Orthodontic Treatment (Hansard, 18 June 2002)

§ Dr. Fox
To ask the Secretary of State for Health if he(a) collates and (b) will publish details of waiting times for NHS orthodontic treatment. [61450]

§ Mr. Lammy
Information on waiting times for orthodontic treatment carried out in primary care, which accounts for the majority of orthodontic services, is not held centrally. However, information is available for patients who have been referred to hospital for treatment. Latest data show that at quarter ending 31 March 2002 there were 2,716 out-patients who had been waiting over 13 weeks for a first out-patient appointment with an orthodontic consultant and there were 130 in-patients waiting for orthodontic treatment.

Table 1: Waiting time for first out-patient appointment, Orthodontics consultant specialty, England

Of those GP written referrals seen, the number who waited (weeks) Of those GP written referrals seen, the percentage who waited (weeks) GP written referrals still waiting, who have been waiting (weeks)

Quarter ended Number of GP written referral requests seen 0 to less 4 4 to less 13 13 to less 26 26 plus less than 4 (per cent.) less than 13 (per cent.) less than 26 (per cent.) 13 to less than 26 26 plus

March 1996 24,965 4,805 9,598 6,173 4,389 19 58 82 3,978 3,524

March 1997 20,690 3,681 8,936 4,974 3,099 18 61 85 4,442 3,380

March 1998 19,236 2,784 7,838 5,911 2,703 14 55 86 5,170 5,258

March 1999 19,438 2,418 7,464 5,595 3,961 12 51 80 6 524 5,074

March 2000 23,175 3,036 7,971 7,009 5,159 13 47 78 5,225 4,614

March 2001 21,237 2,955 9,339 5,184 3,759 14 58 82 3,996 2,982

March 2002 21,176 3,484 8,980 5,597 3,115 16 59 85 2,713 3

Source:
Department of Health form QM08

Table 2: Patients waiting for elective admission, Orthodontics consultant speciality, England (ordinary and day case admissions combined)

Total patients waiting for admission by month waiting

Quarter ended Waiting Less than 3 3–5 6–8 9–11 12–14 15–17 18 plus

March 1996 257 136 63 34 24 0 0 0

March 1997 253 119 91 28 15 0 0 0

March 1998 304 149 77 50 25 3 0 0

March 1999 184 74 61 29 16 3 1 0

March 2000 84 31 27 17 6 3 0 0

March 2001 170 77 50 26 14 3 0 0

March 2002 130 50 49 18 13 0 0 0

Source:
Department of Health form KHO7

§ Dr. Evan Harris
To ask the Secretary of State for Health what guidance his Department gives on which orthodontic treatments should be made available on the NHS. [60720]

§ Mr. Lammy
Details of all orthodontic treatment that can be made available through general dental services are included in the statement of dental remuneration (SDR), which is issued to all dental practitioners and health authorities annually, in April. The Department does not give specific advice on what treatment a dentist or orthodontist should provide for patients, as this is a matter for the individuals' clinical judgment. However, the range of treatments available in the SDR was introduced in consultatio with the profession and is considered
258W
The intention to reform orthodontic treatment was signalled in the NHS dental strategy "Modernising NHS Dentistry—Implementing the NHS Plan" published in September 2000. The Department continues to work with the profession to see how reform might be achieved.

§ Dr. Evan Harris
To ask the Secretary of State for Health how many people were waiting for orthodontic treatment on 1 May in each year since 1996. [60722]

§ Mr. Lammy
Information on waiting times for orthodontic treatment carried out in primary care, which accounts for the majority of orthodontic services, is not held centrally. However, information is available for patients who have been referred to hospital for treatment. The tables show orthodontic treatment waiting times for in-patients and out-patients in hospitals.
The intention to reform orthodontic treatment was signalled in the NHS dental strategy "Modernising NHS Dentistry—Implementing the NHS Plan" published in September 2000. The Department continues to work with the profession to see how reform might be achieved.
adequate to ensure the best treatment outcome for all patients.
Over recent months officials have had helpful discussions with the profession on possible changes to the current system and the Department will continue to work with the profession on this.

§ Dr. Evan Harris
To ask the Secretary of State for Health how many people per 1,000 of the population were provided with orthodontic treatment in each year since 1996, broken down by health authority. [60721]

§ Mr. Lammy
The available information is shown in the table and quantifies the number of claims made for the 259W provision of orthodontic appliances in the general dental service (GDS) per 1,000 population by health authority (HA) in England for each year from 1996–97 to 2001–02.

General dental service: number of claims for orthodontic appliances per 1,000 population¹, 1996–97 to 2001–02

England

Health authority 1996–97 1997–98 1998–99 1999–2000 2000–01 2001–02

Avon 4.9 5.1 5.6 6.5 6.5 8.3

Barking and Havering 5.6 7.6 6.2 7.4 7.6 7.2

Barnet, Enfield and Haringey 8.0 9.2 8.2 8.2 9.5 9.6

Barnsley 2.2 1.9 2.1 2.0 2.1 1.4

Bedfordshire 5.0 5.7 5.7 3.6 1.9 1.7

Berkshire 7.3 8.1 7.4 5.6 5.8 6.7

Bexley, Bromley and Greenwich 6.0 6.1 6.8 7.2 7.7 7.5

Birmingham 4.4 4.6 4.6 4.7 5.0 4.8

Bradford 2.0 1.9 1.9 2.1 1.8 1.9

Brent and Harrow 9.3 4.3 3.1 3.1 3.3 3.8

Buckinghamshire 3.8 4.4 5.5 4.8 4.2 4.3

Bury and Rochdale 5.5 5.8 6.5 5.3 5.9 6.0

Calderdale and Kirklees 3.3 3.5 3.8 3.6 4.0 4.3

Cambridge and Huntingdon² 6.8 5.7 4.9 — — —

Cambridge² — — — 4.4 4.1 5.4

Camden and Islington 1.1 1.5 1.9 1.9 2.4 2.6

Cornwall and Isles of Scilly 2.6 2.9 3.0 3.5 3.5 3.3

County Durham 2.5 2.2 2.3 2.5 2.3 2.6

Coventry 2.5 2.7 2.8 3.0 3.1 3.3

Croydon 6.5 6.9 6.9 6.6 6.7 6.4

Doncaster 4.3 4.4 5.0 5.2 5.7 6.1

Dorset 4.3 3.9 3.9 3.9 4.0 3.6

Dudley 2.6 3.1 3.4 3.7 3.7 3.8

Ealing, Hammersmith and Hounslow 1.8 2.1 2.6 3.2 3.8 4.0

East Kent 4.2 3.0 3.4 3.7 3.6 4.0

East Lancashire 4.3 3.6 3.7 3.6 3.3 3.3

East London and The City 2.8 3.0 3.1 3.5 4.8 4.2

East Norfolk² 6.0 5.8 5.7 — — —

East Riding 2.4 2.5 2.7 3.1 3.1 3.0

East Surrey 4.2 4.6 5.2 4.8 5.5 6.1

East Sussex, Brighton and Hove 3.8 4.7 4.6 4.5 4.0 4.0

Gateshead and South Tyneside 1.8 1.6 1.9 2.0 1.9 1.7

Gloucestershire 4.5 4.8 5.8 6.5 6.4 5.9

Herefordshire 2.9 2.8 2.8 3.3 4.5 4.7

Hertfordshire 6.5 6.7 6.6 6.4 7.9 8.9

Hillingdon 8.0 7.0 8.4 8.3 7.5 6.2

Isle of Wight, Portsmouth and South East Hampshire 3.9 3.4 3.5 3.1 2.5 1.8

Kensington, Chelsea and Westminster 0.7 2.9 4.6 4.7 5.6 6.8

Kingston and Richmond 4.7 6.3 4.6 5.8 7.9 7.2

Lambeth, Southwark and Lewisham 1.0 2.1 2.9 4.2 3.8 3.1

Leeds 4.8 5.1 5.9 5.8 6.0 6.6

Leicestershire 3.3 3.8 3.7 3.7 3.7 4.8

Lincolnshire 2.0 2.4 2.7 2.3 2.5 2.6

Liverpool 7.0 7.0 7.2 6.6 6.5 5.5

Manchester 3.1 2.9 3.1 2.6 2.8 2.7

Merton, Sutton and Wandsworth 4.5 4.1 2.8 2.7 3.3 4.5

Morecambe Bay 3.2 3.5 3.6 3.7 3.4 3.4

Newcastle and North Tyneside 3.5 4.4 3.8 4.5 3.8 4.2

Norfolk² — — — 4.7 4.7 4.7

North and East Devon 4.5 4.6 5.0 4.6 5.1 6.4

North and Mid Hampshire 2.2 2.2 2.6 2.5 3.1 3.6

North Cheshire 6.3 5.7 6.7 7.3 7.1 7.1

North Cumbria 3.0 2.5 2.6 2.3 2.6 2.3

North Derbyshire 4.5 4.8 4.6 4.3 4.5 4.3

North Essex 6.6 5.9 6.2 5.8 5.2 5.3

North Nottinghamshire 5.8 5.8 6.6 5.9 6.0 5.9

North Staffordshire 3.4 3.3 3.2 2.9 3.1 2.8

North West Anglia² 3.8 4.0 4.8 — — —

North West Lancashire 5.7 7.4 8.9 9.6 8.9 8.8

North Yorkshire 4.4 4.3 4.6 4.5 4.2 4.4

Northamptonshire 3.6 3.8 3.8 4.4 4.3 4.8

Northumberland 2.3 2.1 2.0 1.8 1.6 1.6

Nottingham 6.3 6.9 6.4 6.8 5.7 7.4

Oxfordshire 3.8 4.0 4.1 4.9 4.9 5.6

Redbridge and Waltham Forest 7.9 6.3 7.6 7.4 7.8 8.1

Rotherham 3.5 3.6 3.6 3.2 2.8 2.7

Salford and Trafford 5.3 5.4 7.0 8.4 8.0 8.4

Sandwell 0.7 1.1 2.2 2.3 2.8 4.2

Sefton 2.5 2.2 2.4 1.5 1.4 1.0

Sheffield 5.8 5.0 4.6 4.4 4.8 5.2

Shropshire 3.1 3.1 2.9 3.1 5.6 4.3

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The figures for HAs will be af ected by some patients receiving treatment in a different HA area from one in which they reside.
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General dental service: number of claims for orthodontic appliances per 1,000 population¹, 1996–97 to 2001–02

England

Health authority 1996–97 1997–98 1998–99 1999–2000 2000–01 2001–02

Solihull 4.0 4.5 4.5 4.0 5.7 7.1

Somerset 3.5 3.2 3.4 3.6 4.4 4.6

South and West Devon 4.8 4.6 4.9 4.2 4.3 4.7

South Cheshire 9.0 9.8 11.0 11.1 11.0 10.6

South Derbyshire 2.7 3.0 2.9 3.0 3.4 3.7

South Essex 4.7 3.9 2.9 2.4 3.4 3.4

South Humber 2.5 2.7 2.8 2.3 2.5 2.3

South Lancashire 3.3 3.9 3.5 5.1 6.2 6.1

South Staffordshire 3.0 2.8 2.8 2.7 2.6 2.7

Southampton and South West Hampshire 4.4 4.0 4.0 4.5 4.2 4.6

St. Helens and Knowsley 2.6 3.2 3.0 2.2 2.4 1.7

Stockport 6.5 6.5 6.3 5.2 5.7 5.4

Suffolk 4.9 5.0 5.4 4.9 5.4 5.7

Sunderland 2.8 3.0 3.3 3.2 2.9 3.4

Tees 3.1 3.0 3.6 3.8 3.9 4.4

Wakefield 3.0 2.3 1.9 2.0 3.0 4.9

Walsall 2.2 2.2 2.0 2.2 2.7 2.7

Warwickshire 2.1 2.1 2.4 2.9 3.2 3 4

West Kent 3.9 4.8 5.9 5.8 8.5 8.9

West Pennine 6.3 7.0 5.7 6.2 7.4 4.5

West Surrey 7.9 8.4 8.8 8.3 8.8 8.6

West Sussex 6.4 7.3 7.9 7.9 7.9 8.0

Wigan and Bolton 5.9 6.5 6.3 5.5 5.9 5.7

Wiltshire 4.3 4.8 4.3 4.8 5.4 4.5

Wirral 5.2 6.0 6.7 7.1 9.0 9.7

Wolverhampton 1.8 2.2 2.7 2.8 3.2 3.7

Worcestershire 6.6 5.8 6.3 5.8 5.7 7.4

England 4.4 4.6 4.7 4.7 4.9 5.1

¹ ONS 1996–2000 mid year population estimates based on the 1991 census are used to calculate the number of orthodontic claims per 1,000 population.

² In April 1999 Cambridge and Huntingdon, East Norfolk and North West Anglia were replaced by Cambridge and North Norfolk health authorities.

Table 1: Waiting time for first out-patient appointment, Orthodontics consultant specialty, England
		Of those GP written referrals seen, the number who waited (weeks)	Of those GP written referrals seen, the percentage who waited (weeks)	GP written referrals still waiting, who have been waiting (weeks)
Quarter ended	Number of GP written referral requests seen	0 to less 4	4 to less 13	13 to less 26	26 plus	less than 4 (per cent.)	less than 13 (per cent.)	less than 26 (per cent.)	13 to less than 26	26 plus
March 1996	24,965	4,805	9,598	6,173	4,389	19	58	82	3,978	3,524
March 1997	20,690	3,681	8,936	4,974	3,099	18	61	85	4,442	3,380
March 1998	19,236	2,784	7,838	5,911	2,703	14	55	86	5,170	5,258
March 1999	19,438	2,418	7,464	5,595	3,961	12	51	80	6 524	5,074
March 2000	23,175	3,036	7,971	7,009	5,159	13	47	78	5,225	4,614
March 2001	21,237	2,955	9,339	5,184	3,759	14	58	82	3,996	2,982
March 2002	21,176	3,484	8,980	5,597	3,115	16	59	85	2,713	3

Table 2: Patients waiting for elective admission, Orthodontics consultant speciality, England (ordinary and day case admissions combined)
	Total patients waiting for admission by month waiting
Quarter ended	Waiting	Less than 3	3–5	6–8	9–11	12–14	15–17	18 plus
March 1996	257	136	63	34	24	0	0	0
March 1997	253	119	91	28	15	0	0	0
March 1998	304	149	77	50	25	3	0	0
March 1999	184	74	61	29	16	3	1	0
March 2000	84	31	27	17	6	3	0	0
March 2001	170	77	50	26	14	3	0	0
March 2002	130	50	49	18	13	0	0	0

General dental service: number of claims for orthodontic appliances per 1,000 population¹, 1996–97 to 2001–02
England
Health authority	1996–97	1997–98	1998–99	1999–2000	2000–01	2001–02
Avon	4.9	5.1	5.6	6.5	6.5	8.3
Barking and Havering	5.6	7.6	6.2	7.4	7.6	7.2
Barnet, Enfield and Haringey	8.0	9.2	8.2	8.2	9.5	9.6
Barnsley	2.2	1.9	2.1	2.0	2.1	1.4
Bedfordshire	5.0	5.7	5.7	3.6	1.9	1.7
Berkshire	7.3	8.1	7.4	5.6	5.8	6.7
Bexley, Bromley and Greenwich	6.0	6.1	6.8	7.2	7.7	7.5
Birmingham	4.4	4.6	4.6	4.7	5.0	4.8
Bradford	2.0	1.9	1.9	2.1	1.8	1.9
Brent and Harrow	9.3	4.3	3.1	3.1	3.3	3.8
Buckinghamshire	3.8	4.4	5.5	4.8	4.2	4.3
Bury and Rochdale	5.5	5.8	6.5	5.3	5.9	6.0
Calderdale and Kirklees	3.3	3.5	3.8	3.6	4.0	4.3
Cambridge and Huntingdon²	6.8	5.7	4.9	—	—	—
Cambridge²	—	—	—	4.4	4.1	5.4
Camden and Islington	1.1	1.5	1.9	1.9	2.4	2.6
Cornwall and Isles of Scilly	2.6	2.9	3.0	3.5	3.5	3.3
County Durham	2.5	2.2	2.3	2.5	2.3	2.6
Coventry	2.5	2.7	2.8	3.0	3.1	3.3
Croydon	6.5	6.9	6.9	6.6	6.7	6.4
Doncaster	4.3	4.4	5.0	5.2	5.7	6.1
Dorset	4.3	3.9	3.9	3.9	4.0	3.6
Dudley	2.6	3.1	3.4	3.7	3.7	3.8
Ealing, Hammersmith and Hounslow	1.8	2.1	2.6	3.2	3.8	4.0
East Kent	4.2	3.0	3.4	3.7	3.6	4.0
East Lancashire	4.3	3.6	3.7	3.6	3.3	3.3
East London and The City	2.8	3.0	3.1	3.5	4.8	4.2
East Norfolk²	6.0	5.8	5.7	—	—	—
East Riding	2.4	2.5	2.7	3.1	3.1	3.0
East Surrey	4.2	4.6	5.2	4.8	5.5	6.1
East Sussex, Brighton and Hove	3.8	4.7	4.6	4.5	4.0	4.0
Gateshead and South Tyneside	1.8	1.6	1.9	2.0	1.9	1.7
Gloucestershire	4.5	4.8	5.8	6.5	6.4	5.9
Herefordshire	2.9	2.8	2.8	3.3	4.5	4.7
Hertfordshire	6.5	6.7	6.6	6.4	7.9	8.9
Hillingdon	8.0	7.0	8.4	8.3	7.5	6.2
Isle of Wight, Portsmouth and South East Hampshire	3.9	3.4	3.5	3.1	2.5	1.8
Kensington, Chelsea and Westminster	0.7	2.9	4.6	4.7	5.6	6.8
Kingston and Richmond	4.7	6.3	4.6	5.8	7.9	7.2
Lambeth, Southwark and Lewisham	1.0	2.1	2.9	4.2	3.8	3.1
Leeds	4.8	5.1	5.9	5.8	6.0	6.6
Leicestershire	3.3	3.8	3.7	3.7	3.7	4.8
Lincolnshire	2.0	2.4	2.7	2.3	2.5	2.6
Liverpool	7.0	7.0	7.2	6.6	6.5	5.5
Manchester	3.1	2.9	3.1	2.6	2.8	2.7
Merton, Sutton and Wandsworth	4.5	4.1	2.8	2.7	3.3	4.5
Morecambe Bay	3.2	3.5	3.6	3.7	3.4	3.4
Newcastle and North Tyneside	3.5	4.4	3.8	4.5	3.8	4.2
Norfolk²	—	—	—	4.7	4.7	4.7
North and East Devon	4.5	4.6	5.0	4.6	5.1	6.4
North and Mid Hampshire	2.2	2.2	2.6	2.5	3.1	3.6
North Cheshire	6.3	5.7	6.7	7.3	7.1	7.1
North Cumbria	3.0	2.5	2.6	2.3	2.6	2.3
North Derbyshire	4.5	4.8	4.6	4.3	4.5	4.3
North Essex	6.6	5.9	6.2	5.8	5.2	5.3
North Nottinghamshire	5.8	5.8	6.6	5.9	6.0	5.9
North Staffordshire	3.4	3.3	3.2	2.9	3.1	2.8
North West Anglia²	3.8	4.0	4.8	—	—	—
North West Lancashire	5.7	7.4	8.9	9.6	8.9	8.8
North Yorkshire	4.4	4.3	4.6	4.5	4.2	4.4
Northamptonshire	3.6	3.8	3.8	4.4	4.3	4.8
Northumberland	2.3	2.1	2.0	1.8	1.6	1.6
Nottingham	6.3	6.9	6.4	6.8	5.7	7.4
Oxfordshire	3.8	4.0	4.1	4.9	4.9	5.6
Redbridge and Waltham Forest	7.9	6.3	7.6	7.4	7.8	8.1
Rotherham	3.5	3.6	3.6	3.2	2.8	2.7
Salford and Trafford	5.3	5.4	7.0	8.4	8.0	8.4
Sandwell	0.7	1.1	2.2	2.3	2.8	4.2
Sefton	2.5	2.2	2.4	1.5	1.4	1.0
Sheffield	5.8	5.0	4.6	4.4	4.8	5.2
Shropshire	3.1	3.1	2.9	3.1	5.6	4.3