Michael Moynihan (Cork North West, Fianna Fail)
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27. To ask the Minister for Health the action being taken to address the long waiting times for orthodontic services in counties Cork and Kerry. [48208/17]

Michael Moynihan (Cork North West, Fianna Fail)
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Will the Minister address the issue of the waiting times for orthodontic services in counties Cork and Kerry?

Simon Harris (Wicklow, Fine Gael)
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I thank the Deputy for his question. 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 greatest clinical need are prioritised, which is appropriate, and are seen within one year. Some patients will particularly benefit from treatment coinciding with their growth. These patients are generally seen within 18 to 24 months. While too many are waiting, it is important that we factor in the clinical view regarding treatment coinciding with a patient's growth and appropriate age.

A Programme for a Partnership Government contains a commitment to providing timely access to orthodontic care. In order to address long waiting times, the HSE has procured orthodontic services in primary care from a number of private service providers and a budget of €1 million per annum is being dedicated to this initiative, which commenced in 2016. To date, 142 patients from Cork and Kerry have been treated under this initiative. The Cork and Kerry community health care organisation, CHO, has also commenced a capacity planning review of orthodontic services. This will identify whether changes may be required to the current allocation of resources, including staff, in order to be more responsive to patients' needs.

Nationally, the HSE is also working on a programme to upskill dental hygienists and dental nurses to become orthodontic therapists. This will facilitate a greater throughput of patients, which has been very much welcomed by those working in dentistry.

The national approach to future oral health service provision will be informed by the national oral health policy, which is currently being finalised. I expect to publish that in early 2018. Resources are being finalised as part of the service plan. I expect more funding to be available to help utilise private providers while building up capacity in the public service, including in Cork and Kerry, in 2018.

Michael Moynihan (Cork North West, Fianna Fail)
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The report may determine that more funding is needed. A total of 1,200 children in Cork and Kerry are in need of orthodontic treatment, with the vast majority in the grade 4 and grade 5 categories of higher-level need. There is an outcry about this characterised by the large number of parents who are calling into our clinics trying to get orthodontic treatment for the children. It is an emotive issue and there are other issues associated with it. There is a crisis in terms of those waiting for treatment, particularly in Cork and Kerry. For us to have to wait for a report or a paper to state that more resources may be needed is fantasy stuff. More resources are needed. Something needs to be seriously done to tackle this issue and to discover how treatment can be secured for these children in a faster and more efficient way to ensure they get the treatment they require. Rather than waiting for a report, we need to act now.

Simon Harris (Wicklow, Fine Gael)
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I assure the Deputy that we are certainly not waiting for any report and that, as I already outlined, under the procurement procedures being put in place, a number of children in Cork and Kerry and a significant number of children throughout the country have had offers of treatment and received orthodontic treatment in a primary care setting through private providers. In addition, as we speak, we are upskilling dental hygienists and others to perform the function of orthodontic therapists, which will help to increase the capacity within our existing primary care structures.

The Cork and Kerry CHO has decided that it wants to examine what it considers it needs in terms of current resources, including its staffing and service level agreements. I assure the Deputy that as soon as it comes back with that information, we will look at acting upon that in the context of the HSE's service plan for 2018. I would like to see much more done on this area. We are providing additional funding for this year and substantial additional funding for next year in terms of addressing waiting lists and longest waiters. I do not see why we cannot direct more of that to the Cork and Kerry area. After these questions, I will link with the CHO, through the HSE, to see when I can expect that ask from the Cork and Kerry CHO.

Michael Moynihan (Cork North West, Fianna Fail)
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When will the Minister get that document or information in order that we can have a resolution to this issue? As Minister for Health, does Deputy Harris agree that it is completely unacceptable that people have had to wait so long for fundamental orthodontic treatment? I ask that he give a "Yes" or "No" answer to that question. Will he consider availing of the National Treatment Purchase Fund? That is the only way we can reasonably address the numbers on the waiting list, not only in this sector but across the health sector. Is he prepared to consider using the National Treatment Purchase Fund to source funding and resources and to avail of services outside the State to alleviate this problem?

Simon Harris (Wicklow, Fine Gael)
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Regarding when the report is due back from the CHO, I will find that out directly from the HSE and revert to the Deputy. I absolutely find this unacceptable. Who could find it acceptable? What I am going to do to solve the problem is probably what citizens and the Deputy's constituents want to know. I am very much open to using the National Treatment Purchase Fund as a vehicle. In many ways, we are doing the equivalent by already procuring through private service providers. There is a more effective way of doing that in a co-ordinated way with the National Treatment Purchase Fund that might even drive better value for money and a greater volume of patients. I am due to meet representatives from the National Treatment Purchase Fund this afternoon and I will discuss that matter with them in this context. I have no difficulty whatsoever in considering orthodontics in the context of the putting together our waiting list plans for 2018.