Billy Kelleher (Cork North Central, Fianna Fail)
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I thank the Ceann-Comhairle for allowing me this opportunity to speak about orthodontic treatment in the Health Service Executive's southern region.

I raise this matter to highlight the plight of the thousands of young people in the southern region who are being denied orthodontic treatment within a reasonable timeframe. In some situations people are waiting up to three years for assessment and a further number of years before they receive treatment. It is wholly unacceptable that parents and young children are required to wait for so long.

Without a doubt the issue of orthodontic services has been debated ad nauseam in various committees of the Houses of the Oireachtas, including the Joint Committee on Health and Children which heard from experts on the issue in 2002 and 2005. However, we seem to have an unfortunate problem in Cork in that the HSE seems unable to provide to our young people there the services that are provided in the rest of the country. It is time to address the issue in a serious and professional manner.

I am not quite sure what the problems in Cork are but Dr. Ian O'Dowling, the consultant orthodontist in St. Finbarr's Hospital, has highlighted on numerous occasions, both privately to political representatives and openly to the public at large, that insufficient resources are being made available. A lack of training facilities has resulted in the region being unable to provide orthodontic services. Given that we have a dental training hospital attached to the Cork University Hospital, I feel we should take the opportunity to explore that as an avenue for addressing the problem. We need to ensure that the university hospital has the resources to provide adequate training and upskilling to ensure we can deliver services to those who most need them.

Dr. O'Dowling told Cork's Evening Echo:

In the past two weeks I received a call from a teenage girl's mother who said her daughter is suffering from depression and is on anti-depressants, as she is being bullied at school over her teeth.

Like Dr. O'Dowling, as a public representative over the past 14 years I have received similar phone calls from parents who, in exasperation, have gone to a private provider simply because their son or daughter has suffered psychologically — either by being bullied and intimidated at school or because they have low self-esteem — because they have been unable to receive proper orthodontic care.

I hope the Minister will convey to the Minister for Health and Children my genuine belief that, rather than engage in finger pointing, we need to resolve the issue. I do not know what the difficulties are in Cork, but there have been difficulties. Dr. O'Dowling has stated his case. Although appointments have been made to the dental hospital, those have been short term and we are still left with only one consultant orthodontist. It is time that we made a serious decision to address the chronic problems of orthodontic care in the former Southern Health Board region.

Some might say orthodontics is unimportant but some people have severe dental problems for which surgery is required, such as disproportionality of the jaw and crowding of teeth. All those issues create great problems for the individual concerned.

It is not good enough that we have 4,000 people waiting for assessment and another awaiting 3,500 treatment. Particularly when children are vulnerable, forming their identity, or going through their teenage years, this issue is of paramount importance. It affects their mental and physical well-being socially and in school with regard to dental and oral hygiene. I hope the Minister can take back my message that we must address this issue quickly.

I have already mentioned the fact that we have a dental hospital. Training is very important there. If patients were treated there it would facilitate the upskilling of those providing the treatment. If there is an issue regarding St. Finbarr's — and Dr. Ian O'Dowling says that he is the only consultant orthodontist — an appointment should be made immediately to assist and help him in addressing those problems. He has commented publicly on numerous occasions. I do not know who was right or wrong, but I know that thousands of children in the former Southern Health Board region are suffering because of the lack of orthodontic services. That is wholly unacceptable.

Éamon Ó Cuív (Galway West, Fianna Fail)
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On behalf of the Tánaiste and Minister for Health and Children, Deputy Harney, I am happy to address the issue raised by Deputy Kelleher.

Under the Health Act 2004, provision of orthodontic treatment to eligible persons in the southern area is the statutory responsibility of the Health Service Executive, HSE. The Tánaiste and Minister for Health and Children is aware of the waiting list for orthodontic treatment in the HSE southern region. It has been noted that some improvement has been made there, with a decrease of 555 in the assessment waiting list and of 1,230 in the treatment waiting list.

At the end of September 2005 almost 24,000 patients were receiving orthodontic treatment in the public orthodontic service. Over twice as many patients are getting orthodontic treatment as are awaiting treatment. More than 7,000 extra patients are receiving treatment now compared with four years ago. That tangible improvement will be further enhanced as the HSE develops the orthodontic services.

Developing the quality, standards, treatment capacity and outcomes of our orthodontic services in a sustainable way is an objective shared by the Tánaiste, the Department of Health and Children and the HSE. I believe that it will be supported by all clinicians and professionals involved in the public orthodontic services. To ensure best use of resources and develop treatment capacity in a sustainable manner, guidelines were introduced by the Department of Health and Children to enable the HSE to prioritise resources for those with the severest orthodontic conditions.

The Joint Oireachtas Committee on Health and Children carried out a review of orthodontic services that culminated in 2002 in the publication of its report, The Orthodontic Service in Ireland. The Joint Oireachtas Committee also published a follow-up during 2005. The Department, in conjunction with the HSE, is considering each of the recommendations set out in the report of the Joint Oireachtas Committee. A range of measures to enhance the orthodontic services, both nationally and in the HSE southern region, has already been taken, and further improvements can be anticipated.

The grade of specialist in orthodontics has been created in the HSE's orthodontic service. The creation of that new grade has attracted orthodontists to work in the health service on a long-term basis. Over the last four years, the Department and the HSE have funded 22 dentists from various HSE areas for specialist in orthodontics qualifications at training programmes in Ireland and at three separate universities in the United Kingdom. A further four public dentists commence specialist training in October 2006. Those additional trained specialists will play a vital role in increasing the numbers in treatment and reducing waiting times. No one should have to wait any longer than necessary for clinically needed orthodontic treatment.

The Department's commitment to training development is manifested in the funding provided for the training of specialist clinical staff and the recruitment of a professor in orthodontics for Cork Dental School. That appointment at the school is facilitating the development of an approved training programme leading to a specialist qualification in orthodontics.

In recognition of the importance of that post at Cork Dental School, the Department has provided €2.7 million to the school to make further substantial improvements to training facilities there for orthodontics. That project has seen the construction of a state-of-the-art orthodontic unit and support facilities; it will support an enhanced teaching and treatment service for the wider region under the leadership of the professor of orthodontics. Cork Dental School has advised the Department that training will commence at the start of the next academic year, October 2006. As part of the training programme, orthodontic treatments will be provided at the dental school, and it is envisaged that this will have a further positive impact on waiting list numbers in the southern HSE area.

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. That undoubtedly presents challenges for service delivery and will continue to do so. The aim is to continue to make progress to develop a high-quality, reliable and sustainable public orthodontic service.