2. What conclusions has the Cabinet Secretary reached in light of the report on the state of orthodontic services in Wales as discussed in the Assembly on 7 December 2016? OAQ(5)0123(HWS) [W]

Thank you for the question. The report recognises the continuing good progress being made. Working with Public Health Wales, health boards and the clinical networks, we are using the report’s recommendations to inform action to further improve the effectiveness and efficiency of the delivery of this specialist orthodontic service here in Wales.

I thank the Cabinet Secretary for his reply. I’m not quite sure if we’ve been reading the same report, and I obviously looked at the report from the particular aspect of the area I represent and Hywel Dda in particular, where it says there is a real problem in accessing orthodontic services. I had confirmation this week from the British Dental Association as well that waiting lists in Hywel Dda for children aged between nine and 17 are, at the moment, at three years and four months, and that is against the target of six months. So, I have to ask, in light of the report, which doesn’t have any firm outcomes and targets within it, what is the Government doing to ensure that the constituents who I represent in the Hywel Dda health board region are able—particularly young constituents—to access orthodontic treatment within a reasonable period of time, remembering that this impacts upon their schooling and their upbringing?

I accept what the Member is saying. Hywel Dda is one of our problem areas within an overall improving national picture. Hywel Dda itself has made further progress in the last few years, but there’s actually been a significant backlog built up within Hywel Dda. Some of that is about making more effective and efficient use of the specialist service that exists. It’s also about making sure that people really do get to see a specialist in this area, as opposed to a general practitioner who does some work. We actually think we get better outcomes for individuals doing that, but also about making sure that referrals are made at an appropriate time and for the appropriate service. So, it’s something about referral behaviour. It means proper investment in the specialist end of the service and those that are genuine specialists in this area, and trying to make sure that we properly meet and match the supply and demand. I do accept that, in Hywel Dda, that has not been the case to date. But the health board are investing in this particular area and I expect to see further improvement made, because, as you said, waiting times in the Hywel Dda area are too long and I expect to see further progress made in the rest of this Assembly term.

Cabinet Secretary, I very much echo the comments of the Member for Mid and West Wales, and I can highlight plenty of examples in my own constituency of patients having to go private and having to travel further afield for orthodontic treatment. So, in the circumstances, what additional steps are the Welsh Government taking to monitor the effectiveness of the working relationships between orthodontic practices and the Hywel Dda Local Health Board in terms of the management of local orthodontic provision?

Well, as I said in my response to the Member and, indeed, to his previous question before the new year break, we recognise in particular in Hywel Dda that there’s been a need to improve on where they are. There is something there, as I said, about making sure that specialist practice is undertaken in the service and that they are actually more effective and more efficient in turning round and providing additional capacity. The health board are investing more in that specialist area of provision, and, in fact, we know that more people have been seen in the last three years within Hywel Dda. We know that there have been 24 more assessment clinics in the last year throughout the health board area. But that doesn’t mean that it resolves the whole problem. They need to continue to do that to actually properly get into the backlog. So, I recognise that constituents across the Hywel Dda health board area, some of them are waiting simply too long for this specialist treatment. So, it is about investing in the future—not pretending that we can fix it within a period of months, but to make sure that people see, progressively, an improvement that is sustainable now and in the future.