asked the Minister for Health the plans he has for the development of the dental services.

8.

asked the Minister for Health if he is aware that many children in County Meath are waiting one year or more for urgently required dental treatment due to the lack of professional services in the North-Eastern Health Board; the action, if any, he intends taking to improve the situation; and the plans he has for the development of the national dental services.

I propose to take Questions Nos. 7 and 8 together.

The report of the Joint Working Party on Dental Services, which consisted of representatives of the Department of Health, the health boards and the Irish Dental Association, is the blueprint for the development of the dental services. Among recommendations of the working party which have already been implemented are the use of dentists in private practice to treat eligible health board patients and the re-structuring of the grading of dentists in the health board service, including the provision of additional promotion outlets for dental surgeons.

In line with the recommendations of the joint working party efforts are being made at present to recruit a number of full-time consultant orthodontists for the health boards and it is intended to proceed also with posts of oral surgeon when circumstances permit. Recommendations to increase substantially the numbers of dentists employed in the health boards cannot be proceeded with at present due to the general embargo on the creation of additional posts in the public service. Some other recommendations of the joint working party, involving the use of auxiliary dental workers in the health board service, cannot be proceeded with until the new Dentists Bill has been passed.

While the recommendations of the Joint Working Party on Dental Services represent the plans for future development of the dental services generally, the services are nevertheless the subject of an ongoing review by a group representing the Departments of Health and Social Welfare, the health boards and the Irish Dental Association.

In regard to the dental service for school children in County Meath, there are some children served by the Trim dental clinic who, on the basis of the numbers awaiting treatment and the staff available to attend to them, will have to wait more than a year before they are reached. However, many of those whose names are on the waiting list have not been clinically examined and it is thought that a high proportion of them may not require any dental treatment whatsoever. The health board intends to screen all those on the present waiting list and to draw up a new list of those genuinely requiring treatment. When this was done in other areas of County Meath the waiting lists for dental treatment were drastically reduced.

The Minister has told us about a number of recommendations which were made by the working party. He will have to accept that since he took office none of these recommendations has been implemented. The first one he gave us was the use of dentists in private practice to look after public patients. This was in operation when the Minister took office. In a number of health board areas it has been abolished as a result of the cutbacks. None of the other recommendations has been implemented. The Minister has already told us that he advertised for orthodontists but the posts have not been filled. He has said that at some time in the future an old surgeon will be appointed.

A question please, Deputy.

Is the Minister aware that in the official report of the working party it is stated that less than 10 per cent of eligible adults receive treatment and that the level of treatment provided for eight to nine year olds is only 40 per cent? The amount of money being allocated to the health boards for dental services has been reduced from 1 per cent to 9 per cent between 1983 and 1984. Surely the Minister must have some ideas of improving the services.

I would remind the Deputy that the recommendations to which he is referring are six years old. They were made in 1979.

But the use of private dentists had been in operation until the Minister came into office.

No Minister for Health since then has given more attention to this area than the present incumbent, whether it be in terms of——

Abolishing the services, certainly.

——of updating the legislation and conducting national surveys — particularly in relation to school children. All that work has been done. I have not cut back in any way on the allocations to health boards. I have given them sufficient money to run their programmes and they then decide how much money they are going to allocate to dental work. If they do not give it the kind of priority which I might believe they should and which members of health boards, such as the Deputy, might believe they should, that is the responsibility of the health boards.

Question 9.

They have sufficient money. If they want to spend it all on acute hospital care or other areas rather than on preventative work in dental care, which is far less spectacular but equally costly, they will have to accept responsibility for that.

Surely the Minister must accept that the health boards, with a reduced allocation, have no alternative but to reduce the services. He must accept that he is responsible for the fact that they have reduced allocations. Is he going to condemn the health boards for the manner in which they are using the allocations which they are receiving?

No. I would point out to the Deputy that the number of dentists employed in the health services in 1979 and the following years, including 1982 when I took over, has not been reduced. I have approved the employment by the health boards of five additional consultant orthodontists. The posts are being filled where they become vacant; there has been no reduction. We have not, however, increased overall the number of dentalologists. I would remind the House that the number of children being born dropped in the period 1979 to 1985 from 76,000 to 63,000. Therefore, in the years ahead those dentists dealing with schoolgoing children from the age of five upwards requiring treatment will have fewer cases to deal with. This is a valid point.

Would the Minister accept that the dental scheme has not been available in most health board areas since he came to office?

If they are not available, that is the responsibility of the health boards. I have issued no directive whatsoever on that.

9.