Patrick O'Donovan (Limerick, Fine Gael) | Oireachtas source

I welcome the opportunity to make a few brief points on the main thrust of this Bill. I feel like a character in the film "Titanic", because I am about to ask whether there is anyone alive out there and whether anyone can hear me. I do not know whether it is me or the Minister of State but it appears as though each time I rise to speak on legislation in this Chamber, I am stunned by the presence, or the lack thereof, of some of our Opposition colleagues. While the legislation before Members is technical in nature and seeks to tie down a few loose ends with regard to representative bodies and so on for a number of health care professionals, it also is an opportunity to reflect on the work actually done by some of the professionals named in the legislation. There are two such groups to whom I wish to refer briefly, the first of which relates to orthodontics while the second is to follow on from my colleague, Deputy John Paul Phelan, with regard to psychology services and child psychology services in particular.

In the previous two Dáileanna, extensive work was carried out by the Oireachtas health committee on the treatment of young people, that is, children in primary school, with regard to orthodontic care. Although a number of recommendations were made at the time in respect of the roll-out of orthodontics and on the time being taken for the delivery of good orthodontic services, to be honest we still are long distance from this in 2014. At the outset, I pay tribute to a man from my own part of the world, who will not mind me saying this. I refer to the orthodontic surgeon in Limerick, Dr. Ted McNamara, who over a number of years has pioneered the need for reform of this sector and to bring practice in Ireland into line with what happens elsewhere around the world, which is that orthodontists work with orthodontic therapists to carry out the work that is needed for young people in particular. This is with a view to doing two things, namely, saving the State money and, more important, seeing children at a much earlier stage and thereby reducing the waiting lists. While previous speakers may have referred to this point, for many parents of primary schoolchildren, their children's teeth are of huge concern to them. The question, as the children emerge from primary school to go into secondary school, is whether their teeth will be dealt with but at present, the length of time it is taking on the waiting lists is unsustainable. A solution is being proposed, which is that orthodontic therapists could work in parallel with and under the supervision of orthodontic surgeons. This would ensure that some work that need not necessarily be carried out by an orthodontist could be carried out by a therapist, thereby reducing the waiting list.

This reform has been spoken about since Job was a boy but, until recently, very little has been done. I welcome the recent encouragement by the Department of Health and the Minister of the engagement of the Dental Council, the HSE and others to try to resolve this issue because, ultimately, the key point is that the child whose bite is wrong or whose teeth are in great need of such treatment should receive it much faster. If this can happen in continental Europe, and there has been much talk recently about Dutch, Norwegian, Finnish models and so on, why not make use of best practice from elsewhere to examine this issue from the perspective of the delivery of treatment to children who ultimately will be its main beneficiaries? As all Members are aware from their constituency office work, the alternative is that parents will take their children out of the waiting lists or will opt for private care, thereby incurring massive costs and in some cases even being obliged to borrow to so do. Not only does it lead to obvious issues with the physical appearance of the child's mouth, as the child gets older it also leads to difficulties with teeth being taken out and lost unnecessarily because of the existing delays, many of which could be dealt with through dental therapy.

The other area, which is of equal importance to many people, concerns child psychology services. As a teacher, I have seen at first hand the good work that is available from the child psychology services in respect of getting children assessed for intervention at primary school level in particular.

However, there is more than anecdotal evidence, as the Minister of State will know as well as anybody else from her constituency, that in some cases parents are able to jump to the top of the queue if they can afford to have their child's psychological assessment carried out privately, and may thereby have quicker and easier access to hours. It is not fair that children whose parents cannot afford a private assessment are thereby disadvantaged and will spend more time on the waiting list before being assigned hours.

I have emphasised on previous occasions the importance of early intervention, and the earlier the intervention the better. I have seen this at first hand in my constituency, where the Limerick early intervention service recently opened a new premises in Newcastle West, which was partially funded by the Department. The excellent staff provide a safe place there for children and their families, as well as for the psychologist. The system is family and community inclusive and, most important, child inclusive. For too long, these types of services were designed merely as box-ticking exercises whose only purpose was to ascertain whether a child required X, Y or Z. Now, however, we are moving to a situation where intervention does not just happen at the start but is extended over a period of time, thereby giving parents, communities, schools and the psychological services themselves the capacity to see a child's progress over a period of time. That is ultimately what we should be striving for across the board. Budgetary constraints notwithstanding, no child should be disadvantaged in terms of his or her ability to access that type of service. Specifically, no child should be disadvantaged on the basis of his or her socio-economic background. As I said, middle class parents with disposable income can secure a psychological assessment privately for their child, and good luck to them. However, such capacity should not in any way disadvantage the child who does not have that access.

We have seen evidence in recent months that the economy is beginning to improve. The Government's position in this regard has been proven correct, contrary to what the Opposition would have us believe. There is no more vulnerable group than children who require orthodontic, eye, ear or psychological care, much of which is encompassed in this Bill in respect of the professionals who deliver it. In the past three years the two cohorts with which I have interfaced most often are those children requiring psychological services and orthodontic care. In both instances, the professionals involved have tangible and positive contributions to make by way of their views on how waiting lists can be shortened and services enhanced within existing budgets. We must engage with these professionals and encourage them to bring forward any suggestions they might have. If they are off the wall, so be it. When one hears that recommendations made by an Oireachtas health committee in 2002 or 2004 are only now, in 2014, at the pilot stage, it is easy to see how a level of frustration has built up among professionals and parents. The Minister of State is committed, together with the Minister, Deputy Leo Varadkar, to address that disservice.

This is a technical Bill which might not light too many fires in terms of the headlines it attracts. However, the people who deliver these services and the representative organisations to which they subscribe can have a real impact on individuals, families and communities. Anything that helps them to carry out their work must be welcome.

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