JOINT COMMITTEE ON HEALTH & CHILDREN - REPORT ON ORTHODONTIC SERVICE IN IRELAND

JOINT COMMITTEE ON HEALTH & CHILDREN - REPORT ON ORTHODONTIC SERVICE IN IRELAND

Summary of Recommendations - 26 February 2002

The Joint Committee recommends that:

Relationships
1. In the continued absence of agreement from all Regional Consultants, the areas of dispute should be referred to an expert panel. This panel should consist of an expert nominated by the three consultant orthodontists in question, an expert nominated by the other parties in the dispute, and an independent Chairman to be agreed by the two other nominees. The findings of this panel should be binding on all parties.
[Chapter 8.12]

Orthodontic Service Strategy
2. An Orthodontic Action Plan should be prepared within the next six months by the Department of Health and Children in which the critical success factors, performance indicators including target timeframes for access to the service and possible corrective actions are clearly spelled out.
[Chapter 3.7(i)]

3. The proposed legislation for an independent Health Information and Quality Authority provides that the relevant Houses of the Oireachtas Committee may request it to review matters it considers appropriate, in a similar manner to the Public Accounts Committee's access to the Controller and Auditor General.
[Chapter 3 .7(iii)]

Guidelines for prioritising Service
4. A mechanism is put in place to ensure that guidelines for prioritising the orthodontic service are not amended before they have been considered by an appropriate Committee of the Houses of the Oireachtas and that an agreed copy is laid before the Houses of the Oireachtas.
[Chapter 4.8(i)]

5. A reduction in the 1985 guidelines, if considered appropriate, should apply only to the next group of l2 year olds to be assessed and not to children on the existing waiting list for assessment or treatment.
[Chapter 4.8(ii)]

Training
6. The primary Dental Degree course in Dublin and Cork be upgraded/amended to cover primary level orthodontics. [Chapter 5.12(i)]

7. Dublin Dental Hospital and School receive State funding to upgrade their facilities for orthodontic postgraduate training with a view to catering for up to 18 trainees.
[Chapter 5.12ii)]

8. All specialist training places in Dublin and Cork be funded by the State and attached to health authorities until health authorities have a minimum of 50 specialists.
[Chapter 5.12(iii)]

9. A second Consultant Orthodontist be appointed to each Health Board to speed up assessments and facilitate training of Dentists and trainee specialists.
[Chapter 5.12(iv)]

10. The minimum number of trainee specialists in training be increased to 24 by 2004 at latest, with not less than 6 of these being trained in Cork
[Chapter 5.12(v)]

11. Flexibility be shown to Dentists with considerable experience in Orthodontics so that they can avail of specialist training.
[Chapter 5.12(vi)]

12. Health authorities encourage and with the Department facilitate dentists to apply for specialised courses in the U.K. and N.I.
[Chapter 5.12(vii)]

13. That Health Boards be facilitated in developing links with U.K. and N.Ireland Dental Colleges to train specialists in view of the inadequate training facilities available at present.
[Chapter 5.12(viii)]

14. Section 34 of the Dentists Act, 1985, which sets out the duties of the Dental Council in relation to education and training, be amended to require the Council to ensure that the number of people in training is adequate to meet public dental needs.
[Chapter 5.12(ix)]

Manpower levels
15. Specialist manpower levels should be based on the 1985 guidelines and on a caseload of 250 completed cases each year per Specialist Orthodontist.
[Chapter 6.4]

Recruitment
16. The qualifications for the grade of Specialist Orthodontist be directed by the Minister as a matter of urgency.
[Chapter 7.7(i)]

17. The number of permanent whole-time posts of Specialist Orthodontist in each Health Authority be decided as a matter of urgency and that the position of existing qualified Specialists and trainees be sorted so that the remaining posts in Health Boards are clearly identified.
[Chapter 7.7(ii)]

18. Planning should now commence involving the appropriate recruitment body, the Department and the Health Authorities to:

identify and target the recruitment of the 15 Irish postgraduate students mentioned in 7.5

identify countries and schools training prospective Specialists and identify appropriate times for focused targeting of personnel.

travel to interview applicants for Specialist posts in their country of residence, if necessary
[Chapter 7.7(iii)]

19. The health authorities prepare an attractive information pack for circulation to prospective Specialist applicants.
[Chapter 7.7(iv)]

20. Priority in the filling of permanent whole-time Specialist posts be given to health authorities with the greatest need e.g., Southern and Eastern authorities.
[Chapter 7.7(v)]

21. A recruitment campaign for permanent whole-time Specialist posts focusing on Scandinavia, Northern Europe and the U.S.A. be undertaken as soon as possible in view of the perceived overproduction of Specialists in these areas.
[Chapter 7.7(vi)]

22. State funding be provided to train Consultant Orthodontists, to try to avoid a shortage at this level and to facilitate manpower planning.
[Chapter 7.7(vii)]

23. Consideration be given to the provision of free accommodation or an accommodation allowance, for the first two years, to qualified applicants from abroad.
[Chapter 7.7(viii)]

Delivery of Orthodontic Service
24. Each Health Board initiate a review of its awaiting assessment lists immediately.
[Chapter 8.4]

25. An Automated Appointment system be considered for use by each Health Board.
[Chapter 8.5]

26. A Grant-in-Aid option be provided for persons over 16 years on the treatment waiting lists either by amending legislation or through the Social Welfare system.
[Chapter 8.6]

27. Arrangements with the Dental Schools be negotiated to treat the maximum number of public service patients at the minimum fee.
[Chapter 8.7]

28. Video conferencing links with Cork, Galway and other appropriate Orthodontic Units be the subject of public funding to facilitate more efficient training.
[Chapter 8.8]

29. The Joint Committee consider that the Chief Dental Officer of the Department should be at least of equal status with Consultant Orthodontists.
[Chapter 8.9]

30. Planning for the orderly provision of oral surgery in the Health Boards commence immediately.
[Chapter 8.10]

31. An accurate system of outcome measurement and audit is put in place as a matter of urgency to verify completed cases, confirm quality and facilitate cost comparisons.
[Chapter 8.11]

Updated 28.03.2002