As the Deputy is aware, responsibility for the provision of orthodontic treatment to eligible persons in Dublin 10 rests with the Eastern Regional Health Authority. My Department has therefore asked the regional chief executive to investigate the matter raised by the Deputy and to reply to him directly.
The aim of my Department is to develop the treatment capacity of orthodontics in a sustainable way over the longer term. Given the potential level of demand for orthodontic services, the provision of those services will continue to be based on prioritisation of cases based on treatment need, as happens under the existing guidelines. The guidelines were issued in 1985 and are intended to enable health boards to identify in a consistent way those in greatest need, and to commence timely treatment for them. 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 and are placed on the orthodontic treatment waiting list. 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. In fact, the provision of orthodontic services is currently severely restricted due to the limited availability of trained specialist clinical staff to assess and treat patients. However, I am pleased to advise the Deputy that I have taken a number of measures to address this shortage of specialists and so increase the treatment capacity of the orthodontic service.
The grade of specialist in orthodontics has been created in the health board orthodontic service. In 2003, my Department and the health boards funded 13 dentists from various health boards for specialist in orthodontics qualifications at training programmes in Ireland and at three separate universities in the United Kingdom. These 13 trainees for the public orthodontic service are additional to the six dentists who commenced their training in 2001. There is thus an aggregate of 19 dentists in specialist training for orthodontics, including five from the ERHA. 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.
In June 2002, 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 ERHA received €1.815 million for the treatment of cases in this way. Finally, the chief executive officer of the Eastern Regional Health Authority has informed me that at the end of the December quarter 2003, there were 4,656 children getting orthodontic treatment from the authority.