Paudie Coffey (Waterford, Fine Gael)
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As a Waterford Deputy, I also have serious concerns about the cessation of dermatology services at UHW. In the past year, concerns were raised in the south east when the reorganisation of hospital groups was proposed. We received assurances from the Minister for Health and departmental officials that essential services would not be downgraded, which was welcomed. The Minister visited the hospital only recently.

However, the issue Deputy Conway has rightly raised relates to the future of dermatology services at UHW. I fully support what she said. Dermatology is a key health service for people suffering with serious skin problems, including melanoma. Regular monitoring of these lesions is essential for successful patient outcomes. UHW has three consultant dermatologist posts. One consultant has retired, one has gone on maternity leave and, in correspondence I have had with the HSE, it says it has consistently advertised for a third consultant without success. This has resulted in patients from the south east being referred to South Infirmary Victoria University Hospital Cork, SIVUH, increasing the burden on the dermatology unit there. This is not good enough. It behoves us as public representatives to voice serious concerns on behalf of the people of Waterford and the south east. These need to be addressed without delay.

I am not sure what the HSE and the Department can do because if they are advertising and no applicant is successful, we have a serious problem. One applicant was successful but when the contracts were drawn up, the applicant pulled out and we were left with no consultant in the region.

General practitioners have raised concerns regarding a backlog of communications between them and the dermatological unit in UHW. The HSE has addressed this by providing additional resources. However, this is a cry for help by two Waterford Deputies. The issue has been ongoing for a number of months. There has been continual correspondence between us and the HSE. It is with reluctance that we have brought our concerns to the House but we are seeking the direct intervention of the Minister of State and the help of the Department of Health to ensure these important positions are filled as soon as possible.

Alex White (Dublin South, Labour)
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I thank the Deputies for raising the issue and for affording me the opportunity to advise the House of the arrangements made for patients requiring dermatological services at UHW.

I assure the House that the HSE and the South-South West Hospitals Group are committed to ensuring the continuation of dermatology services for people in the south east, notwithstanding the temporary staffing and recruitment difficulties being experienced in UHW. I understand every effort is being made to fill the three vacant consultant dermatologist posts, two of which arose recently, one due to a retirement and the other because of maternity leave. Efforts are continuing to recruit temporary replacements until the posts are filled on a permanent basis. In the interim, UHW has put in place an arrangement with the dermatology service at South Infirmary Victoria University Hospital, SIVUH, in Cork. Arrangements for urgent referrals for a dermatology service, for example, melanomas or suspicious pigmented lesions and patients requiring emergency dermatology review, should be referred to the dermatology department at SIVUH or to the nearest dermatology unit, as appropriate. Patients with an established diagnosis of melanoma will be followed up at a designated clinic in the dermatology department, SIVUH. In addition, complex dermatological cases such as those receiving biologic agents for psoriasis will be followed up at a designated clinic in the dermatology department, SIVUH.

I understand UHW will ensure ongoing and close linkages between its dermatology department and that of SIVUH through the making of arrangements for the clinical nurse specialist from UHW's dermatology service to attend the Cork-based clinics. In addition to the SIVUH arrangement, the hospital is also endeavouring to make arrangements with other hospitals in the surrounding regions to take some of the patients. All these arrangements will be kept under review and GPs and patients-clients will be updated accordingly.

I share the hospital's regret and that of the Deputies that, in the current circumstances, dermatological services have been curtailed. It is important, however, to acknowledge that the HSE has the capacity to recruit consultants and other front-line staff where there is an established service need, notwithstanding the requirement to reduce the numbers employed across the health service to meet fiscal and budgetary targets. In light of the difficulties experienced by some hospitals in filling certain consultant posts, the Minister for Health established a working group, chaired by Professor Brian MacCraith, to carry out a strategic review of medical training and career structure. The review is aimed at improving graduate retention in the public health system and planning for future service needs. To date, the working group has issued two reports. The first report submitted in December focused on improving the training experience for trainees. The second report submitted at the end of April reviewed career structures and pathways following completion of specialist training. The final report, which will deal with workforce planning, is due to be submitted by the end of this month.

I again thank the Deputies for the opportunity to discuss this pressing matter and I assure them and the House that the HSE is making every effort to secure the services of permanent consultants. While the closing date for applications for the third vacant post is tomorrow, 26 June, I understand the HSE hopes it may recruit two consultants under this process. In the interim, every effort will be made to continue to provide urgent services to patients.

Paudie Coffey (Waterford, Fine Gael)
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The HSE knew full well for some time that one consultant was due to retire, with the other to go on maternity leave, while the third post was advertised. I appeal to the Minister of State to use his good offices and officials to ensure the HSEwill do all in its power to ensure the consultant posts are filled as soon as possible. The irony is that the dermatology unit in University Hospital Waterford was physically upgraded. The physical infrastructure is in place and we need the specialised staff which the people of Waterford and the south east deserve. We were assured of this in the House and correspondence when the new hospital groupings were established. Although we were informed that when specialist services were required in University Hospital Waterford, they would be delivered, it is not the case. While the HSE has stated it is a temporary problem, a temporary problem can lead to a very serious one for many patients who do not have access to these essential services. I want the Minister of State to take on board what Government Deputies are saying and ensure the problem is addressed as soon as possible.

Alex White (Dublin South, Labour)
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I very much take on board what Deputies Paudie Coffey and Ciara Conway have said about this matter and the urgency attached to it. The closing date in respect of the third vacant post is tomorrow and the HSE hopes to recruit two consultants under this process. The matter is being addressed as urgently as is required and I accept what the Deputies said. On the future of dermatology services in Waterford, Deputy Paudie Coffey's statement on the physical infrastructure in the dermatology unit in University Hospital Waterford demonstrates the intention on the part of the HSE, the Government and the Minister to maintain these critical services in Waterford. There is no question about the intention to maintain these important and necessary services in Waterford. This is a temporary difficulty in the recruitment of consultants. As I indicated, there are issues about workforce planning, to which Professor MacCraith's report is relevant. I very much hope the recruitment process can be expedited and fully accept and share the Deputies' views.