Tuesday, 22 June 2004
Dáil Eireann Debate
204. Mr. Durkan asked the Minister for Health and Children his plans to upgrade the facilities available at the various health centres throughout the country with a view to alleviating the pressure on hospital accident and emergency departments; and if he will make a statement on the matter. [18638/04]
Minister for Health and Children (Mr. Martin): The primary care strategy, Primary Care: A New Direction, aims to shift the emphasis from the current over-reliance on acute hospital services to one where patients will be able to access an integrated multidisciplinary team of general practitioners, nurses, health care assistants, home helps, occupational therapists, physiotherapists, and social workers in their local community. Appropriately structured, primary care can meet 90%-95% of all health and personal social service needs.
The strategy also envisages the development of extended-hours and out-of-hours cover for defined primary care services. The management of this wide range of care within the primary care setting represents the most appropriate, effective and user-friendly approach to the organisation of service delivery.
Primary care, planned and organised on this basis, can lessen the current reliance on specialist services and the hospital system, particularly accident and emergency and out-patient services. Based on available evidence, it has the potential to reduce the requirement for specialist services, reduce hospitalisation rates, reduce lengths of stay for those who are hospitalised, promote more rational prescribing and improve efficiency.
The primary care strategy also recognises that the provision of modern, well-equipped, accessible premises will be central to the effective functioning of the primary care team. One of the Government’s key objectives is to facilitate and encourage the development, where appropriate, of modern, well-equipped, user-friendly buildings in which the broad range of primary care services, including general practice, can be delivered. The strategy also emphasises the need to gain full benefit from existing buildings and to fully exploit any opportunities for public private partnerships in implementing the development programme. I am committed to developing policy in such a way as to maximise the opportunities to attract private sector interests into the provision of facilities to support delivery of primary care service in accordance with the new interdisciplinary model.
The identification, prioritisation and provision of health centres, including the upgrading of such facilities, to meet the health and personal social service needs of local communities are matters for the health boards or the Eastern Regional Health Authority in the first instance.
206. Mr. Durkan asked the Minister for Health and Children the number of patients on orthodontic waiting lists who have had to seek private treatment in the past five years; and if he will make a statement on the matter. [18640/04]
207. Mr. Durkan asked the Minister for Health and Children the position in regard to the provision of orthodontic services with particular reference to waiting lists; and if he will make a statement on the matter. [18641/04]
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. These 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. These 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.
Furthermore, the commitment of the Department to training development is manifested in the funding provided to both the training of specialist clinical staff and the recruitment of a professor in orthodontics for the Cork Dental School. This appointment at the school will facilitate the development of an approved training programme leading to specialist qualification in orthodontics. The chief executive officer of the Southern Health Board has reported that the professor commenced duty on the of December 2003. In recognition of the importance of this post at Cork Dental School my Department has given approval in principle to a proposal from the school to further substantially improve the training facilities there for orthodontics. This project should see the construction of a large orthodontic unit and support facilities; it will ultimately support an enhanced teaching and treatment service to the wider region under the leadership of the professor of orthodontics.
Orthodontic initiative funding of €4.698 million was provided to the health boards/authority in 2001 and this has enabled health boards to recruit additional staff, engage the services of private specialist orthodontic practitioners to treat patients and build additional orthodontic facilities.
In June 2002, my Department provided additional funding of €5 million from the treatment purchase fund to health boards/authority specifically for the purchase of orthodontic treatment. This funding is enabling boards to provide both additional sessions for existing staff and purchase treatment from private specialist orthodontic practitioners.
Finally, the chief executive officers of the health boards/authority have informed my Department that at the end of the March quarter 2004, there were 21,033 children receiving orthodontic treatment in the public orthodontic service. This means that there are nearly twice as many children getting orthodontic treatment as there are children waiting to be treated and almost 4,000 extra children are getting treatment from health boards/authority since the end of 2001.
208. Mr. Durkan asked the Minister for Health and Children when he expects to ensure the provision of adequate resources to meet the requirements of the Kildare psychiatric services; if his attention has been drawn to the urgent requirements in this area; and if he will make a statement on the matter. [18642/04]
Minister of State at the Department of Health and Children (Mr. T. O’Malley): Responsibility for the provision of the services referred to by the Deputy rests with the Eastern Regional Health Authority. The further development of our mental health services, including those in the Eastern Regional Health Authority, will be considered in the context of the estimates process for 2005 and subsequent years.
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