Ruairi Ó Murchú (Louth, Sinn Fein) | Oireachtas source

I apologise; I was at another committee meeting earlier so I did not hear all the back and forth.

I do not think anyone would be shocked to realise that there has not been a solution with regard to the dental treatment service scheme, DTSS, and dental care for people on medical cards. It is an ongoing issue. We keep hearing about interaction and interventions by the Department and the Minister, but I have yet to see anything that looks like a result. We could end up utterly hopeless as a result of constantly having the same conversation.

I realise Deputy Durkan took up the issue of orthodontics. I did not hear all of that discussion either. I am going to bring up a very specific issue regarding orthodontic care in my own constituency. I am talking about the HSE orthodontic centre at Louth County Hospital in Dundalk, which looks after Louth, Monaghan and some parts of Meath. There are hundreds of under-18s on the waiting list for orthodontic treatment who are split into category 4, which is technically regarded as cosmetic, and category 5, which is people who are clinically in more need of treatment. If they do not get treatment, that can get very bad very quickly. The national oral health office, NOHO, is spending a huge amount of money. The figure we got for 2021 for 77 patients was €200,999.95 but, by 2023, accepting 256 patients, that is €889,530.88. It is a significant amount of money. That is going on getting kids seen through a private system within weeks. These are all category 4 patients. However, the issue is that the category 5 patients who are more clinically in need are not getting seen at all.

We are told there is - I love these terms - an assessment of the feasibility of a similar initiative for category 5 patients on eTenders. This was to be done in April of this year but I have not been updated as to whether it has happened or not. What is also happening is that parents of these category 5 kids are being regularly contacted by the HSE, which is wondering if they have taken the child to the North for treatment or if they are still waiting. I know of a kid who turns 17 this Christmas. He has been waiting three years for category 5 treatment. He has protruding front teeth. His parents are obviously waiting on the HSE to deal with this issue but, at this stage, will this happen before he turns 18 in December 2024? I cannot give an answer on the basis of the answer I am getting.

I am right in thinking there is a shortage of orthodontists. I am advised that the centre in Dundalk has engaged in a worldwide recruitment campaign. Obviously, it has not been particularly successful so far. I assume there is a solution. Can this work be done by orthodontists in the private sector in this State? This sometimes relates more to the Minister, the Department and the HSE, but why are people being sent to the North for the cross-border treatment programme if there are orthodontists in the State who are able to do it? As I said, we are at least able to deal with those in category 4, but those in category 5 could be people who will end up in a far worse set of circumstances and then we will be talking about incredibly serious recruitment issues. It is the whole idea of not carrying out the early intervention.