Seanad debates
Tuesday, 24 February 2015
Commencement Matters
Orthodontic Service Provision
2:30 pm
Kathleen Lynch (Cork North Central, Labour) | Oireachtas source
I do not wish to dismiss what orthodontists and their assistants do in their clinics every day of the week, they do great work and are always juggling to get children in on time under the particular age set out and those with greatest severity as well. We all know that from our own personal if not constituency experience.
The review tells us what we need to do and we have now established an individual within the HSE who looks at how to develop a national programme for orthodontics. In the main, that applies to people under 16 years of age. Part of the review and national programme is telling us we should be looking at alternative methods of treatment, for example the orthodontic practitioners, who are highly trained nurses already nursing within the dental service and who have taken on additional training in how to fit braces. I am not certain yet and it is just a pilot programme but I must admit I was very impressed by the people who came in to talk to me about it. I am told that in other countries orthodontic practitioners are widely used, under the supervision of the orthodontist, of course. Other countries have managed to bring down waiting lists and deliver services in a far more timely fashion than we have in the past.
Private practitioners not normally working within the HSE will be assigned in order to ensure that long waiters will be dealt with as a priority. My worry is that those children who are waiting longer than four years will go over the age barrier of 16 before they are seen.These two initiatives should have a visible impact on waiting lists.
Stephen Murray
Posted on 27 Apr 2015 1:13 pm (This comment has been reported to moderators)
In the interests of proper disclosure, I am an orthodontist (Orthodontic Practitioner) involved in training Orthodontic Therapists. At time of writing, I have no political party membership or affiliation.
Just in the interests of clarity, I would like to point out that "Orthodontic Practitioner" is normally a term applied to an orthodontist, that is a dentist that has a specialist registration in orthodontics, that is capable of independent "practice".
"Independent" here means that they are capable of making their own clinical decisions and will be responsible for them - it's not connected to whether they are public or private orthodontists.
In this paragraph, Kathleen Lynch is referring to Orthodontic Practitioners, but I think she means Orthodontic Therapists, which she mentioned in the previous response in the debate. An Orthodontic Therapist only works under the supervision and prescription of an Orthodontic Practitioner and is NOT legally capable of independent practice.
It may be true that other countries use orthodontic therapists and manage their waiting lists, but they may have significantly different ways of providing state-funded orthodontic treatment and deciding who is entitled to it. In Ireland, this is currently provided by state-salaried orthodontists working directly for the state and this number is limited.
Towards the end of her response, Kathleen Lynch mentions that Private Practitioners will be involved in providing services for patients waiting long on HSE lists. At time of writing, there has been no engagement with the private practice orthodontists in the country regarding this.
I hope this helps add some detail and additional information in this debate.