Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank the Deputy for the opportunity to address the issue of waiting lists for orthodontic services on behalf of the Minister, Deputy Stephen Donnelly. The HSE provides orthodontic treatment to those who have the greatest level of need and have been assessed and referred for treatment before their 16th birthday. An orthodontic assessment determines if the referral meets the criteria for the service and, if so, what priority the patient is given. Those with the greatest clinical need are prioritised.

Orthodontic services are generally provided by orthodontic consultants and specialist orthodontists who are based in the HSE orthodontic clinics throughout the country and, in addition, orthodontic therapists assist in providing services in some areas.

The Minister and I accept that there are significant delays in accessing some services provided by the HSE, caused in part by the necessary concentration of resources on managing the current Covid-19 pandemic. I also acknowledge that prior to the pandemic, there were already ongoing difficulties which led to lengthy waiting periods in accessing orthodontic services. Waiting lists vary regionally and according to the complexity of the condition. There are generally longer waiting lists for the least complex care. At the end of 2019, more than 10,000 children were awaiting assessment, while 19,000 were awaiting treatment. However, a further 17,000 children were in active treatment. I do not have total waiting figures for 2020 because the staff involved have been redeployed. However, I am aware that the service has experienced 12 months of continual disruption because of the pandemic. The Minister is informed by the HSE that during 2020, more than 9,200 orthodontic patients were seen for assessment and 1,466 patients commenced active treatment.

Elective orthodontic services have gradually resumed. Social distancing and other organisational measures, as well as infection prevention and control guidance, mean that the usual throughput of patients is currently reduced but this is expected to improve over time. Difficulties in recruiting consultant and specialist orthodontists in some parts of the country have added to this problem. The HSE is putting in place a number of measures to address waiting times. The filling of permanent vacancies is being prioritised, with recruitment to fill two consultant posts ongoing. A treatment waiting list initiative between 2016 and 2020 resulted in 1,996 patients being placed in treatment with service providers at a total cost of €5.8 million. A new initiative to outsource treatment for patients with less complex orthodontic needs who have been waiting for more than four years is now at invitation to tender stage. This will provide treatment for approximately 300 patients annually at a cost of €1 million. It is anticipated that the first group of patients will be allocated to service providers in the second half of 2021.

The HSE is also developing a standardised approach to assessment with consultant and specialist orthodontists and annual training for referring dentists. The purpose of this is to ensure that all referrals will receive an orthodontic assessment within six months and that the number of inappropriate referrals will be reduced. Access to orthodontic treatment in another EU jurisdiction is available under the EU cross-border healthcare directive for patients who are already on an orthodontic treatment waiting list. Many patients in Border areas accessed care in Northern Ireland through this route pre-Brexit. A total of 342 patients accessed cross-Border care in 2020. This is being continued through the Northern Ireland planned healthcare scheme.

I reiterate that the Minister, Deputy Stephen Donnelly, and I fully acknowledge that the waiting lists for essential orthodontic treatment are unacceptable and we want to see real improvement this year with the significant funding that the Government has made available for enhanced community care.

See this speech in context