Micheál Martin (Cork South Central, Fianna Fail)
Link to this: Individually | In context

As the Deputy is aware, the provision of orthodontic services to eligible persons is the responsibility of the health boards or authority in the first instance.

The aim of my Department is to develop the treatment capacity of orthodontics in a sustainable way over the longer term. Given the potential level of demand for orthodontic services, the provision of those services will continue to be based on prioritisation of cases based on treatment need, as happens under the existing guidelines. It is widely recognised that decisions made in the private sector regarding orthodontic treatment are based primarily on subjective need and are not based on any evidence linking the orthodontic condition to any aspect of dental ill health. On the other hand, decisions made in health boards are based on prioritised guidelines ensuring that cases are selected for treatment based on the objective severity of the condition.

The guidelines for orthodontic treatment were issued in 1985. They are intended to enable health boards to identify in a consistent way those in greatest need and to commence timely treatment for them. Patients in category A require immediate treatment and include those with congenital abnormalities of the jaws such as cleft lip and palate, and patients with major skeletal discrepancies between the sizes of the jaws. Patients in category B have less severe problems than category A patients and are placed on the orthodontic treatment waiting list. Patients in category C have less severe problems than in category B. The number of cases treated is dependent on the level of resources available in qualified staff in the area, and that is reflected in the treatment waiting list. The provision of orthodontic services is severely restricted due to the limited availability of trained specialist clinical staff to assess and treat patients. Consequently, a category C waiting list may not be maintained in some health boards.

However, I am pleased to advise the Deputy that I have taken several measures to address the shortage of specialists and so increase the treatment capacity of orthodontic services in the Eastern Regional Health Authority, or ERHA, area and on a national basis.

The grade of specialist in orthodontics has been created in the health board orthodontic service. In 2003, my Department and the health boards funded 13 dentists from various health boards for specialist in orthodontics qualifications at training programmes in Ireland and at three separate universities in the United Kingdom. Those 13 trainees for the public orthodontic service are additional to the six dentists who commenced their training in 2001. Thus, there is an aggregate of 19 dentists in specialist training for orthodontics, including five from the ERHA. Those measures will complement the other structural changes being introduced into the orthodontic service, including the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area.

In June 2002, my Department provided additional funding of €5 million from the treatment purchase fund to health boards specifically for the purchase of orthodontic treatment. That funding is enabling boards to provide both additional sessions for existing staff and purchase treatment from private specialist orthodontic practitioners. The ERHA received €1.815 million from the fund for the treatment of cases in that way.

The regional chief executive of the authority has informed my Department that, at the end of the March quarter for 2004, 3,695 children were awaiting orthodontic treatment. The regional chief executive of the authority has also informed my Department that the number of children in treatment in the years 2001, 2002 and 2003 was 3,776, 3,896 and 4,012 respectively.