Mr. Fintan Hourihan:

The fees are usually four figure sums. Prioritisation is already being done on the basis of what could best be described as rationing because of the drastic cuts in the public service. It is difficult to see how any further prioritisation can take place without some relaxation of the moratorium.

The backdrop to the reform of the HSE public dental service was that the HSE commissioned a firm of management consultants to examine how the service was structured. It was previously structured on the basis of what were the 32 community care areas in the days of the health boards. The ensuing report suggested that certain services be consolidated or amalgamated and that a national oral health office be established within the HSE. This has happened and we participated in the process. Dentists have taken on a lot of extra work without additional remuneration. One of the key components of the report was the recommendation that the moratorium on recruitment be lifted.

By contrast, what has happened since that report came out is that the numbers have decreased by 20% in net terms. In some parts of the country one will find it is far greater, but, as I said earlier, one will also find that dentists who retire, leave permanently or take maternity leave are not being replaced, and nor are their nurses or hygienists. That is practically the entire explanation for the problems one is seeing in terms of waiting lists and screening not taking place until sixth class. Very often the orthodontic waiting lists can be misleading, because by the time people get to see the orthodontist they have other dental problems which need to be treated, cured and cared for before they can proceed with orthodontic treatment. Bad and all as the figures look, the situation is worse.

The figures we have provided are based on parliamentary questions but those figures are not representative of the actual situation. Dentists in some parts of the country have said to me that the waiting lists are far worse than stated in the replies to parliamentary questions. I have been called to task for the figures we have put out. I have explained they are based on parliamentary questions but dentists who do not want to be identified have said to me that the waiting lists in some parts of the country are far longer.