Written Answers. - Orthodontic Service.
Michael Creed
Ceist:
402
Mr. Creed
asked the
Minister for Health and Children
the guidelines which are used by health board orthodontists when determining entitlement to orthodontic treatment for children in view of the fact that there are now three sets of guidelines (details supplied); and if he will make a statement on the matter.
[8910/02]
Michael Creed
Ceist:
407
Mr. Creed
asked the
Minister for Health and Children
the reason orthodontic guidelines issued by his Department in June 2001 and in October 2001 are far more restrictive when determining eligibility for treatment than the 1985 guidelines; and his proposals to resolve the problems of a lack of an orthodontic service for children as a result.
[8915/02]
I propose to take Questions Nos. 402 and 407 together.
Orthodontic guidelines were issued by my Department in 1985 and are still in operation. Their purpose is to allow prioritisation of children for orthodontic treatment based on the severity of need. The guidelines are intended to enable health boards to identify in a consistent way those in greatest need and to commence timely treatment for them. Persons assessed as category A have severe malocclusions and should receive urgent orthodontic care; those assessed as category B have less severe problems and are placed on orthodontic treatment waiting lists. The number of cases treated will depend on the level of resources available in terms of qualified staff in an area.
Health board consultant orthodontists recommended that the 1985 guidelines be modified to prioritise treatment for the most severe cases. The purpose of the modified 1985 guidelines is to ensure that the most severe cases receive priority treatment as soon as possible. My Department will be writing to the chief executive officers of the health boards concerning the operation of these modified guidelines with regard to maintaining the delivery of orthodontic services in a prioritised way. The chief executive officers' report on orthodontics, known as the Moran report, recommended the use of an alternative index of need. This is known as the index of orthodontic treatment need, IOTN. The chief dental officer has advised that this new index should not be implemented until its implications have been evaluated in a national survey of children's dental health. This survey is currently under way and is expected to be completed this year. The purpose of the survey is to identify accurately the number of children that would benefit from orthodontic treatment and the resources needed to meet the corresponding level of care.
I have taken a range of important measures to improve the capacity of the public orthodontic services and place it on a sound long-term footing. Structural changes are being introduced into the orthodontic service such as the creation of the grade of specialist in orthodontics, the development of specialist training programmes and the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area. 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 €541,000 in 2002 for this 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. Discussions on providing an additional training course to commence this year are also under way.
My Department has funded the appointment of a director of specialist training for the Irish Committee for specialist training in dentistry through the Postgraduate 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 also 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.
In the short-term, I have funded an orthodontic initiative to ease current pressures on the system. Additional funding of €6.729 million was approved for orthodontic services last year of which €4.698 million was to fund an initiative on orthodontic waiting lists. This is enabling health boards to recruit additional staff and engage the services of private specialist orthodontic practitioners to treat patients. An additional six-surgery and five-surgery facility at the Loughlinstown regional urthodontic unit and the St. James' Hospital regional orthodontic unit respectively have also been developed under the initiative. My Department is exploring with boards every possibility to expand the level of services in the short-term such as the use of private specialist orthodontic practitioners and the treatment of patients in out-of-hours sessions by health board orthodontists.
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 last year. The chief executive officers of the health boards have advised me that the number of patients awaiting assessment and treatment fell by 1,133 and 1,613 respectively between June and December 2001. In addition, at the end of the December 2001 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 measures that I have taken to improve orthodontic services take effect.
