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Dáil Éireann díospóireacht -
Wednesday, 20 Feb 2002

Vol. 549 No. 1

Written Answers. - Orthodontic Service.

Bernard J. Durkan

Ceist:

169 Mr. Durkan asked the Minister for Health and Children the action taken by him in each of the past four years to reduce the numbers on orthodontic waiting lists; the number of patients who have received treatment; the number awaiting treatment; his plans for the service during the next four years; and if he will make a statement on the matter. [6104/02]

The provision of orthodontic treatment to eligible persons is the statutory responsibility of the health boards in the first instance. Over the past four years, I have initiated a range of measures to increase the number of patients in orthodontic treatment. At the invitation of my Department, a group representative of health board management and consultant orthodontists reviewed orthodontic services. The objective of this review was to ensure equity in the provision of orthodontic treatment throughout the health boards. Following this review, known as the Moran report, structural changes are being introduced in the 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. The Dental Council has established a register of dental specialists with a division of orthodontics and agreement has been reached at the Health Service Employers Agency on the introduction of the grade of specialist in orthodontics into the orthodontics service. This agreement resulted from complex and time consuming negotiations and its introduction will have a tremendous impact on the future delivery of orthodontics.

Six dentists from the Eastern Regional Health Authority, North-Eastern Health Board and South-Eastern Health Board commenced their training last October for specialist in orthodontics qualifications. My Department has provided €0.541 million in 2002 for such training. Furthermore, three dentists from the Western Health Board and North-Eastern Health Board are already in specialist training for orthodontics and this brings the total number of dentists in such training to nine. The general objective of these training programmes is to educate dentists to become specialists in orthodontics with a broad academic background and experience in different clinical treatment methods. They are made possible by co-operation between health boards, consultant orthodontists and dental teaching institutions. Discussions on providing an additional training course to commence this year are also under way.

The review group also recommended that auxiliaries be employed in the regional orthodontic units of the health boards. In order to enable the achievement of greater caseloads, the Dental Council has been approached concerning the creation of a scheme for the recognition of auxili ary dental workers in orthodontics. This grade, to be known as orthodontic therapist, will act as a support to the consultant orthodontists, specialists and other dentists working in the orthodontic units thus enabling a greater volume of treatment.
My Department has funded the appointment of a director of specialist training for the Irish committee for specialist training in dentistry through the Post Graduate Medical and Dental Board. The director has taken up duty and will play a pivotal role in assisting the different agencies involved in dental specialist training programmes. In addition, my Department has funded the recruitment of a professor in orthodontics at Cork University dental school to facilitate the development of an approved training programme leading to specialist qualifications in orthodontics. Capital funding of approximately €1.27 million was also provided to the orthodontics unit there for its refurbishment to an appropriate standard. My Department has also funded the development of new regional orthodontic units at Dundalk and Navan, both of which are operational, and the recruitment of a consultant orthodontist for the Midland Health Board who was appointed in 2001.
Last year, given that it may be some time before the structural changes take effect, I funded an orthodontic initiative to ease current pressures on the system. Additional funding of €6.729 million was approved for orthodontic services in 2001 of which €4.698 million was to fund an initiative on orthodontic waiting lists. The chief executive officers of the health boards have informed me of the following progress with developments under the initiative. Two consultant orthodontists, five specialists in orthodontics, one dental team and two permanent superintendent radiographers have been recruited. A six surgery facility at Loughlinstown regional orthodontic unit has been developed and is now open and the treatment of patients there has commenced. The equipping of an additional five surgery unit at the St. James's Hospital orthodontic unit has been completed and the unit is now operational, and three orthodontic managers have been recruited in the Eastern Regional Health Authority to manage the orthodontic services of the area health boards. Furthermore, under this initiative my Department is exploring with health boards new arrangements for the treatment of patients, both by private specialist orthodontic practitioners and in out-of-hours sessions by health board orthodontists.
The chief executive officers have informed me that at the end of the December 2001 quarter, the total number of patients on the waiting list for treatment was 11,890. This is a reduction of 1,613 in comparison with the corresponding figure at the end of the June 2001 quarter. The chief executive officers of the health boards have also informed me that at the end of the same quarter there were 17,295 patients in orthodontic treatment in the health boards. This is an increase of 3,086 patients in orthodontic treatment when compared with the number of patients in treatment in May 1999. I expect that the number of patients in orthodontic treatment will continue to increase as the range of measures that I have initiated continue to impact on the orthodontic service. Finally, over the next four years, my Department will continue to develop the public orthodontic service in line with the recommendations of the Moran report and ultimately implement the above structural changes envisaged for the service.
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