Paul Gavan (Sinn Fein) | Oireachtas source

It is always good to see the Minister of State. I need to bring him back to the 1990s, when a number of what were known as regional orthodontic units were set up around the country to treat children who needed dental work on public waiting lists. At the time, waiting lists were very long but, within a few years, the regional units proved very successful at reducing waiting times. In fact, in Dublin and the mid-Leinster area, we understand waiting lists were more than halved from 18,000 children to approximately 6,000 children. All of that changed when, in the late 1990s, support for the regional orthodontic units was withdrawn. As a result, the units ran into trouble and, in effect, began to collapse.

The regional orthodontic units in Dublin and the mid-Leinster area were particularly affected and the knock-on effect was that up to 9,000 children were left stranded mid-treatment. Many of them were still wearing orthodontic appliances, meaning some suffered irreversible damage. The situation deteriorated so much that some parents staged sit-ins in dental clinics as they desperately tried to get treatment for their children. In particular, an orthodontist, Ted McNamara, expressed serious concern in regard to what was happening. The HSE appointed two people to investigate - Professor Richmond from Cardiff and Professor Bearn from Dundee – and they reported back to the HSE in 2015. However, four years later the report had still not been published.In 2019, the issue was highlighted by an RTÉ "Prime Time" programme. We know the medical files of more than 7,500 children were reviewed as part of a large-scale audit by the HSE following these allegations.

When regional orthodontic units were practically abandoned back then, many children were left with orthodontic appliances in for far too long. They were left stranded and without care and, in some cases, were left with irreversible damage. Some of these children were left with pain, as well as distortion of the teeth much worse than they had before they started treatment.

However, the original damning report that was given to the HSE in 2015, seven years ago, has still not been published. We know the audit of these files has been completed but there is still no publication. Will the report be published soon, even in redacted form if necessary? In the seven years we have been awaiting publication of that report, what has changed to prevent further damage being done and to ensure the best standards of practice are being maintained by practitioners in the profession, particularly those in the public service? What changes to the orthodontic teaching, training and monitoring of practice are in place? Why might Ted McNamara and some of his orthodontist colleagues be feeling that they have been ignored and undermined?

Some orthodontists claimed the recruitment process was rife with nepotism and that some professionals lacked the proper postgraduate qualifications. It would be helpful to know what is being done to increase the availability of orthodontic treatment in the public sector for children who need these services, because it appears the system supports the private model of provision of orthodontic services rather than encouraging a better service for the public sector.

I cannot help but mention the crisis in wider dental care for children, especially those who rely on the public system. We need drastic changes to help stop dentists leaving the medical card scheme. I presume this has a direct effect on the orthodontist service as well. There has been a lot of concern for a long time in respect of the delivery of orthodontic services. Have lessons been learned from this scandal or is it just business as usual and let the report be buried?

I hope that when the Minister of State responds he will not try to defend the indefensible. This report should have been published. The public have a right to know. This was an outrageous scandal. It has been buried by the HSE for the past seven years. I look forward to a positive response.