As if the crisis that exists in the provision of ophthalmology services across the south-east was not enough, we have an even greater crisis in the provision of orthodontic treatment for children across the region. I can only describe the state of orthodontic services in County Tipperary, in particular, as deeply worrying and shocking following new information that I received from the HSE. Figures reveal that 546 children are waiting for critical orthodontic treatment, some of whom have been waiting for up to 82 months, or almost seven years. There are another 312 children waiting for an initial assessment. Children in my constituency of Tipperary South are being left to wait for the best part of their childhood for essential orthodontic care. This is not a delay but a systems failure. The HSE has confirmed to me that there are no waiting list reduction targets for 2026 or 2027. The service is operating with just 0.1 whole-time equivalent consultant orthodontist cover for assessments in Clonmel. A specialist orthodontist post has effectively been reduced from full time to 0.6 whole time equivalent and vacancies remain unfilled dating back as far as 2021.
It is extraordinary that in the face of such extreme waiting lists the HSE has set no targets whatsoever to reduce lists. This points to a lack of urgency and a lack of accountability. Even more concerning is the admission that waiting lists will continue to grow over the next two years. This means children who are now only being referred may not be treated until they are well into their teens. The HSE acknowledged to me that demand is exceeding capacity, with more patients joining the waiting list than can be treated. Urgent action is now required. We need immediate recruitment to fill long-standing vacancies, a clear recovery plan with measurable targets and additional capacity put in place without delay.
I am sure the Minister of State will agree that no child should be left waiting years for care that is critical not just to their health but also their confidence and development. What we are looking at here is not just pressure on a service but the effective absence of a functioning orthodontic service across the south-east and particularly in my constituency. Seven years is not a waiting list but a denial of care. The most shocking element is not just the delays but that there are no targets at all to reduce them. The HSE has openly admitted that waiting lists will continue to grow over the next two years. We are talking about children missing the critical window for treatment that can have life-long impacts on their oral health and confidence.
Parents are being left with an impossible choice: either pay privately or watch their children wait for years. By the time some of these children are seen, the clinical need may be more complex and, indeed, more costly. This is a classic example of a service where demand is known and predictable but not planned for. There is no credible explanation for having no reduction targets in the face of such a crisis and such extreme delays. If this were happening in any other part of the health service, it would be treated as an emergency.
