Vol. 557 No. 6
7 Mr. Deenihan asked the Minister for Health and Children if a consultant orthodontist has been appointed for the Tralee unit at Moyderwell as promised in a reply to a parliamentary question on 18 June 2002; and if he will make a statement on the matter. [22935/02]
The provision of orthodontic services is a matter for the health boards in the first instance. I am pleased to advise the Deputy that I have taken a number of measures to improve orthodontic services in the Southern Health Board area and on a national basis. 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.
The Southern Health Board was allocated an additional €1.191million last year for orthodontic services, of which €1.032 million was for the orthodontic initiative. Under the initiative, the board proposes, inter alia, to recruit an additional two consultant orthodontists, one of whom will be based in Tralee. The chief executive officer of the board has informed me that it recently advertised this position through the Local Appointments Commission, but on this occasion no eligible applicants applied for it. The board will again consider the possibility of advertising the post at the earliest opportunity.
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. The Southern Health Board was allocated an additional €720,000 from this fund for the treatment of cases in this way.
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 qualification in orthodontics.
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 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 in addition to the six dentists who commenced their training last year and one dentist whose specialist training is nearing completion. That is an aggregate of 18 public service dentists currently in training for specialist in orthodontics qualifications.
Additional informationThe 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.
The chief executive officer of the Southern Health Board has informed me that at the end of the September 2002 quarter, there were 3,067 patients in orthodontic treatment in the board. This is an increase of approximately 767 patients in orthodontic treatment compared with the number of patients in treatment in December 2001. 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.
Is the Minister aware that 1,000 people are awaiting treatment at the Tralee unit, there is a four year waiting list in that unit, there is a large number waiting for assessment – we are unsure of the figure – and that he promised in the Dáil to appoint a consultant orthodontist for the unit earlier this year? Although the Minister has outlined the investment in the orthodontic service, the service on the ground is deteriorating rapidly. Does he agree that there is an urgent need to ensure that the row in the orthodontic service between orthodontic consultants, dental colleges and his own Department be sorted out? If he spent some time solving that row—
There is a time limit, Deputy.
—and getting people around the table to work together, it would be better than throwing money at the problem without the service.
With respect, I am not taking any responsibility for any of the historic conflicts between individuals and dental schools.
The Minister has a responsibility to sort it out.
No, I have a responsibility to provide a service and I will do that.
But the Minister is not.
I am. I actually provided funding—
Please allow the Minister to reply.
People are being knocked off the list.
Deputy Durkan will have a question later, which I will gladly deal with then.
I have, several of them.
I do not hold the interviews. I do not go around the world myself to grab some consultant orthodontist to ask him to come to Cork to work. There is a process for doing that and it is carried out by the Local Appointments Commission. It is done independently.
Why is that process not working?
Two attempts were made. I provided the funding for a consultant orthodontist in Tralee. I would like nothing more than to get a consultant into Tralee—
Why is it not working?
—and the second consultant for the city of Cork and the north county area.
There is something seriously wrong with the training system.
For five years, we—
We have not had it for five years. We only sanctioned it—
Allow the Minister to reply.
We sanctioned these posts in 2001. We also sanctioned funding to develop the regional orthodontic unit in Tralee. The problem is that it has not been able to locate or secure—
Why?
There is something wrong with the training system.
Order, please.
Let us take the training—
The Minister is now in possession. Please allow him to reply.
It is worth pointing out, for example—
What about what happened in Dublin?
I will tell the Deputy what happened in Dublin. I gave the money to the ERHA and it was successful in securing two additional consultants. It was successful in redeveloping and putting facilities in at Loughlinstown. It was in a position to use the money I made available and it has made very substantial progress—
Why did the Minister reverse the system?
The second point, if I may—
A validation exercise is a validation exercise. If somebody should be on a list, he or she should be on it. I will tell Deputy Durkan how validation works.
Unfortunately, I know how it works. Obviously the Minister does not.
I do, I have read the file. One writes letters and if a person does not respond or come forward for treatment after the third letter, the person is on the list.
The Minister should not insult our intelligence like that. If he really wants to know—
With respect—
What happened was that, in order to comply with cutbacks, the Minister reviewed it and removed people on the list. That is what happened.
The unfortunate story in this regard is – and I accept that Deputy Neville has put his finger on it to a point – that there are a number of consultants in the system who are very annoyed and upset by what they perceived as an injustice to them and training programmes. The committee on health and children went through all of this.
Understandably so.
I do not know about that. The committee on health and children did not have that view on the episode in question. I appeal to all sides. I cannot go back to the time when all this happened. What I can do is provide training now and a basis for that training, and that is why we are putting a professor of orthodontics into the region.
Question No. 8.
At long last I understand the board has a candidate.
Where is he?
The first time it tried, it could not get a professor of orthodontics. It is now in a position to do so or is very close. It is a matter of regret that, of the 18 specialists that are currently in training, none comes from the Southern Health Board or Mid-Western Health Board areas. That speaks volumes—
Good people could not be attracted.
Very briefly, Deputy Durkan.
Will the Minister explain why private orthodontists will now certify that most of the cases that have been scrubbed off the list in the course of the assessment he has ordered are, in fact, in need of urgent orthodontic treatment? How does he square that with the opinions and diagnosis of his orthodontists?
Firstly, I do—
We know full well what it is all about. It is about cutting people off the list to save money and the Minister knows that.
A brief reply.
The Deputy did ask me a question and I should have the chance to reply. I do not scrub people off lists and I have no involvement with the lists. The validation exercise—
The Minister ordered it.
I did not.
We are wasting time. Will the Minister deal with Question No. 8?
Deputy Durkan is in this House longer than I am. He and the Oireachtas in their wisdom decided to give jurisdiction over the provision of health services, including orthodontics, to regional health boards.
But the Minister has a responsibility—
The health boards are responsible for the provision of services and it is time the Deputy stopped this nonsense of coming into the House—
The Minister is now attempting—
I call Question No. 8.
The Minister has a responsibility for health services.
The Chair has called Question No. 8.
