Bernard Durkan (Kildare North, Fine Gael)
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Question 164: To ask the Tánaiste and Minister for Health and Children the method for assessment in respect of orthodontic requirements; the average number deemed to require such services in a single year; the number expected to receive treatment in the same year; and if she will make a statement on the matter. [9738/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes responsibility for orthodontic services.

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 orthodontic guidelines.

Under the Health Act 1970, a child is eligible for orthodontic treatment on the basis of defects noted at a school health examination carried out while the child is attending national school. Entitlement to orthodontic treatment is determined by reference to orthodontic guidelines, a set of objective clinical criteria applied by HSE orthodontists when assessing children's priority of need for treatment.

The guidelines were issued by my Department in 1985; they are intended to enable HSE areas 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 terms of qualified staff, in the area, and this is reflected in the treatment waiting list. In fact, the provision of orthodontic services for patients in category C is currently 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 HSE areas.

The chief officers of the HSE areas have informed my Department that at the end of the December 2004 quarter there were 9,954 children awaiting orthodontic assessment, 10,953 children awaiting orthodontic treatment and 23,572 children receiving orthodontic treatment in the public orthodontic service.