Mid-Western Health Board, has been filled to date. I have made inquiries of the Local Appointments Commission and am informed that the five vacant posts have been advertised on a number of occasions since 1984, both in the national press and in international professional journals. The dates on which the posts were advertised are as follows: Western, 11-12-85, 28-10-87; NorthWestern, 23-1-85, 17-9-86; Southern, 23-1-85, 11-12-85, 17-9-86; South-Eastern, 18-4-84, 13-6-84, 23-1-85, 11-12-85, 17-9-86; Eastern, 13-6-84, 23-1-85.
In some cases, candidates were offered appointment but declined the posts.
My Department have been reviewing the terms and conditions that apply to the posts of consultant orthodontist with a view to making them more attractive to suitable candidates. Following this review I would expect that the health boards including the Western Health Board will request the Local Appointments Commission to readvertise the vacant posts.
The health boards have made alternative arrangements for the provision of orthodontic treatment and have been able to expand the level of treatment provided as a result of the special allocations made by the Government before Christmas and again in the budget. Those additional moneys will bring about a significant improvement in orthodontic services.
Would the Minister of State agree that the reason why these posts cannot be filled is that there is no scope for private practice, which is normal with other consultant posts, and will he include some small element of that or change the post from that of consultant to specialist? This has been known for two years to be the problem. Why has the Minister not taken action to alter the posts in this way and re-advertise them and fill them?
I accept that people who have considered the posts have chosen to remain in private practice. The matter is being reviewed by my Department——
Another review.
It seems the Deputy does not want to make progress on the matter or bring the matter to a successful conclusion. That will not deter us from bringing this matter to a successful conclusion as quickly as possible. We have allocated extra resources in the budget and in the Estimates for the orthodontic and dental services. We are presently reviewing the situation to try to find a solution that would allow for the employment of more orthodontists because we appreciate the need for them. We regret that it has not been possible in the life time of this Government or of previous Governments to fulfil the requirement and fill the posts that were advertised.
In reviewing the conditions has the Minister identified the reasons why these posts have not been taken up and can he give the salary for these posts?
We are going into a lot of detail that might require separate questions.
We know some of the reasons why the posts have not been taken up——
I have told you the reasons.
You told us one reason.
Let us hear the Minister's reply. Order.
They are so well off in private practice that they are not interested.
Questions have been asked. Let us be good enough to hear the reply.
We are trying to find a balance between the desire of consultants and orthodontists to work in the private sector and the public sector. I have not the information about the salaries that the Deputy has requested but we hope that on the basis of the review and in the totality of the information that will be made available to us we will find a consensus which will allow us to fill the posts as quickly as possible.
Will the Minister clarify how much of the £3 million he referred to will be allocated to orthodontist services this year, in view of the fact that over 20,000 people are on the waiting list?
The information that the Deputy now seeks was not sought in the original question, but suffice it to say that a good proportion——
You do not know.
I do. I have a good idea.
Tell us?
I want to be exact. I want to give the House——
It is a drop in the bucket.
It is not a drop in the bucket. It is a good proportional percentage of the £3 million. I can get the Deputy the information if he wishes.
Right.
