Orthodontics: There are more than 750 patients waiting up to three years for orthodontic treatment in the Western Health Board (WHB), an external review has found.
Although the number of patients waiting for specialist treatment has dropped from 2,704 in 1994, following the appointment of a consultant orthodontist in 1997, patients still wait nine months for initial screening.
The report, compiled by consultant orthodontists from Britain, Northern Ireland and the North Western Health Board, found staff shortages and low staff morale are hindering the delivery of orthodontic services in the region. It recommends the appointment of a second consultant orthodontist to Merlin Park Hospital, Galway.
The reviewers identify the absence of an orthodontic laboratory at the hospital as "a significant shortcoming". And while two dentists with orthodontic expertise work in the service, two further posts remain unfilled.
The report found there was a problem with patient selection for treatment in the WHB. It blames this on the practice in the Republic of basing treatment need on an 1985 Department of Health grading system and recommends the adoption of the Index of Treatment Need (IOTN) system in use in the UK. While acknowledging IOTN may become universally accepted here, the reviewers suggest it be immediately adopted by the WHB.
They express the strong view that screening of patients for orthodontic services should take place in the community and be carried out by a consultant on an outreach basis. Such a move would promote greater understanding of the system and increase rapport with principal dental officers.
Welcoming the report, which she said gave a clear strategy for the future development of the orthodontic service, a WHB spokeswoman said it was considering the recommendations and "will implement those that are within the WHB's remit".
But, in a reference to the ongoing debate on the adequacy of orthodontic services nationally, the authors state the WHB unit "is operating within the background of extreme political and media pressure, which far out-weighed the significance of orthodontics".