Deirdre Clune (Cork South Central, Fine Gael)
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I thank the Ceann Comhairle's office for allowing me to raise this issue again, having had the opportunity to raise it during the past 12 months. It is an extremely important issue to a number of people. I have given a commitment to a number of mothers in particular who have adult children over 16 years of age with an intellectual disability who cannot get routine dental treatment because it is required under general anaesthetic. This issue is particular to the Cork region. It is a distressing situation that has arisen for the parents, who are the carers of these adult children, and for the adult children.

The problem is that for a simple procedure such as a filling or for even a scale and polish adults with intellectual disabilities in some cases require a general anaesthetic. It is a day procedure but it must be done under strict criteria, which we all accept. They have been referred by their dentist or general practitioner to the Cork University Dental Hospital for these procedures, the waiting list for which is mounting and is now more than two years. In the period I have been raising this issue, one or two of these adults have been dealt with as an emergency case in Tralee, but that is not satisfactory. It does not address the ongoing problem and the fact that the waiting list for these procedures is mounting.

I tabled a question on this issue to the Minister in June of this year to which I received a reply from the HSE. I was told in June that the HSE has made provisional agreement with the Cork University Hospital anaesthesia and day treatment departments to commence an additional two treatment sessions per month for adults with special needs beginning in September 2008. This will be provided by HSE staff in collaboration with the dental school and the service will increase capacity, reduce existing waiting lists and manage referrals. That reply in June was welcome news.

In November I again raised this question and was told that progress had been made, nevertheless, no service has been provided. The HSE in north Cork recruited a senior dentist in July 2008. He commenced in September and is skilled and experienced in the delivery of dental services to adults with an intellectual disability under general anaesthetic. He is currently working on preparing the protocols, policies and procedures to commence this service and discussions are ongoing with Cork University Hospital with an anticipated starting date of early December 2008, which is this week. I was contacted yesterday by two parents of adult children who are in this position and no service has been provided for them. The dentist and anaesthetist are in place but there are no beds available. Therefore, there is no provision again in December for these adults.

I cried with a parent as she told me on the telephone of her daughter who needs a filling in her front tooth. Her tooth is deteriorating and it will get to the stage where she will push her tongue against her broken tooth and get a crack in her tongue and will end up with untold problems. That is a small issue, but it must be dealt with. It is only one of the stories of all these adults provision for whom is being neglected.

The Minister of State will probably tell me this is a matter for the HSE, but it is matter for this House and for those of us who have been elected to represent these people. It is a matter for the Department of Health and Children which has decided policy in this area, namely, that these people will be given the necessary dental treatment, yet it is not happening on the ground. It is a tragic situation that needs to be addressed. We are getting there slowly, but we cannot close the circle to ensure that these people receive the necessary dental treatments that should be available to them.

Mary Wallace (Meath East, Fianna Fail)
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I am happy to have the opportunity to address the issue raised by Deputy Clune. My ministerial colleague, Deputy Haughey provided the Deputy with information on this issue earlier this year and I am happy to be to a position to update this information.

I would like to explain the current position. In January 2007 a decision was taken by Cork University Dental School not to accept any further referrals to its existing waiting list for adult special needs patients who required treatment under general anaesthetic. The services in question in the Cork University Dental School were provided under an arrangement with the HSE. This decision was taken after considering a number of factors, including the length of time for patients on the current waiting list and the capacity of the current services at Cork University Dental School.

In addition to these factors, there were also concerns regarding the appropriateness of the facilities in regard to the treatment of both adult and child patients in a shared treatment environment and the lack of a consultant specialist for adults within the dental school. After considering all these factors, a decision was taken to cease services and no new referrals were added to the list from January 2007. I would like to point out that patients who were already on the waiting list continue to be treated and will receive all the dental treatment involving general anaesthetic that has been prescribed for them.

The Minister is now informed by the HSE in Cork that it has recruited a dentist with experience in the delivery of dental services to adults with special needs who require general anaesthetic. This dentist will also provide a service to all clients referred from both voluntary and statutory sources in the greater Cork area, including the city and county. As this service needs to be provided in an acute hospital setting, the HSE is currently negotiating with Cork University Hospital and the dental school to reconfigure existing theatre sessions in order to accommodate this new service development. Discussions in regard to these theatre sessions are ongoing and the HSE anticipates that it will be in a position to commence services as soon as the theatre capacity is made available.

The HSE is aware of those patients who have been unable since January 2007 to access services at the Cork University Dental School and will contact them in due course regarding treatment when the new arrangements are in place. In the interim period while these arrangements are being finalised, the UCC Dental School will continue to provide emergency dental care to adults with special needs and a limited service is also provided to adults with special needs by HSE dental staff.

On a broader issue, I wish to inform the House that the Minister for Health and Children is in the final stages of developing a new national oral health policy. This new policy, the first such policy in 13 years, has been undertaken by the Department of Health and Children in conjunction with the HSE. Among the matters that have been examined are service delivery issues such as the availability of dental and oral health care services for people with special needs. In this regard, officials in the Department of Health and Children have met a number of groups who work in the area of special needs dentistry to ascertain their views on recommendations for improving oral health services to people with disabilities. These groups include the Irish Society for Disability and Oral Health and a group of principal dental surgeons in the HSE who have responsibility for special needs dentistry.

In addition to meeting these groups, the Department of Health and Children has also sought the views of various organisations who work with people with disabilities. As a result of these meetings and consultations, the Department of Health and Children intends to bring forward a series of recommendations to improve the position of dental and oral health services to people with special needs in its forthcoming national oral health policy report, which will be available shortly.