Dr. Anne O'Neill:

It would be remiss of me not to mention at the outset that while orthodontics tends to be the area that gets attention because it has a waiting list structure that is easily quantified, the lack of access to what is commonly referred to as school screening is a much bigger impediment in child health at this time. Mr. Hourihan has accurately described the issues with orthodontic provision. As things stand, free orthodontic care is provided only to children who have very specific clinical needs. The nature of those clinical needs means that they can only be provided for by people who have what is known as the masters in orthodontics, MOrth, or its equivalent, and are entitled to be included on the orthodontic specialist register of the Dental Council. While a certain level of orthodontic intervention might be possible in a primary care setting, it will do nothing for the waiting lists that are the subject of so much interest and tend to be the basis of the conversations members would have with people in their jurisdictions.

On the issue of auxiliaries, there was an announcement last week by the Department regarding a waiting list initiative. I understand my HSE colleagues have made representations for funding for auxiliaries to be included in the skills mix of people available to provide specialist orthodontic care. That may alleviate some of the stress and strain on orthodontic provision. However, the supporting services that are needed for children to be able to access fillings or extractions as part of an orthodontic care plan are not currently in position. It may alleviate one pinch point in the system but it will not alleviate the other one, because the supports that are needed for an entire orthodontic treatment plan are not necessarily in place.