Tuesday, 1 May 1990
Dáil Éireann Debate
26. Mr. R. Bruton asked the Minister for Health the number of people on the waiting list for orthodontic treatment (a) in the Eastern Health Board region and (b) nationally; the average waiting time for treatment of a person now joining the list (i) in the Eastern Health Board and (ii) nationally; and if he will make a statement as to whether extra funds will be earmarked to deal with the problem.
Minister of State at the Department of Health (Mr. N. Treacy): The health boards do not keep comparable waiting lists for orthondontic services. In some health boards the lists are comprised of those who are awaiting assessment while in others, those who have been assessed and are awaiting treatment. My Department are currently taking steps to ensure  that all waiting lists are assembled on the same basis. I will be writing to the Deputy further on this matter when realistic figures are available.
What is clear is that the waiting lists for orthodontic treatment are too long. However, the Government made a special allocation of £300,000 available to the health boards late in 1989 to bring about an improvement in orthodontic services, while a further allocation from the 1990 budget provision of £3 million for dental services brings to about £1 million the additional amount provided for orthodontic services in recent months. These allocations demonstrate the Government's commitment to tackling the problems which have arisen. As I stated in the Dáil recently, these measures are the beginning of a continuous programme of action to boost services in these areas designed to eliminate the problems which have arisen, as quickly as possible.
It is not possible to state when treatment will be provided for children now joining the waiting list because arrangements for the delivery of orthodontic services are under review. The five vacant posts of consultant orthodontist in the health board dental service will be advertised again shortly with improved conditions of service. If these posts were filled it is anticipated that there would be a considerable improvement in the waiting times for orthodontic services.
Mr. R. Bruton: Does the Minister not agree that this £1 million will not provide for a fraction of the waiting lists, which in the Eastern Health Board alone runs to 7,000 people? Does he not further agree that this old hoary chestnut of filling posts is one we have been hearing about for several years and there is no greater prospect now of these posts being filled in the way he suggests than there was several years ago?
Mr. N. Treacy: I do not accept what the Deputy has said. The problem with the orthodontic waiting lists has existed for a number of years and we have done our utmost to tackle this problem. On  the direction of the Minister, the health boards and the Department are trying to establish if it is possible to involve the private sector and to have much more flexibility attached to employing people from the private sector to ensure that services can be improved. If we can get agreement on this I think we will be able to improve the services. The fact that we have provided £1 million extra for orthodontic services this year shows how committed we are to reducing the lists and providing the best service possible as quickly as we can.
Mr. R. Bruton: Is the Minister aware that in the Eastern Health Board area people joining these lists, even after the provision of £1 million, are being told that the waiting time for orthodontic treatment will be eight years?
Mr. N. Treacy: I am not aware of what these people are being told but I can tell the Deputy that the health boards, the health board dental surgeons and the people involved in the administration of the dental services in the health board were told that £300,000 was being made available on a commitment that they would see to it that when the extra funding was made available the lists would be reduced as quickly as possible. We hope, with our attitude of flexibility, to be able to assist them in reducing these lists through the provision of extra personnel.
Mr. Yates: Does the Minister not agree that despite all the rhetoric and bluster we have heard the dental services are still a total disaster, with more than 20,000 people awaiting orthodontic treatment and old age pensioners not being able to get dentures? Will the Minister clarify how this £3 million announced at the time of the budget is to be spent and whether the basic service of an ad hoc referral scheme will be introduced? When can we reasonably expect to have even a moderate public dental service?
Mr. N. Treacy: We have provided an extra £3.3 million for dental services, something which was not done for years. Surely this is proof of our commitment to improving the services. The allocations and the conditions attaching to them have been notified to the health boards. We are awaiting a response from the boards on their programme of activity and work for the rest of this year. We want to ensure that this money is spent and the waiting lists reduced.
Mr. Sherlock: Does the Minister not agree that he will have a difficult job in getting his act together now that the service has fallen asunder because the personnel are not available to deliver a service. The Southern Health Board do not have access to the Cork Dental Hospital at present. Does the Minister not  agree that this matter has to be reviewed with some seriousness?
Mr. N. Treacy: I appreciate what the Deputy has said. We will have a difficult job in getting the acts of many people together to ensure that these services are improved. We are committed to doing this and we will strive to do it as quickly as possible.
Mr. Durkan: Having regard to the information available, with particular reference to staffing and the numbers on the waiting lists, will the Minister give some indication to the House as to when the waiting lists might be reduced and by what deadline?
Mr. N. Treacy: It is a bit premature to give that information because the money was only made available in the budget and the health boards are working to the strict and detailed criteria which have been laid down for them. I hope to be in a better position to assess the situation and to give much more firm information towards the end of the year.
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