Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I wish to thank the Deputy for the opportunity to address the issue of orthodontic services. I am taking the debate on behalf of the Minister of State in my Department, Deputy Kathleen Lynch, who is attending to business elsewhere.

Orthodontic treatment is provided by the HSE to patients based on their level of clinical need. The HSE provides orthodontic treatment to those who have been assessed and referred for treatment before their 16th birthday. Patients are assessed by the HSE orthodontic service under the modified index of treatment need. Patients with the greatest level of need are provided with treatment first. The HSE endeavours to provide patients with services close to where they live. Occasionally, when there is capacity to provide this treatment sooner in another centre this option is offered to patients. In this way, patients on a waiting list who live in Dublin may be offered treatment in Louth County Hospital. Should they choose not to avail of this option, treatment will still be provided in Dublin. Most patients - approximately 75% - who are given this option choose to accept it. At the end of the second quarter of 2014, a total of 23,982 patients were in treatment, 6,658 were awaiting assessment and 16,518 were awaiting treatment. While patients with greatest need are given priority, long waiting times for orthodontic assessment and treatment are a matter of concern for my Department and the HSE.

The HSE commissioned an independent review of orthodontic services in 2012. The key issue highlighted by the review, which assessed services nationally, is that the orthodontic service should be fully integrated within the primary care service. This recommendation will be implemented as part of the HSE's wider reform programme. The HSE has also recently established a pilot scheme which will involve the use of orthodontic therapists. The HSE Dublin north east, or DNE, orthodontic service has been chosen as the pilot area for this new and innovative training programme. One member of the dental hygienist staff and one member of the dental nursing staff commenced this training in September 2014. During the course of their training, the students will work under the direct supervision of specialist orthodontists currently working in HSE units in the Dublin north east region in the treatment of a select number of children eligible for HSE funded orthodontic treatment. In addition, orthodontic treatment for certain categories of misalignment will be provided over the next three years by a panel of independent practitioners under contract to the HSE. A tender process is underway and provision is due to commence in 2015. It is expected that these changes will have a positive impact on waiting times and on the services available to patients.

I have a copy of the standard letter sent out to patients which Deputy Kenny's constituent would have received. The only thing that is wrong with its tone is that it does not give an indication as to where a person is on the waiting list for Ashtown Gate. If it did, parents could make an informed choice as to whether to wait it out at Ashtown or go to Dundalk. I am very familiar with Ashtown Gate as the service which serves my own constituents and is located in my own constituency. It is not practical or appropriate for me to start deciding where clinics should be located for reasons the Deputy will appreciate.

The reason the policy is pursued is a good one. In the HSE Dublin mid-Leinster area, there is only one person who has been waiting more than seven months for assessment yet there are 556 children in the Dublin north east area waiting between six and 12 months for assessment. If it is not possible or we do not have the resources to bring waiting lists down everywhere, does it not make sense and is it not fairer to allow people who live in an area where there is a very long waiting list to choose to transfer to an area where there is a low or no waiting list? That is why this is being done. It is an attempt to provide some equity across the regions so that people do not face excessive delays just because they happen to live in the wrong place.

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