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Dáil Éireann díospóireacht -
Wednesday, 31 Mar 1993

Vol. 428 No. 6

Adjournment Debates. - South Tipperary Orthodontic Service.

I want to thank you, a Cheann Comhairle, for your permission to raise this very important issue on the Adjournment. It is alarming that the orthodontic service in South Tipperary is now almost at a standstill. This position has pertained since September 1992 and no treatment can be provided due to the lack of essential X-ray equipment. As a result, the waiting lists get longer and the length of time for which people have to wait for this service is extending into the distant future. That this should be allowed to happen is disgraceful. Even before this emergency arose there was much dissatisfaction with the service, and rightly so, but this feeling of dissatisfaction is now replaced with anger and frustration. At present 230 people are waiting for orthodontic service in South Tipperary and a further 150 are awaiting assessment. A total of 380 people are suffering as a result of the disgraceful delay in providing this X-ray facility.

I must at this stage compliment all the staff of the dental department of the county clinic in Clonmel who are trying to cope with this problem with an amazing degree of pleasantness despite their unsatisfactory working conditions. On a daily basis they have to deal with distraught parents who are annoyed with the lack of service and with young adults who are fed up waiting for the service, the lack of which in many cases causes embarrassment and distress.

The entire national orthondoctic service is in a shambles. Pressure on the State service will continue while private orthodontic treatment is so expensive. It is essential that an improved service be provided because the majority of parents cannot afford to pay for private treatment.

I must seriously question the delay — since September last — in the provision of this equipment in South Tipperary. Surely, so essential a resource should have been given priority. I now understand that an order was placed for the X-ray unit in December, yet three months later there is still no X-ray unit in place. This is just not good enough and indeed it saved the Minister and his Department from much embarrassment and angry comment in that the general public were unaware of the reasons for the worsening delay for orthodontic treatment.

The Programme for a Partnership Government states:

we will implement a series of major improvements in the dental service.

I hope that commitment will be honoured but the service is in such an appalling state at the moment that I do not know if they can cope with the demand. The Government should not have allowed even the first two months in office to pass without taking immediate action.

Problems arose in Clonmel in regard to the accommodation for the X-ray unit and who will operate it. This caused further delay and but for the co-operation of the staff, the hope of this X-ray unit for South Tipperary could indeed have been extinguished. I am asking the Minister to take immediate action to ensure that this equipment is placed in South Tipperary immediately and that sufficient staff will be provided to cope with the demand for orthodontic service and now to cope with the enormous backlog that has arisen.

Daily, I am contacted by distraught and anxious parents who are totally disillusioned with the service and see no hope of their children ever being called for treatment.

I urge the Minister to come to their aid, to allow the dental staff in South Tipperary to do their work and provide a proper service to which our children and teenagers are entitled.

I thank the Deputy for bringing my attention to this matter. I understand from the South Eastern Health Board that the treatment of new orthodontic cases from the South Tipperary area has been deferred pending the installation in Clonmel clinic of new dental X-ray apparatus. There have been no cancellations of existing treatments for which X-ray procedures continue to be available.

The position is that the board intends to install in Clonmel clinic a specialised piece of dental X-ray equipment which is necessary for the provision of secondary care orthodontic treatment. Its purpose is to provide standardised and identical X-rays over the period of treatment of orthodontic cases in order to detect and monitor changes in the patient's orthodontic condition.

The apparatus has, in fact, already been purchased by the board but it has not yet been installed pending the finalisation of the arrangements arising from its location in the clinic. This includes the structural alterations to the premises and the provision of radiation protection which is currently in train.

The board hopes to have the equipment installed and operational within the next four weeks, at which stage the treatment of new orthodontic cases will recommence.

I might mention that over the past few years additional moneys have been made available by my Department to the South Eastern Health Board specifically for the development of its orthodontic services. These additional moneys enabled the board to re-advertise the post of consultant orthodontist and the board was successful in filling the post. The consultant took up duty in October 1992 and immediately undertook a review of the boards orthodontic services.

Arising out of the consultant's review and proposals made to my Department by the South Eastern Health Board, my Department approved funding for the setting up of a number of surgeries for the consultant in Ardkeen Hospital. In addition a capital grant of £100,000 has been approved for the orthodontic developments proposed by the board within the community care programme.

A primary task of the new consultant is the organisation of orthodontic training for the board's dental staff. This will enable the board to make further improvements in service levels.

I might mention that despite the temporary cessation in new cases being taken on for orthodontic treatment from the South Tipperary area the board is currently providing such treatment for 264 children from the area. This compares very favourably with the throughput of cases in previous years when fewer than 100 persons commenced treatment and the waiting list was over 1,000. The current waiting list is 224 and the availability of the new X-ray apparatus, together with the service improvements I indicated, will enable the health board to provide a much enhanced orthodontic service for the areas in the immediate future.

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