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 Header Item State Pensions Payments (Continued)
 Header Item Ceisteanna ó Cheannairí - Leaders' Questions

Thursday, 4 April 2019

Dáil Éireann Debate
Vol. 981 No. 5

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  12 o’clock

(Speaker Continuing)

[Deputy Regina Doherty: Information on Regina Doherty Zoom on Regina Doherty] The ambition is for us to ensure that we carry out reviews of all 90,000 cases as quickly as we can.

In response to Deputy Aindreas Moynihan regarding the staging of the recruitment, that is how long it took us to find staff. It certainly was not our ambition to start off with 60 staff, before increasing the number to 80 and then 120. I am completely satisfied that the staffing levels are sufficient to ensure this process will be completed in a couple of months. It will certainly not take anywhere near as long as the Deputy suggested. I am also adamant that I will not tell the Deputy or anybody else that we are finishing on 1 June when people still not have given us the information required to allow their cases to be reviewed. In many cases, we can probably do reviews based on the information we have. Those cases are easier to review but there are many gaps where we do not have the information and that requires co-operation and information flow back and forth. To be fair and truthful, we had anticipated being able to do the vast majority of these reviews online, meaning we expected that if I emailed the Deputy today, he would email me back tomorrow. However, this approach does not quite work with some members of our older population and there is a delay in receiving responses when we send out requests for information.

  Written Answers are published on the Oireachtas website.

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary We saw another press release from the Government announcing a new national oral health policy called Smile agus Sláinte. Only Fine Gael could try to make dental treatment sound fluffy. The new policy implements one of the recommendations of the Sláintecare report. All children will receive eight oral healthcare packages while medical card holders who are over 16 years will also receive packages. However, there is no mention in the fluffy press release of the 18,000 children who are currently on the orthodontic waiting list or the 24,000 children waiting for dental treatment in general, including many in my constituency. I have been lobbying the Government hard on this matter. As we speak, up to 9,000 children with moderate to severe malpositioned teeth and jaw problems have been waiting for more than two years for access to an orthodontist. Those who can afford treatment will pay in excess of €3,000. All of that was glossed over.

  The proposals are welcome but as with every press release and announcement from Government Buildings, also know as spin central, this one comes with a health warning. While the president of the Irish Dental Association, Dr. Kieran O'Connor, welcomed the publication of the document, he pointed out that his members were not involved in or consulted in detail regarding its formulation. We have a new dental strategy that has been formulated without talking to dentists. One could not begin to make it up.

  I remind the Tánaiste of the conversation I had with him on Tuesday regarding an article by Paul Cullen published in The Irish Times and followed up by Aoife Hegarty in "RTÉ Investigates" on Tuesday evening. The programme, which was compiled following whistleblower allegations, reported on an audit of orthodontic treatment affecting 7,500 people in the greater Dublin and Leinster area in the period between 1999 and 2002. The report was finalised in 2015 and still has not been published. We need to know the details of that report. Why is it taking so long so deal with the findings? Have the people affected been contacted? Since Tuesday, what has been the Government's response to Paul Cullen's article in The Irish Times and the "RTÉ Investigates" report? What action is being taken to contact people whose orthodontic treatment has been compromised by the difficulties within the service?

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney I am still not quite sure whether the Deputy welcomes the new approach to orthodontic care.

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary I am sceptical.

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney It is certainly a very positive new policy, with eight new packages of care for children up to the age of 16, and an attempt by the Government to be proactive. For what it is worth, there was extensive consultation before the new approach was launched.

On the second issue raised by the Deputy, in 2015, the HSE received a review report it had commissioned following receipt of a statement of concern from two consultant orthodontists relating to an orthodontic service serving the greater Dublin area between 1999 and 2002. The statement of concern was initiated by the consultants who claimed that some children suffered damage as a result of interrupted orthodontic treatment at the time of the dispute between the consultants and the HSE relating to the model of care for delivery of orthodontic services. The original review report of 2015 was, in effect, a scoping report commissioned to advise the HSE on what actions should be taken to determine if there was a risk of harm to patients during that period. The report did not include a review of any patient records for the period and so, understandably, reliable conclusions could not be drawn at the time regarding definitive patient harm.

Since receipt of the 2015 report, the HSE has initiated a comprehensive audit of more than 7,500 patient files available from that period. Dedicated funding and personnel have been allocated by the HSE for this work. Due to the scale of the audit of the files and the requirements for dedicated personnel and resources, the timeline has been protracted. However, this work is nearing completion. While the Minister and the HSE regret that the work has taken a long time to progress, the priority for the HSE at all times has been for a robust audit on which to base further action. The HSE has informed the Minister that it cannot, as a matter of course, commit to the publication or otherwise of the report prior to the completion of the audit process. The benefits of publication must be balanced with the requirement for patient confidentiality and its obligations to afford natural justice to all other parties concerned. I assure the House that once the audit of patient files from the period is complete, a HSE serious incident management team will consider the results to determine if a recall of any patient is required and to co-ordinate open disclosure, as necessary.

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary I welcome the proposals relating to the dental strategy generally. I am just quoting from the press release issued by the Irish Dental Association, which represents the people who will deliver the proposals. It stated that nothing short of a complete reversal of Government policy would be required if the policy was to be rolled out successfully. The Government does not do reversals very well. Therefore, while I welcome the approach, I am sceptical.

Regarding the report into orthodontic services, have the 7,500 people affected been contacted? Have they been advised by the HSE review team that their files are being examined and they may have to undergo treatment? What is the level of contact with them? Are the individuals involved in the treatment still in the service of the HSE? Are they still working for it? The Tánaiste spoke about natural justice and I accept that but what is the timeline for the completion of this review? The HSE has had the report since 2015. Four years later, surely there should be an end in sight for the completion of the review and publication of the lessons learned.

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney It is important to remember that these files go back to the period from 1999 to 2002 so they relate to quite a long time ago and there are many patients are involved - 7,500. My understanding is that this audit is likely to be completed in the next couple of weeks. That is the indication I have from the Minister.

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary What about contact with the patients?

The Tánaiste: Information on Simon Coveney Zoom on Simon Coveney I do not have a direct answer to that question but I presume the patients will not be contacted until the audit has been confirmed and we understand what we are dealing with and they can be informed properly. I can confirm the position for the Deputy later. The priority is to finalise the audit to understand the number of patients involved and the detail of each of those patients so that we can contact them and fulfil the obligations under the open disclosure requirements that are now in place.

Deputy Pearse Doherty: Information on Pearse Doherty Zoom on Pearse Doherty On Tuesday, my party leader, Deputy McDonald, raised the issue of hospital overcrowding with the Tánaiste. I raise it with him again this morning because, in the past number of days, the problem has gone from bad to worse.


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