Denis Naughten (Roscommon-South Leitrim, Independent)
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The Minister for State will be aware that in recent weeks worrying facts have come to light regarding the sale of used orthodontic braces by a dentist employed by the HSE in Merlin Park, Galway. These braces which should have been incinerated were sold to private practices. The HSE became aware of this fact in 2009 and it was exposed in the Connacht Tribune recently. Four years later, however, there is still no explanation from the HSE as to why this practice was allowed to occur or the action it took on learning of this matter. Furthermore, it has not answered questions on the potential risks for those who had the second-hand braces used in the course of their treatment. More worryingly, further information has since come to light which raises serious concerns about potential exposure to infection. Many parents are rightly concerned and seeking information on whether the braces they worked hard or, in some cases, borrowed to pay for were second-hand.

If so, what are the risk factors for their child?

As both the Minister and the HSE are aware, the information that has come into my possession in recent times raises very serious questions about a range of issues including the action taken by the HSE on being made aware of this practice being carried out by one individual dentist but, most important, it raises extremely serious questions regarding the exposure of patients to the risk of infection.

We must know whether the HSE took steps to address the risk on becoming aware of the practice in 2009 and whether contact has been made with any patient - either private or public - who was potentially exposed to such a risk, as a result of the individual's actions and the sale of second-hand braces. The HSE must also clarify whether the risk to patients continued even after it became aware of the actions of this individual in 2009. People are rightly horrified at the thought of the practice taking place. It beggars belief that the HSE in Merlin Park would not re-use crutches but the re-use of dental braces was going on for a number of years. What action has been taken against the dentist concerned?

The Minister must now establish an immediate, independent investigation into the issues surrounding the sale of second-hand braces by the HSE dentist. Such an investigation is needed to establish when allegations of the practice were first known; what action was taken and when; and also to identify any risks that may exist regarding infection; communicate with patients and-or their parents; investigate the private practice concerned; clarify what cleaning and sterilisation processes were employed before the braces were placed in another child's mouth; if there was an element of fraud involved in the re-use of the braces; and to make the results public as soon as is practicable.

Such an investigation is needed to establish whether the HSE's actions on learning of this practice were in line with its own policies on infection control and patient safety. We must know how long this practice had been going on and when it was first brought to the attention of the authorities. We also need to know where the braces went and the steps taken to trace the children involved.

There are many professional health care staff working within the department in Galway whose reputation must be protected and who would, no doubt, like to see a fully independent investigation take place to expose the truth behind this disgusting practice carried out by one individual and the issues that have arisen as a consequence. The HSE has confirmed that it will fully investigate this matter. However, in light of the information that has come into my possession it is clear that this is not adequate and that a full and independent investigation must now take place.

Kathleen Lynch (Cork North Central, Labour)
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On behalf of my colleague, the Minister of State, Deputy White, I thank the Deputy for raising the issue. The Minister of State, Deputy White, became aware through recent media reports that a dentist employed by the HSE at the orthodontic unit in Merlin Park hospital has admitted giving braces that had been removed from children at the unit to a private dental practitioner. I am very constrained in what I can say at present on the case. I understand that the HSE became aware of this matter in 2009. It was investigated at the time and the practice of removing braces from the unit ceased. My colleague, the Minister of State, Deputy White, has asked the HSE to advise him if there are any outstanding issues that may need to be addressed concerning the possible re-use of the braces. Deputy Naughten will appreciate that the HSE is not in a position to comment on any individual staff member working within the service.

Where the HSE becomes aware of any patient safety issues, they are dealt with promptly and effectively. In this case, the HSE has provided assurance that staff of the orthodontic unit concerned were trained at the time to ensure correct policies and procedures were followed and to prevent the situation occurring again. The patient safety processes have recently been reassessed to ensure that staff remain compliant. As a further assurance the HSE is arranging an assessment by its dental inspectorate of patient safety control and policies in this area. An intensive infection control audit of the orthodontic unit is carried out once a year as part of the audit of the hospital. A routine audit is also carried out at least twice a year by the local cross-infection team. The Dental Council has been notified of this individual case. The council is liaising with the HSE and treating this as a matter of priority. The General Dental Council in the UK has also been notified to ensure that any patient safety issues will be dealt with in tandem if necessary. I assure the Deputy that there is no ongoing risk to the public in relation to this case. The matter is receiving urgent attention in the HSE. My colleague, the Minister of State, Deputy White, expects a report early in the new year.

Denis Naughten (Roscommon-South Leitrim, Independent)
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I thank the Minister of State for her reply but she did not address the core issue underlying the matter, namely, the potential risk of infection for the children involved in the debacle. Everyone has said checks and balances will be put in place but what is being done about the potential risk of infection for the children who were involved? The HSE is failing to deal with public health and infection issues and is using the excuse that it cannot comment because the matter relates to an individual member of staff. I want reassurances on the issues relating to infection that I have raised publicly and on which I have written privately to the Minister. I raised the issue on a couple of occasions by way of parliamentary question with the Minister of State, Deputy White. The response that I have received is not good enough; that the Minister is waiting for the HSE to come back to him on whether there are any outstanding issues.

The Minister of State, Deputy White, has been aware of the matter for a month. We should know what has happened since then. When did the Dental Council become aware of the matter? Why is it only now that it is inquiring into the matter and making it a priority? Why has it not been a priority in the past four years? When was the dental authority in the UK made aware of the matter, and was it informed that the dentist was not allowed to have direct patient contact in this jurisdiction? What steps have been taken in the past four years to deal with the potential risk of infection? Those critical issues must be clarified because there have been significant breaches of cross-infection control procedures and of data protection.

Kathleen Lynch (Cork North Central, Labour)
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As soon as the Minister became aware of the issue he made inquiries and treated it as a priority. It is not unreasonable to expect that a comprehensive report would take a month or even two to conclude. The report will concentrate on the outstanding issues such as the re-use of the braces and the contact made in that regard. The issue is being dealt with internally in the orthodontic unit in Merlin Park. The infection teams have been there, as has HIQA, and reassessment has taken place of the training provided. The outstanding issue is the re-use of the braces within the private sector. It begs the question of whether the private sector dentist knew the braces were coming from another dental practice. They are the key questions that require to be answered. It is not unreasonable that we would await the compilation of the report.

Denis Naughten (Roscommon-South Leitrim, Independent)
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I accept the Minister of State’s response but the difficulty is that the matter came to the attention of the HSE four years ago and the answers should be available. That is at the heart of the scandal and that is why I do not have confidence in the individuals carrying out the investigation.

Kathleen Lynch (Cork North Central, Labour)
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No doubt we should have the answers but the matter just came to our attention recently.

Denis Naughten (Roscommon-South Leitrim, Independent)
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I accept that.