BUDGET CUTS IMPACTING OPERATION OF ORAL HEALTH CLINIC (via @TodayInBermuda)

11 Aug

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In response to queries about Government dental services the Ministry of Health, Seniors and Environment would like to clarify the status of this provision.

The Oral Health section of the Department of Health provides dental health services for school aged children, special patients, prisoners and seniors. The   Oral Health Section   delivers   both clinical   services   and   school-based   prevention   services.

The current fiscal space has imposed restrictions on hiring which limit the Department’s capacity to meet all demands in the timely manner it would prefer. We are conscious of the impact on patients and every individual at the front line and behind the scenes is working tirelessly to remedy the situation within the constraints of the existing economic environment.

The Department of Health is actively seeking a locum and anticipates to have one full time locum and one part-time. The Department is restricted in its ability to fill all the positions but has worked tirelessly to meet patients’ needs with limited resources. In the interim, urgent cases will take priority.

Ten days ago Government dentists stopped accepting new patients but there was a waiting list before due to high demand. The difference at this point is that no one is being moved from the waiting list to the active list unless their needs are urgent. The reason for this shift is so that two dentists who are leaving can finish up the work on the current active cases. This is absolutely necessary since there is no guarantee that immediate replacements will be available to take over the work.

Over 8,000 people use the Government dental service. However, the active utilization by these people varies from year to year. In 2014 there were 4,434 visits to the dental clinics and 2,358 screenings (not including health fairs).

For the last seven years, since we have added seniors to our service, periodically there have been waiting lists. The number of people on the waiting list fluctuates according to the ability of the service to accommodate them. However, at last count, there were 504 patients in all. The majority of these were children. 37 were special patients and 87 were seniors. The service has been taking patients off the waiting list to see the new dentist, where possible.

There are people who come to the clinic but are ineligible for the service. However, for some time, of those who are eligible we have been encouraging some to go to private practice when they have insurance coverage. The Hamilton Health Care Clinic does not have access to any kind of financial assessment.

Avoiding gaps between employment of all clinical staff has been the continuous goal, but the reality of hiring freezes, due process involved in recruitment and approvals, and the career choices of incumbents, means gaps are sometimes unavoidable. This is compounded when overseas recruitment is required which prolongs the process further.

Three contract officers who served us well for many years are moving on in their careers.  The Dental Officer posts have been approved for recruitment to enable the Department to meet patient need. However the recruitment of the three vacant Dental Officer posts takes time and could take up to one year. In the interim, service provision has had to be adjusted to be met by existing capacity.

At the time the hiring freeze was put in place, the Ministry acknowledged that some services would have to be prioritized and undertook to make the case for those services deemed essential. The Dental Officer positions are now approved for recruitment. Every effort has been made to meet the most pressing patient needs with limited resources, and we believe the public can appreciate Bermuda’s economic reality and the impact of the fiscal space on service provision. With respect to the dental services, the Ministry is seeking to put in place a service complement within the reality of recruitment and approval processes.

The advice the Department gives to parents wanting to use Government dental services is that urgent and emergency cases will be accepted and dental advice will be provided. When the parent calls they should be able to provide as much information as possible about the problems that are occurring.

The waiting period for routine oral health services could be as long as six to eight months. In patients’ best interests, where the family has insurance it is advisable to seek services through a private practice rather than the Government clinic at this time. This would alleviate pressure on stretched services. The public is reminded that from September 1, 2015, parents on HIP will be able to put their children on HIP at a lower premium designed for dependents.

Priority is being given to eligible patients who, upon triage, are determined as requiring urgent or emergency care.  If an emergency should arise notify the dental clinic or contact a private practitioner. Meanwhile, diligently follow proper oral hygiene practices to avoid oral health problems, brush twice daily for 2 minutes each time, floss daily from the age of four onward and use a tongue scraper.

The Department wishes to thank clients for their understanding and patience as the Department endeavours to work through these challenges with the minimum disruption in services.

Source: http://www.todayinbermuda.com/news/health/item/2151-budget-cuts-impacting-operation-of-oral-health-clinic

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