Martin Conway (Fine Gael)
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Like others, I was pleased to see Deputy Flanagan become a senior Minister. It is long overdue and well-deserved. This may be his maiden visit to Seanad Éireann, since he has not served here but has always been in the other House. He is very welcome.

I am tabling this Adjournment matter this evening because I visited a house where I met a 15 year old girl who has been waiting five years to have orthodontic treatment. This is having a detrimental effect in her formative years. We all know that early second level education is remarkably important and that, where possible, students should have all their faculties operating to their best capacity. That has not happened in this case.

We are in a modern society and a delay of more than five years is altogether unacceptable. I have noted the responses we have received from the HSE to the effect that it will be dealt with within three to six months. I strongly believe that this young lady in north Clare should be accommodated if there are extended hours or if a cancellation arises. We have no wish to see some other poor unfortunate losing out because of the fact that I have the facility of raising the matter in Seanad Éireann, but I believe the HSE has a responsibility and a duty of care to this young lady to ensure that she gets the treatment she requires as a matter of urgency. I would like to think this could be resolved in a matter of weeks rather than months.

Charles Flanagan (Laois-Offaly, Fine Gael)
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I am taking this Adjournment matter on behalf of my colleague, Deputy Alex White, Minister of State with responsibility for primary care. I thank Senator Martin Conway for raising the issue this evening.

Orthodontic referrals are received via the HSE's dental service school screening programme. Referrals are assessed for eligibility and patients with the greatest clinical need are treated within the public health system.

There have been particular difficulties in the mid-west area concerning waiting times for assessment in recent years. However, progress has been made in finding a resolution to the issue. At the end of 2010 there were 1,890 patients awaiting assessment in the mid-west area. In 2010 and 2011 a local initiative succeeded in reducing waiting times and numbers on the assessment waiting list. The most recent figures for the first quarter of 2014 show that there are 421 awaiting assessment and that 87% of these patients are seen within one year.

The individual to which Deputy Conway has adverted was assessed by the orthodontic specialist on 12 April 2012, deemed to be eligible for orthodontic treatment and placed on the treatment waiting list.

It is expected that she will be called to begin treatment within the next six months. I acknowledge what Senator Conway said about her condition and that the six-month wait may cause further anxiety, pain and suffering. I note, too, the Senator's point regarding a cancellation or appointment in lieu. We will contact the HSE with particular reference to such an arrangement.

Orthodontic services are provided mainly by orthodontic consultants, orthodontic specialists and support staff, including dental nurses and hygienists. The recruitment moratorium and the number of staff on long-term leave have had an impact on waiting lists in some areas. The HSE is considering a number of options to tackle waiting lists where they are problematic. These include skills mixes and the procurement of services. Pilot schemes involving the use of orthodontic therapists are being introduced. Such a scheme is already under way in the HSE's Dublin north east area and it is hoped to extend it to the mid-west area, including County Clare, within the next 18 months. These changes will have a positive impact on waiting times for patients such as the individual referred to by the Senator.

An independent national review of orthodontic services, commissioned by the HSE, has recently been completed. The key issue highlighted by the review is that the orthodontic service should be fully integrated within the primary care service. This is under consideration by the HSE to be implemented as part of its transformation programme. In addition, a new overall oral health policy is being developed. This new policy will aim to set out how services can best be integrated with general health services and aligned with the current and future needs of the population. The project will have three key parts. First, a needs assessment will inform how new services should be provided. The second part will be a review of resources. Finally, there will be consultation with stakeholders, including the public, on new ways of delivering oral health services in County Clare, the mid-west and beyond.

I thank Senator Conway for bringing this matter to my attention. I hope a resolution can be found to the individual's difficulties.

Martin Conway (Fine Gael)
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I thank the Minister for his reply. I acknowledge that a great deal of progress has been made nationally. Unfortunately, however, there seems to be a significant number of hiccups in the health services in the mid-west. This is a very sensitive issue for the young woman to whom I referred, as it would be for any young person. I ask the Minister to request the Minister of State at the Department of Health, Deputy Alex White, to ensure that an official from the HSE contact this young woman to assure her she is at the top of the cancellation list and that the necessary arrangements will be made whereby she will be informed by telephone of any cancellation and can respond at short notice.

Charles Flanagan (Laois-Offaly, Fine Gael)
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I will be pleased to convey the Senator's views to the Minister of State, Deputy Alex White. I am sure he will be in direct contact with the Senator in due course.