Thursday, 24 November 2016
Commencement Matters (Resumed)
Dental Services Waiting Lists
I welcome the Minister of State. I think it is my first time speaking in her presence in this Chamber. She is heartily welcome. I congratulate her on her well-deserved appointment. As a Deputy and as a former councillor over the years, I am sure she has experienced the issue I am raising today. Children who have difficulties with their teeth can become agitated, difficult and demoralised. Their parents can become anxious. They become worried and concerned. Many ordinary children who have braces on their teeth, or other dental difficulties, are bullied and suffer difficult challenges in school. We can imagine what it is like for children with special needs who have been diagnosed as needing urgent, detailed and intensive dental treatment. It causes awful anxiety and desperate worry for such children. Their parents experience unbelievable uncertainty, fear and anxiety.
I am dealing with a client, a child with special needs, who has been identified as being in urgent need of intensive dental treatment. My office has been in weekly contact with the HSE to try to get this child's dental treatment approved. We have been told it could take up to a year, which is an unacceptable wait for the healthiest, brightest and most confident child, but is just appalling and disgraceful for a child with special needs. I believe this case warrants a special intervention by the Minister for Health. He should direct the HSE to provide the funding that is necessary for this child's dental treatment as a matter of urgency. I have received the standard Civil Service replies from the Department telling me that this is a matter for the HSE, which is responsible for managing the health services. That is fine in ordinary day-to-day situations, but in a specialised situation like this the Minister can and should direct the HSE to put this case at the top of the queue. He should instruct the HSE to provide the necessary funding immediately. I look forward to getting a favourable reply from the Minister of State on this specific case.
I thank Senator Conway for raising this important issue. As he knows, the provision of dental and other services to patients with special needs is a priority. The public dental service of the HSE provides dental services to children up to 16 years of age, and to people of all ages with special needs, through its dental clinics. All HSE denial clinics prioritise emergency care for children up to the age of 16 and treatment for special needs patients. As it is not always possible or appropriate to provide oral health services to special needs patients in dental clinics, some dental services, including general dental anaesthetic services, are provided in general acute hospitals, particularly for patients who require special care. The HSE's policy is that general anaesthesia should, if possible, be avoided in the practice of dentistry. I am informed by the HSE that since 2012, it has been upskilling dental teams in conscious sedation as an alternative. The upskilling of senior dentists in other behavioural techniques and in sedation reduces the reliance on staff in the acute sector, thereby improving access and providing a range of modalities to dentists to treat patients with special needs. These developments, together with regular validation of waiting lists, aim to provide more appropriate and timely access for patients who require these specialised services. Nevertheless, general anaesthetic services continue to be provided on determination of clinical need.
The HSE has advised me that it is aware of and is dealing with the delays that have been affecting patients in area 5 of the community health organisation, which includes south Tipperary, Carlow, Kilkenny, Waterford and Wexford, due to a lack of local access to general anaesthesia in acute facilities. I can inform the Senator that three full-day general anaesthetic sessions are to be facilitated exclusively for patients with special needs at Aut Even Hospital in Kilkenny. Two full days will be facilitated before Christmas, providing treatment for up to ten patients within area 5, and a further day will be provided in early January 2017 to provide treatment for a further five patients. Up to 15 patients will receive treatment under this initiative. The success of this initiative will be evaluated to assess whether it should be further developed. I am informed by the HSE that it is considering other options to provide these services in area 5. As Senator Conway has mentioned, under the Health Act 2004 the HSE is required to manage and deliver health and personal social services, or arrange for such services to be delivered on its behalf. Section 6 of the Health Service Executive (Governance) Act 2013 prevents the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual. However, it does not prevent the Minister from making representations in this regard.
I have no doubt that the Minister of State is genuine in her offer to get the Minister to make representations in this specific and unique case. I would like this young fellow to be treated at one of the sessions in Aut Even Hospital in Kilkenny, which is not that far from where his parents live in Clonmel. I would like the Minister of State to ask her private secretary to talk to the HSE. If the private secretary makes contact with my office with the reply, I will most grateful.