Regina Doherty (Meath East, Fine Gael) | Oireachtas source

I thank the Deputy for raising this issue. From personal experience with my own little lady at home, I can speak about the length of and variations in the waiting lists.

In line with the commitment in A Programme for a Partnership Government to provide more timely access to orthodontic care, the HSE has undertaken a procurement of orthodontic services with a number of private service providers. Since commencing in 2016, this has enabled treatment for an additional 1,180 of the longest waiting patients. Approximately 400 of them were from the midlands.

Another measure being introduced to achieve this aim involves upskilling staff - dental hygienists or dental nurses - to become orthodontic therapists. Orthodontic therapists carry out a certain range of orthodontic treatments under the prescription and direct supervision of a specialist or consultant orthodontist. This facilitates a greater throughput of patients. Four orthodontic therapists are now in place. For each therapist, approximately 150 extra patients are removed from waiting lists annually.

Under Directive 201/24/EU, now commonly referred to as the cross-border directive, which I believe the Deputy alluded to, it is open to persons entitled to public patient health care in Ireland to choose to avail of that health care in another EU or EEA country or Switzerland. Assistance is provided by the cross-border health care directive department of the HSE. Access to treatment under the directive is based on the referral of the treating clinician.

The issue raised by the Deputy is an operational matter for the HSE. The orthodontic service for Longford and Westmeath is part of the midlands orthodontic service. The HSE advises that there is a centralised waiting list in the four counties of Laois, Offaly, Longford and Westmeath. This is to ensure equity of access within those counties and prioritisation of greatest clinical need. Currently, 1,896 service users are on that waiting list.

I am informed by the HSE that there have been three recruitment campaigns to fill the vacant post of consultant orthodontist in the area but that, unfortunately, they have not been successful. There are 2.6 whole-time equivalent specialist orthodontists, supported by dental nurses and clerical staff, covering clinics in Tullamore, Portlaoise, Athlone and Longford. The HSE is actively seeking ways to increase the number of children being seen and to reduce the waiting times for orthodontics. The post will be re-advertised and the HSE will continue to seek local cover.

The HSE will continue to seek to fill the vacant post to provide orthodontic services in a more timely manner than is being done at the moment. Other means will also be used to tackle the waiting lists. The Department of Health is at an advanced stage of developing a new national oral health policy. Future provision of oral health services, including orthodontics, will be informed by the new policy, which is being led by the Chief Dental Officer.

The aim is to develop a model of care that will enable preventative approaches to be prioritised, improve access, which is what we are here to talk about today, and support interventions appropriate to the current needs.

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