Damien English (Meath West, Fine Gael)
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232. To ask the Minister for Health if he will evaluate the prospects of the moratorium on recruitment being lifted for the Health Service Executive's orthodontic service in order that clinical staff can be employed to treat children assessed and placed on the category 4c treatment waiting list; and if he will make a statement on the matter. [53641/13]

Damien English (Meath West, Fine Gael)
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234. To ask the Minister for Health his plans to alleviate the waiting list for treatment for children who have been assessed and have been placed on the category 4c waiting list of the orthodontic services of the Health Service Executive; and if he will make a statement on the matter. [53643/13]

Alex White (Dublin South, Labour)
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I propose to take Questions Nos. 232 and 234 together.

The reduction in size of the public service has been an essential component of the approach to addressing the State’s fiscal difficulties. This has been combined with a firm focus on improving public service efficiency and effectiveness. The Haddington Road Agreement provides for some five million additional working hours annually. These measures will enable the health service to continue to reduce overall numbers, while maintaining services and service levels to the greatest possible extent.

The HSE provides orthodontic treatment to those who have been assessed and referred for treatment before their 16th birthday. Orthodontic referrals are generally received via the Public Dental Service school screening programme. An individual's access to orthodontic treatment is determined in accordance with the Modified Index of Treatment Need. The dental health component has five categories ranging from 1 (no need for treatment) to 5 (great need). Further sub-divisions of these categories are substantially based in accordance with the causes of malocclusion, e.g. misalignment of teeth. Patients with the greatest level of need are provided with treatment and those with urgent clinical need are prioritised. The HSE has commissioned an independent review of orthodontic services. The outcome of this review, which is near completion, will give guidance as to what changes will be desirable to provide the best possible model of care delivery, given the current resources available and future demand for services.