Deirdre Clune (Cork South Central, Fine Gael)
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The Acting Chairman, Deputy Kathleen Lynch, will be aware of the matter I raise as I have raised it on the Adjournment on two previous occasions in this Dáil. I also believe the Minister of State, Deputy Seán Haughey, responded on at least one of those occasions.

Adults with special needs who require dental services, including routine or minor treatments such as fillings and cleaning, must have the work done under general anaesthetic. This usually requires a day procedure in hospital for which theatre space is required. In the Cork area such procedures are performed in Cork University Hospital. Following the development of a significant waiting list for dental services for adults with special needs, a new service was established in Cork in October 2009. As it amounted to only one session per month and usually involved the treatment of only one or two persons, depending on the nature of the work, the service has failed to make an impression on the waiting list in the 12 or 13 months it has been in operation.

I have spoken to people who have been waiting for more than three years for services and there is still no sign they will be treated. Recently, for example, the mother of a man of 29 years contacted me because her son was waiting for treatment at Cork University Hospital. He required a filling and had a developed an abscess which could not be treated owing to another medical complication. As a result, antibiotics could not be administered and he howled in pain for more than week until some form of pain management was eventually provided.

It is pathetic that individuals in this position who deserve to have a dental service provided to them are neglected in this manner. Everyone, whether a medical card holder or private patient, should be able to access routine and commonplace procedures such as fillings. The individuals in question, their families and carers are experiencing major trauma.

Additional theatre space is required to reduce the waiting list for treatment. A serious attempt must be made to eliminate the backlog of more than 200 patients. Once this has been achieved, it will be possible for the service at Cork University Hospital to function as envisaged. The limited service provided at present will not make an impression on the waiting list. When I wrote to the HSE I was informed the matter could be addressed in the reconfiguration of hospital services in the HSE south area. We do not have time for long-term planning of this nature. The matter must be addressed immediately.

I wrote to the director of Cork University Hospital, the centre that is failing to provide the necessary service, who indicated that the matter is one for the HSE. The individuals in question are being passed from Billy to Jack because a proper service is not being provided. The neglect of their dental heath may lead to further complications, which is a source of major frustration for parents, carers and the adults who depend on the service.

I hope the Minister of State will not indicate that the issue is one to be addressed as part of a reconfiguration process and will instead outline a plan to provide some form of emergency service to accommodate the 200 or more individuals on the waiting list and relieve the awful distress they are experiencing.

Seán Haughey (Dublin North Central, Fianna Fail)
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I thank Deputy Clune for raising this matter, to which I will respond on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

It was estimated in 2007 that 43% of special care adults required either intravenous sedation or general anaesthetics for completion of their care. Where general anaesthesia is provided, access to resources such as anaesthetists and theatre space is necessary. Some patients, especially adult patients, who are seriously medically compromised require supporting hospital services. In the HSE south area, Cork University Hospital, CUH, has been the principal provider of such services. In Waterford and Wexford, local hospitals provide these services, with only the most complex cases referred to Cork University Hospital.

The service in Cork University Hospital was suspended in 2007 for safety reasons and reactivated in September 2009. There is currently a waiting list for this service of 113 patients. The current facility only has the capacity to meet the needs of the most urgent cases.

Since August, the HSE has been working on a plan to prioritise and target vulnerable groups and those with intellectual disabilities. A pilot initiative has been established in the HSE south area for children and adults with intellectual disabilities who require dental services. It is expected that the outcome of this initiative will lead to a reduction of up to 50% in the current waiting lists for general anaesthetic. The initiative takes a multifaceted approach. I will outline the initial steps, the first of which is the reprioritisation of waiting lists. An audit is near completion which will provide information regarding the complexity of care that patients require. Following this, a clinical assessment will be carried out on patients. Early results indicate that the majority of patients have moderate to mild medical complexity. This means their dental care may be carried out in a district hospital setting.

The second step is to take a two phased approach to treatment. This will involve providing more urgent as well as less complex care. This will mean stabilising the patients to ensure they can enter a preventative programme while awaiting treatment for any remaining oral health needs. This is to begin in January 2011.

The third step is the training and up-skilling of dental staff. Training dental staff in relative analgesia and intravenous sedation will enable those patients who can be treated by other means to be removed from the general anaesthetic waiting list. The training of staff will begin in spring 2011. The HSE is also exploring the opportunities for the realignment of services in the south in order that access to other general anaesthetic facilities outside of Cork University Hospital will be available to less medically compromised patients. The impact will be immediate since patients with less complex medical histories will be removed from the Cork University Hospital waiting list.

The capacity of other hospitals is currently being determined with a view to treating patients with the least complex medical needs. This will support the two phased approach. As a result, in six to nine months this approach will be used to treat approximately 40% of patients on the current general anaesthetic waiting list.

I thank the Deputy again for raising this matter on the Adjournment.