Dáil Éireann díospóireacht -
Wednesday, 3 Oct 2001

Vol. 541 No. 2

Written Answers. - Orthodontic Service.

Denis Naughten

Ceist:

639 Mr. Naughten asked the Minister for Health and Children the number of children awaiting assessment for orthodontic treatment. the number on the waiting list for treatment in each health board area; the waiting time for reach list; the plans he has to reduce the waiting lists; and if he will make a statement on the matter. [22454/01]

Minister for Health and Children (Mr. Martin):

The provision of orthodontic services is the responsibility of the health boards in the first instance.

Following recommendations in the Moran report, Review of Orthodontic Services, structural changes are being introduced in orthodontic services. One of the review group's recommendations was that appropriately trained, qualified and registered specialist orthodontists be employed in regional orthodontic units to ensure the continuation of a high quality service. An accord has been reached between the Dental Council, the two dental schools and hospitals in Dublin and Cork and the Irish Committee for Specialist Training in Dentistry to establish specialist dental training in this country on a sound footing. The Dublin Dental Hospital, Trinity College and health boards have advertised a specialist training programme in orthodontics and six dentists for the health board orthodontic services will commence training this month. The Dental Council has established a register of dental specialists with a division of orthodontics and a resolution to the issue of a specialist grade in orthodontics within the health board service is expected shortly.

I am confident that the setting up of a specialist register and the creation of the grade of specialist orthodontist in the health board service will result in a substantial improvement in the efficiency and effectiveness of the orthodontic service. I have also approached the Dental Council concerning the creation of a scheme for the recognition of auxiliary dental workers in orthodontics. This grade will act as a support to the consultant orthodontist, specialists and other dentists working in the orthodontic unit thus enabling greater caseloads to be achieved. However, it will be some time before these structural changes impact significantly on service levels. Consequently, I asked health boards to develop proposals to make an immediate significant impact on their waiting lists. An additional investment of £5.3 million – 6.729 million – has been approved for orthodontic services this year, of which £3.7 million – 4.698 million – is to fund an initiative on orthodontic waiting lists. This will enable health boards to recruit additional staff and engage the services of private orthodontists to treat patients.

Overall, this initiative will have a significant impact on orthodontic waiting lists. The health boards have advised me that the ultimate effect of their proposals when fully implemented, will be to increase the numbers in treatment by 5,500 per annum and significantly reduce waiting times for treatment.

I am informed by the chief executive officers of the health boards that at the end of the June 2001 quarter there were 15,527 patients in treatment. The chief executive officers of the health boards have also informed me that the number of patients awaiting assessment and treatment in their areas of responsibility at the end of the June 2001 quarter were as follows:

Health Board	Assessment Waiting List		Waiting Time (Months)	Treatment Waiting List	Category A	Waiting time (Months)	Category B	Waiting time (Months)
ERHA	11,608	72	195	3	685	24
Midland	148	1-3	Nil	N/a	303	15-21
Mid-Western	3,308	24-36	Nil	N/a	1,432	24-36
North-Eastern	Nil	N/a	10	1.5-2	781	24-30
North-Western	450	9	528	32-41	2,075	28-48
South-Eastern	320	2.5-3	Nil	N/a	547	14
Southern	5,500	Currently assessing patients born in September 1987	Nil	N/a	5,164	42-48
Western	676	9	Nil	N/a	1,783	48
Totals	22,010		733		12,770

Patients are referred for secondary care orthodontic treatment in accordance with guidelines issued by my Department that prioritise need for treatment based on the degree of handicap and severity of malocclusion. Patients in category A require immediate treatment and include those with congenital abnormalities of the jaws such as cleft lip and palate, and patients with major skeletal discrepancies between the sizes of the jaws. Patients in category B have less severe problems than category A patients but have a definite need of treatment and are placed on the orthodontic treatment waiting list.