Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Senator Lombard for raising this important issue. It is a matter that comes up regularly. I thank the Senator for the opportunity to address the issue of dental and orthodontic services on behalf of the Minister for Health, Deputy Stephen Donnelly. I will be providing some figures regarding orthodontic services, in particular, but due to the ongoing Fórsa industrial action, the latest data we have is for the end of June 2023. I received confirmation this morning, as we all did, that the Fórsa industrial action has been suspended. However, I expect the backlog will take a few weeks to work through. Unfortunately, the figures I have are from the end of June and the Senator's figures are probably more live than mine.

The Senator has raised a valid question about people working in more rural, but beautiful and scenic, areas where the costs of living and houses are lower. I see that across my brief in respect of mental health. We have, for example, been unable to fill a post in south Kerry for child and adolescent mental health services, CAMHS, since 2014. That role has been funded for ten years and we have been unable to fill it. There are issues attached to it but we have found it challenging recently. In Donegal, for example, we advertised two posts related to nutrition and received no applications. There are challenges in specific areas.

I know west Cork very well and it is a beautiful part of the country, as the Senator said. It is vast and the catchment area is enormous. The Senator spoke to the point that Skibbereen and Dunmanway no longer have these services, which is worrying.

The Department of Health engages with the HSE on an ongoing basis to understand and address any challenges arising in the provision of public dental services. The Minister has been assured by the HSE that it is continuing to restore dental screening and treatment to children up to 16 years of age through identifying local resourcing challenges, prioritising clinical treatment and patient groups, and reallocating clinical resources according to greatest need. However, the Minister is aware that backlogs have arisen in the school system since the Covid-19 pandemic. As the Senator said previously, children were always seen in first or second class, third or fourth class and then fifth and sixth class. Fissure sealing is important to prevent fillings when they later go to secondary school.

The Minister recognises that oral healthcare needs to be modernised in line with best international evidence and practice, as set out in the Smile agus Sláinte policy. The development of prevention-focused oral healthcare packages for children aged from zero to two years is being prioritised this year, supported by €4.75 million allocated in the budget.

The HSE provides orthodontic treatment to those who have the greatest level of clinical need and who have been referred to the service 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. Additional investment in orthodontic services in recent years has enabled the HSE to substantially reduce waiting lists nationally, with a 47% reduction in treatment waiting lists achieved between the end of March 2019 and the end of June 2023. Under a national private procurement initiative, 2,154 patients were transferred into private orthodontic care between January and December 2023. For orthodontic patients who require surgical input, the HSE is developing a model of care for oral and maxillofacial surgery through the national clinical programme for surgery.In 2023, surgery was procured for 41 patients waiting over four years for jaw surgery, which requires a lengthy hospital stay.

I will come back in the next session.