Pat Gallagher (Donegal South West, Fianna Fail)

On behalf of the Minister for Health and Children, I am happy to have the opportunity to address the issue raised by Deputy Deenihan.

As the House will be aware, the Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes the delivery of orthodontic services. The prioritising and resourcing of the development of orthodontic services is now a matter for the Health Service Executive.

It is important that I explain that the report referred to by Deputy Deenihan is an unofficial one, not an official Health Service Executive document. This report was not commissioned or requested by the HSE nor is it a requirement, operationally or legally, of any area of the public orthodontic service to produce such a publication. Furthermore, the author of this report did not make local HSE management aware of its existence or forward them a copy. They became aware of the existence of this unofficial report only when contacted by the local media.

The majority of the issues outlined in respect of the management and future development of the orthodontic services in Cork and Kerry in this unofficial document are under ongoing consideration. The HSE plan regarding the future model of orthodontic service delivery is clearly outlined in the strategy for the provision of orthodontic services in the HSE South, which has been produced by management in the HSE.

Most of the issues outlined in this unofficial report relating to the infrastructural deficits of the orthodontic unit in St. Finbarr's Hospital are documented in a health and safety audit commissioned by management and completed by the orthodontic department in late 2007. Local HSE management have noted that a small number of the issues relating to the infrastructure of the orthodontic unit were not previously brought to the attention of management at South Lee Local Health Office. These issues are now being examined.

The progress of local HSE management in dealing with these issues highlights the necessity and fundamental importance of staff, especially those at a consultant level, engaging openly and in a positive and constructive way with their local management to overcome difficulties and problems and achieve outcomes. Only through this process will we achieve high quality, reliable and sustainable services for patients.

I remind the House that the Joint Oireachtas Committee on Health and Children carried out a review of orthodontic services in Ireland and published two reports — one in 2002 and 2005. On foot of this, the HSE established an orthodontics review group in 2006. The group was chaired by Hugh Kane of the HSE and was made up of consultant orthodontists, a specialist orthodontist working in the HSE, representatives from the two dental schools, Trinity College Dublin and University College Cork, and the Department of Health and Children.

The terms of reference for the group were to review the recommendations contained in the joint Oireachtas committee reports on the orthodontic service in Ireland — February 2002 and June 2005; to examine the recommendations within the operational remit of the HSE and establish their status; to conduct an analysis of the HSE's existing orthodontic delivery structure and capacity; and, based on that analysis, to make recommendations in that regard, the recommendations thus made to be costed and a timeframe for their implementation proposed.

The group made recommendations in four broad areas. These are guidelines and revised eligibility criteria, training, manpower planning and service provision. These recommendations reflect many of the issues raised in the joint Oireachtas committee report of June 2005. A range of measures to improve the orthodontic services on foot of the report of the joint Oireachtas committee and the Kane report is already under way.

In addition, my ministerial colleague, Deputy Mary Harney, announced in October 2007 the research and development of a new national oral health policy. This new oral health strategy, the first such strategy in 13 years, will be undertaken by the Department of Health and Children in conjunction with the HSE. The development of this new national strategy will allow a critical examination of the many challenges and issues currently facing the dental sector in Ireland. Some of the issues which will be examined include service delivery issues such as orthodontic services. Other issues which impact on orthodontic services such as specialisation and skills-mix, including the recognition and future expansion of the role of auxiliary dental professions and the identification of appropriate training needs, will also be examined.

Orthodontics is unique in that the treatment period for a child is between 18 and 24 months and each year thousands of children, with varying degrees of need, are placed on assessment waiting lists. This undoubtedly presents challenges for services delivery and will continue to do so. Our aim is to continue to make progress and to develop a high quality, reliable and sustainable service in HSE South and all other areas of the executive for children and their parents.

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