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Dáil Éireann díospóireacht -
Thursday, 11 Nov 1999

Vol. 510 No. 5

Ceisteanna – Questions. Priority Questions. - Orthodontic Service.

Seán Barrett

Ceist:

6 Mr. Barrett asked the Minister for Health and Children the difficulties with the orthodontic service in the Eastern Health Board area; the reason appointments are not being made for orthodontic consultations; if his attention has been drawn to the number of children awaiting appointments for these consultations; and the steps, if any, he proposes to take to resolve the difficulties. [22812/99]

Alan Shatter

Ceist:

160 Mr. Shatter asked the Minister for Health and Children the difficulties with the orthodontic service in the Eastern Health Board area; the reason appointments are not being made for orthodontic consultations; if his attention has been drawn to the number of children awaiting appointments for these consultations; and the steps, if any, he proposes to take to resolve the difficulties. [23036/99]

I propose to take Questions Nos. 6 and 160 together.

The Eastern Health Board has been experiencing difficulties in the provision of services in its regional orthodontic department in St. James's Hospital in recent months. I understand from the board that these difficulties have been caused by the consultant orthodontist's unilateral decision to withdraw from the provision of orthodontic assessments, orthodontic opinions and the commencement of orthodontic appliance therapy for new patients. The position was exacerbated more recently by the withdrawal of consultant cover and the consultant orthodontist's refusal to provide guidance to dental clinicians regarding orthodontic procedures.

Despite negotiations and discussion at the highest level in the Eastern Health Board, the consultant orthodontist has persistently refused to provide services as outlined. I now understand that the consultant orthodontist's actions have led to her suspension from duty without pay with effect from 4 November 1999.

The Eastern Health Board is now in the process of ensuring that appropriate arrangements are put in place to provide continuity of orthodontic service as heretofore.

Will the Minister confirm that appointments are currently not being given by the Eastern Health Board for orthodontic assessments for children? Will he confirm that, as of 31 March 1999, there were 6,418 patients in the Eastern Health Board area awaiting such assessment? Will he clarify why, in reply to a Dáil question some two and a half weeks ago about the number of children on orthodontic assessment waiting lists in the Eastern Health Board area, he said there were 83 in total, compared with some 6,000 on the Southern Health Board waiting list, with no explanation provided?

The Deputy has raised the last part of his question without notice. I will get whatever explanation exists for that.

As I stated, there was a particularly problematic position in the Eastern Health Board in relation to the consultant orthodontist's refusal to do the work assigned to her. On the need to improve the orthodontic services generally in the Eastern Health Board area, as a result of this suspension without pay, the board is in discussion with its specialist orthodontic staff with regard to the provision of full cover for patients.

The Eastern Health Board also proposes to develop two further orthodontic units at Loughlinstown and Beaumont hospitals. Capital funding of £1,060,000 for the Loughlinstown unit is being provided by the Department and it will be ready before the end of this year. The Beaumont unit will cost more than £2 million. A brief has been submitted and is under consideration in the Department. The development of these units will make a significant contribution to the orthodontic service in the board's area. There is an historic problem in relation to dental services and there will be increased provision in the Estimates for it, to be announced this evening.

What does the Minister have to say to the estimated 8,000 children – it is an estimated figure because we do not have the up to date figures – and their parents who are awaiting appointments for orthodontic assessment from the Eastern Health Board? When will they be given appointments? When is it likely that the treatment they need will be undertaken? How will this issue be resolved, in the context of these difficulties having initially occurred six months ago? Why is it that every parent who contacts the health board to find out the likely timeframe within which their sons or daughters will be assessed, is simply informed they can be told nothing? Does the Minister agree that is a totally unsatisfactory situation?

As I said, there has been an unsatisfactory situation in regard to the Eastern Health Board because of a specific industrial relations problem. I do not want to comment any further on that, other than in the basic information I have given to the House on the current position.

In regard to orthodontic services in the health services generally, there are seven consultant orthodontists available to health boards and to the unit in St. James' Hospital. They are supported by 40 dental surgeons, trained under the direction and supervision of the consultant. I recently consented to the recognition of orthodontics as a speciality for registration by the Dental Council. It is now a matter for the Dental Council to decide on the formal structures for training specialist orthodontists. There was a considerable level of disagreement between the hospitals and the orthodontic consultants about the training modules which were to be used to ensure that we can get more trained people in this area to do the increasing level of work required. We are now proceeding to deal with that issue.

However, I take the point that we have had an unsatisfactory situation in relation to the dental services, generally, for a long time. There will be increased provision in the Estimates this year to try to deal with that historic problem. The backlog will not be resolved in the immediate future but it will be improved upon, based on some recent decisions.

When will the health boards start to give appointments for children to be assessed?

Discussions are taking place with the existing personnel, as a result of the consultant orthodontist not being involved, to resume that basic level of service. I have also indicated to the House that I have provided for the development of two further orthodontic units, in addition to the one we already have.

Time is up on this question. We must proceed to Question No. 7.

A Cheann Comhairle, I indicated that I wanted to ask two short questions.

Time is up. The Deputy must be aware of the time limit on questions.

I am not in charge of time, a Cheann Comhairle.

The Deputy cannot ask a question as the time is up.

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