Brian O'Shea (Waterford, Labour)

There are glaring deficiencies in the provision of dermatology Services in the south east. The appalling situation at present is that one consultant dermatologist is single-handedly providing a service for a population 460,000 people. Comhairle na nOspidéal having consulted the literature relating to dermatology service provision in the UK, North America and Australia published a report in November 2003 recommending that there should be one dermatologist per 100,000 population. The greater Dublin area has the lion's share of consultant dermatologists. The south east which has the largest population outside Dublin remains the only region with only one consultant dermatologist.

Clinics are provided in Waterford Regional Hospital, Wexford General Hospital, South Tipperary General Hospital and St. Luke's Hospital Kilkenny. There are more than 3,500 patients waiting two to three years for a routine hospital appointment in the south east. While it is likely that this list will be somewhat reduced if validated, there are long lists for routine problems and patients are suffering. There is a weekly paediatric dermatology clinic with a current waiting list of six months.

Some general practitioners on the periphery of the region refer their patients to Cork Limerick and Dublin. These centres increasingly refuse to accept referrals from outside their regions which adds to the pressure on the inadequate provision in the south east region. Ever increasing incidents of all forms of skin cancer take up a considerable amount of time at the Department. The Dermatology Department in Waterford is small and inadequate, with one consultant dermatologist, one specialist trainee registrar, a specialist nurse and two nurses, who job share. The Department removes approximately 700 cancers annually. The Department runs a pigmented liaison mole clinic for the early detection of melanoma and provides a mole mapping service.

There is also a multi-disciplinary head and neck skin cancer clinic run in conjunction with the local ophthalmic plastic surgeon and an eye and ear surgeon, all of which generate surgical activity. Waterford is one of the few centres in the 26 counties which provides photodynamic therapy, a non-invasive treatment of superficial skin cancers.

This all amounts to a work load that is way too much for one consultant dermatologist. Added to this is the fact that no suitable locum dermatologist has been available in recent years to provide cover for the annual and study leave of the consultant dermatologist in Waterford.

Skin disease impacts on quality of life, interpersonal relationships and even job prospects. For the past 12 years this situation in Waterford and the south east has been ignored. This appalling situation cannot be allowed to continue and requires immediate and decisive corrective action. I call on the Minister for Health and Children to take urgent action to ensure that there are additional dermatologists and back-up teams appointed forthwith to the south east region within the HSE south, with the appropriate required accommodation.

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