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Health Board Services.

Dáil Éireann Debate, Wednesday - 29 September 2004

Wednesday, 29 September 2004

Ceisteanna (715, 716, 717, 718, 719, 720, 721, 722, 723, 724)

Michael Ring

Ceist:

894 Mr. Ring asked the Minister for Health and Children when a person (details supplied) in County Mayo will be called for an MRI scan on their right hand; and if they can be called to Galway urgently for the scan. [22210/04]

Amharc ar fhreagra

Freagraí scríofa

The provision of hospital services for people living in County Mayo is a matter for the Western Health Board. My Department has asked the chief executive officer of the board to investigate the position in relation to this case and to reply directly to the Deputy.

John Perry

Ceist:

895 Mr. Perry asked the Minister for Health and Children if he will ensure that a personal assistant is appointed for a person (details supplied) in County Sligo in view of the circumstances outlined in attached correspondence; and if he will make a statement on the matter. [22215/04]

Amharc ar fhreagra

The provision of health related services, including personal assistants for people with a disability, is a matter for the Eastern Regional Health Authority and the health boards in the first instance. Accordingly, the Deputy's question has been referred to the chief executive officer, North Western Health Board with a request that he examine the case and reply directly to the Deputy as a matter of urgency.

Michael Ring

Ceist:

896 Mr. Ring asked the Minister for Health and Children the reason a full and detailed reply did not issue from the Western Health Board to a person (details supplied) in County Mayo regarding refusal for orthodontic treatment on assessment. [22218/04]

Amharc ar fhreagra

As the Deputy is aware, responsibility for the provision of orthodontic treatment to eligible persons in County Mayo rests with the Western Health Board. My Department has asked the chief executive officer to investigate the matter raised by the Deputy and to reply to him directly.

Michael Ring

Ceist:

897 Mr. Ring asked the Minister for Health and Children if he will provide a detailed report in relation to the refusal of a person (details supplied) in County Mayo for orthodontic treatment on assessment. [22219/04]

Amharc ar fhreagra

As the Deputy is aware, responsibility for the provision of orthodontic treatment to eligible persons in County Mayo rests with the Western Health Board. My Department has asked the chief executive officer to investigate the matter raised by the Deputy and to reply to him directly.

Michael Ring

Ceist:

898 Mr. Ring asked the Minister for Health and Children if the guidelines for qualification for orthodontic treatment, which issued in 1985 will be updated, in view of the number of children with a clinical need for treatment who do not come within the current guidelines. [22220/04]

Amharc ar fhreagra

Michael Ring

Ceist:

899 Mr. Ring asked the Minister for Health and Children if the guidelines for qualification for orthodontic treatment, which issued in 1985, can be interpreted differently by each health board, dependent on their level or resources or numbers of qualified staff. [22221/04]

Amharc ar fhreagra

I propose to take Questions Nos. 898 and 899 together.

The provision of orthodontic services is the statutory responsibility of the health boards in the first instance. I am pleased to advise the Deputy that health boards are already providing orthodontic treatment to a large number of children. The chief executive officers of the health boards/authority have informed my Department that at the end of the June quarter 2004, there were 20,236 children receiving orthodontic treatment in the public orthodontic service. This means that there are over twice as many children getting orthodontic treatment as there are children waiting to be treated.

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 orthodontic guidelines.

The guidelines were issued in 1985. They 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. Patients in category C have less severe problems than in category B. 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.

Michael Ring

Ceist:

900 Mr. Ring asked the Minister for Health and Children the number of children refused orthodontic treatment in each health board area, for the past five years, on the basis that they did not come within the treatment guidelines; and if any of these people were subsequently treated following a reassessment of their needs. [22222/04]

Amharc ar fhreagra

As the Deputy is aware, the provision of orthodontic treatment services is the responsibility of the health boards/authority in the first instance.

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. They 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. Patients in category C have less severe problems than in category B. 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 information requested by the Deputy is not routinely collected by my Department. My Department has therefore asked the chief executive officers of the health boards/authority to provide the information requested directly to the Deputy.

Michael Ring

Ceist:

901 Mr. Ring asked the Minister for Health and Children the waiting list in each health board area for orthodontic assessment and orthodontic treatment; and the number of people that have received orthodontic treatment in each area in the past 12 months. [22223/04]

Amharc ar fhreagra

The provision of orthodontic services is a matter for the health boards/authority in the first instance.

I am pleased to advise the Deputy that I have taken a number of measures to improve orthodontic services on a national basis. 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. Thus, there is an aggregate of 19 dentists in specialist training for orthodontics. 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.

Furthermore, the commitment of the Department to training development is manifested in the funding provided to both the training of specialist clinical staff and the recruitment of a professor in orthodontics for the Cork Dental School. This appointment at the school will facilitate the development of an approved training programme leading to specialist qualification in orthodontics. The chief executive officer of the Southern Health Board has reported that the professor commenced duty on 1 December 2003. In recognition of the importance of this post at Cork Dental School my Department has given approval in principle to a proposal from the school to further substantially improve the training facilities there for orthodontics. This project should see the construction of a large orthodontic unit and support facilities; it will ultimately support an enhanced teaching and treatment service to the wider region under the leadership of the professor of orthodontics.

Orthodontic Initiative funding of €4.698 million was provided to the health boards/authority in 2001 and this has enabled health boards to recruit additional staff, engage the services of private specialist orthodontic practitioners to treat patients and build additional orthodontic facilities.

In June 2002, my Department provided additional funding of €5 million from the treatment purchase fund to health boards/authority 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 chief executive officers of the boards/authority have informed my Department of the following information on their orthodontic waiting lists as at the end of June 2004 quarter:

Assessment Waiting List

Treatment Waiting List

Health Board

Average waiting time (months)

Category A

Average waiting time (months)

Category B

Average waiting time (months)

SWAHB

382

3-6

784

< 10

517

< 12

ECAHB

130

< 3

37

< 6

183

< 18

NAHB

257

3-6

125

< 12

2,249

< 24

MHB

228

4

Nil

No waiting time

187

12

MWHB

2,784

24-36

Nil

No waiting time

519

24-36

NEHB

Nil

No waiting time

6

1.5-2

286

12-18

NWHB

1,999

5.5

223

14

1,081

32.6

SEHB

122

1.5

Nil

No waiting time

667

20

SHB

2,972

According to date of birth. Currently 1990

Nil

No waiting time

3,172

42-48

WHB

558

11

Nil

No waiting time

866

38

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.

The chief executive officers of the boards/authority have also informed my Department of the following number of patients currently in treatment:

ERHA

MHB

MWHB

NEHB

NWHB

SEHB

SHB

WHB

3,701

2,155

1,637

2,652

3,044

2,104

3,400

1,543

Children in treatment in the health board orthodontic service receive between 18 to 24 appointments over the course of their treatment period of approximately two years.

Finally, the chief executive officers of the health boards/authority have informed my Department that at the end of the June quarter 2004, there were 20,236 children receiving orthodontic treatment in the public orthodontic service. This means that there are nearly twice as many children getting orthodontic treatment as there are children waiting to be treated.

Michael Ring

Ceist:

902 Mr. Ring asked the Minister for Health and Children the number of people referred for orthodontic treatment, under the national treatment purchase fund; the cost for each health board area and if he will indicate the average time spent on the treatment waiting list for these people. [22224/04]

Amharc ar fhreagra

As the Deputy is aware, the provision of orthodontic services is a matter for the health boards in the first instance.

In June 2002 my Department provided additional funding of €5 million from the treatment purchase fund towards the treatment of persons on the orthodontic waiting lists. My Department instructed the health boards/authority that the funding was to be allocated on the basis of the following principles: treatment of clients longest on the waiting list in accordance with the severity of their treatment need; allocation to provide additional treatments over and above what was provided in the normal way; efficiency and value for money; and equitable delivery across health board populations.

The chief executive officers of the health boards/authority have informed my Department of the following information regarding patients receiving treatment under the treatment purchase fund as at the end of June 2004:

Health Board/Authority

TPF Allocation € (1)

Numbers in treatment

ERHA (2)

1.815m

721

MHB

0.289m

198

MWHB (3)

0.451m

176

NEHB (4)

0.421m

196

NWHB

0.285m

119

SEHB (5)

0.554m

n/a

SHB (6)

0.720m

258

WHB (7)

0.465m

101

(1) The proportion of allocated funds spent to date will vary according to private capacity in the health board areas.

(2) 27 of these patients have completed their treatment under this scheme

(3) 15 of these patients have completed their treatment under this scheme.

(4) 26 of these patients have completed their treatment under this scheme.

(5) 2,104 children getting orthodontic treatment from the board (at 30/6/04).

(6) 49 of these patients have completed their treatment under this scheme.

(7) 13 of these patients have completed their treatment under this scheme.

Children in treatment in the health board orthodontic service receive between 18 to 24 appointments over the course of their treatment period of approximately two years. Information on the length of time of these patients spent on the treatment waiting list is not available.

Michael Ring

Ceist:

903 Mr. Ring asked the Minister for Health and Children the current staffing levels in the orthodontic section of the Western Health Board. [22225/04]

Amharc ar fhreagra

The management of orthodontic services in the Western Health Board area is the responsibility of the chief executive officer of the Western Health Board. My Department has asked the chief executive officer to investigate the matter raised by the Deputy and to reply to him directly.

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