Written Answers. - Orthodontic Service.
Enda Kenny
Ceist:
338
Mr. Kenny
asked the
Minister for Health and Children
the reason patients on the orthodontic waiting list for treatment in the Western Health Board area have to wait four years for treatment given the moneys made available; the numbers employed and the general treatment period involved for patients; and if he will make a statement on the matter.
[22288/02]
Enda Kenny
Ceist:
340
Mr. Kenny
asked the
Minister for Health and Children
the extent of finance allocated for orthodontic treatment in the Western Health Board area for each of the past four years; the criteria which are used for assessment for eligibility for orthodontic treatment; if these criteria conform to the 1985 agreed guidelines; the approximate waiting times for those assessed as being in category A, B and C; and if it is the policy of the Western Health Board area to indicate to those assessed as being in category C that they should have private treatment carried out
[22290/02]
Enda Kenny
Ceist:
341
Mr. Kenny
asked the
Minister for Health and Children
the number of full-time orthodontists employed in the Western Health Board area; the number of part-time orthodontists employed in the Western Health Board area; the number of orthodontic practitioners employed in the Western Health Board area; the numbers on the waiting list for orthodontic treatment as of 1 November 2002; the waiting times for treatment as of 1 November 2002; and if he will make a statement on the matter.
[22291/02]
I propose to take Questions Nos. 338, 340 and 341 together.
The provision of orthodontic treatment in the Western Health Board is the responsibility of that board in the first instance. Entitlement to orthodontic treatment is determined by reference to orthodontic guidelines, a set of objective clinical criteria applied by health board orthodontists when assessing children's priority of need for treatment. The orthodontic guidelines were issued by my Department in 1985 and are still in use. The orthodontic guidelines are used to ensure that orthodontic resources are prioritised for and applied equitably to the most severe cases. Patients assessed as category A have severe malocclusions and should receive urgent orthodontic care. Patients assessed as category B have less severe problems and are placed on orthodontic treatment waiting lists.
In the Western Health Board – WHB – as in other boards, the number of cases treated is dependent on the level of resources available in terms of qualified staff in the area and this is reflected in the treatment waiting list. The provision of orthodontic services is severely restricted due to the limited availability of trained specialist clinical staff to assess and treat patients.
The board does not maintain a category C waiting list and the chief executive officer has informed me that the board makes patients and their parents aware of the availability of tax credits on private treatment undertaken. The chief executive officer has further informed me that the average treatment period involved for patients is approximately two years and one year retention.
I have taken a number of measures to improve orthodontic services on a national basis, including those services provided in the Western Health Board area. The grade of specialist in orthodontics has been created in the health board orthodontic service. The introduction of this pivotal grade will have a tremendous impact on the future delivery of orthodontics in the public service. Ultimately, it will address the issues of recruitment and retention of qualified clinical personnel in the service.
This year, my Department expects to fund 11 dentists from various health boards, including the Western Health Board, for specialist in orthodontics qualifications at training programmes in Ireland and at two separate universities in the United Kingdom. These 11 trainees for the public orthodontic service are additional to the six dentists who commenced their training last year and one dentist whose specialist training is nearing completion. This is an aggregate of 18 public service dentists in training for specialist in orthodontics qualifications. Two dentists from the Western Health Board have recently completed their specialist in orthodontics training and have taken up duty with the board.
The training programmes concerned provide a broad academic background and experience in different clinical treatment methods and are made possible by co-operation between health boards, health board consultant orthodontists and dental teaching institutions.
These measures will complement the other structural changes being introduced into the orthodontic service, including the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area. The grade of orthodontic therapist will act as a support to the consultant orthodontist, specialists and other dentists working in the orthodontic unit, thus enabling a greater volume of treatment.
In 1999 and 2000 I provided additional ongoing funding of €89,000 and €190,000 respectively for orthodontic services in the board. For 2001 I provided an additional €628,000 to the board, of which €533,000 was for an orthodontic initiative to ease pressures in the system. Under the initiative, the board has recruited an additional specialist in orthodontics and engaged the services of private specialist orthodontic practitioners to treat cases. The chief executive officer of the WHB has informed me that, as of 15 November 2002, the board employs the following wholetime equivalent orthodontic staff in its orthodontic service:
|
Consultant
|
Specialist
|
Trainee
|
Principal Dental Officer
|
Dental Surgeon
|
|
1
|
3.2
|
1
|
0.2
|
1
|
Last June, my Department provided additional funding of €5 million from the treatment purchase fund to health boards specifically for the purchase of orthodontic treatment. This funding is enabling boards to provide both additional sessions for existing staff and purchase treatment from private specialist orthodontic practitioners. Under the scheme, the Western Health Board received €465,000 to treat cases in this way.
The chief executive officer of the Western Health Board has informed me that as of 30 September 2002, the number of cases awaiting orthodontic assessment was 599, and the number of category B cases awaiting orthodontic treatment was 1,066. On the same date the average waiting time for orthodontic assessment and treatment in the Western Health Board area was nine months and three to four years respectively.
There are no cases on the board's category A treatment waiting list and, consequently, there is no waiting time for category A cases. The chief executive officer has further informed me that on the same date 1,403 cases were in treatment.
The initiatives and structural changes I have set out will bring about an improvement in numbers treated and waiting times for treatment and will positively impact on the future delivery of orthodontic services in the longer term.
