The Department of Health and Children was accused yesterday of putting the interests of a powerful professional lobby group ahead of the needs of children who are facing delays of over four years for essential orthodontic treatment.
Addressing the Joint Oireachtas Committee on Health and Children, three public sector dental care workers severely criticised the Department's handling of the growing waiting lists problem.
Ms Triona McNamara, consultant orthodontist with the South Western Area Health Board, said she had been "naïve" to think the Department would side in favour of patient care ahead of the interests of the Dublin and Cork dental schools, and private practitioners. In fact, she said, the Department had allowed the dental schools to be inward looking, scuppering reforms which challenged their monopoly on training.
"This 'political whim' has caused chaos and confusion for everyone: patients, parents, politicians, managers, and consultants alike," she said.
Echoing this view, Mr Ian O'Dowling, consultant orthodontist with the Southern Health Board, said the national orthodontic service was "disintegrating . . . because of the incompetence of the Department . . . and the greed of the dental schools."
He said the Department was reducing waiting lists "by reducing access to waiting lists". This was being done through introducing stricter guidelines for the treatment of children and eliminating certain conditions from priority categories.
Dr Antonia Hewson, principal dental surgeon with the Western Health Board, said it was inexplicable at a time of unprecedented prosperity that children were finding it harder to receive treatment.
She also traced the problem to the Department's decision in 1999 to prohibit the training of consultants within health boards.
"It is wrong that genuinely deserving children in the west of Ireland are being unfairly denied essential orthodontic treatment because of politicking by powerful lobbies in Dublin," she said.
Ms McNamara noted that a training programme had reduced waiting times from over six years to two years at the Western Health Board and cut waiting lists from over 18,000 in 1996 to 6,600 in 1998 at the Eastern Health Board.
She claimed, however, this success had "upset" the dental schools and the Department.
Asked by Mr Gay Mitchell FG) if "the pressure was to stop you seeing so many patients", Ms McNamara replied: "yes."
She said she believed a "blunder" had been made in 1999, and since then Department officials had "shielded" information from the Minister.
Mr O'Dowling remarked that the dental schools "never did anything for the public health service". However, they had "the ear of the Minister and the ear of the Department".
Later, Dr Therese Garvey, a senior lecturer at the Dublin Dental School, representing the Orthodontic Society of Ireland, said it was no longer acceptable for children to receive "compromised" orthodontic treatment. She added the majority of treatments carried out were for cosmetic rather than health care reasons.
In a separate submission, the Irish Consultant Orthodontists' Group said the consultant-patient ratio in the Republic was better than that in the UK.
Mr Mitchell said the professional bodies sounded "very inflexible" and "arrogant", adding there had to be something better than the 15-year solution they were proposing to the waiting list problem.
