A tribunal of inquiry is needed to investigate very serious allegations about the running of the public orthodontic service, a member of a HSE-appointed review group has said.
Dr Ian O'Dowling said a completely independent person was needed to examine why thousands of children are waiting for treatment or being denied treatment when dental schools in Cork and Dublin have a monopoly on the training of orthodontists but are currently only training four people.
The dental school in Dublin is currently not training any orthodontists.
Dr O'Dowling leads the orthodontics service in the HSE South region. He said a report of the Oireachtas Joint Committee on Health and Children last year suggested that 50 new orthodontists were needed.
He also alleged that money was being wasted because of the way the service is being managed in his own area in Cork and Kerry.
The report of the review group, of which Dr O'Dowling was a member, is due to be published shortly. He says he saw a final draft of the group's report at its sixth and final meeting on November 17th.
Dr O'Dowling, who has issued a minority report because he said he could not endorse the review's findings, said he believed a recommendation to examine training options, other than those involving the Dublin and Cork dental schools, would never materialise.
One of these options stems from an offer from Bristol Dental School in England.
"I believe the dental schools will try to hinder any opportunity to develop a training programme outside of their control," said Dr O'Dowling.
"So we are going around and around in circles and what we need is somebody to look at all of this independently because restricting training to the dental schools is counterproductive - it is about control and about power, and nothing will change unless somebody completely independent of dentistry looks at it."
Dr O'Dowling said there were between 3,500 and 4,000 children waiting for treatment in the Cork and Kerry area.
Until October eight dentists were working under him. Two left to train as orthodontists and Dr O'Dowling asked that two more dentists be appointed. He intended to give them training in orthodontics as he had done years previously with the two departing dentists.
However, he was told last week that the HSE would not appoint new dentists but would advertise for two specialist orthodontists. This is likely to take a long time and the HSE has now decided that some 1,000 children, the former patients of the two dentists, are to be treated by private orthodontists.
"This is going to cost the HSE an absolute fortune and is an example of the short-sightedness of management. Instead of taking on two people on dentists' salaries that would have allowed us to continue providing the service, they are going to pay five times that amount to private orthodontists," he said.
In his minority report, he also outlines a number of other reasons why a tribunal needs to be established.
He says there is a need to examine allegations that children were damaged when a consultant treating them was suspended from her job; to investigate what he alleges is "a campaign of harassment" against certain personnel, and why certain health boards have been allowed to refuse treatment to patients who he claims are legally entitled to that treatment.
The 2005 joint Oireachtas committee report recommended that children classified as category C, who have been told in certain regions that they are not entitled to treatment, should be put back on waiting lists.
The chairman of the HSE-appointed review of orthodontic services, Hugh Kane, was not available for comment yesterday.
A HSE spokeswoman said: "The issue of orthodontic training is addressed fully in the review. Recommendations will be made around this issue. However, given that the review has not yet been completed, the HSE is not in a position to make any direct comments at present." She said the allegation that children had been damaged "was never part of the remit of the review".