‘Appalling’ shortage of skin specialists

CHILDREN and adults with embarrassing and irritating skin conditions that affect quality of life, interpersonal relationships and job prospects face substantial waits for treatment because of a shortage of specialists.

The problem is acute in the south-east where more than 3,000 adults are waiting up to three years for routine appointments with a consultant dermatologist and where the weekly paediatric dermatology clinic has a waiting list of six months.

Dr Colin Buckley, the only dermatologist in the public service for a region with a population of 460,000, said he was “blue in the face” from asking for a second dermatologist.

“All I get is the usual tripe from administration locally. They say they understand the need for more resources, but dermatology has never been a priority. It is not a serious emotive issue, it’s not about poor crippled grannies, it’s not headline grabbing,” said Dr Buckley.

What people failed to understand was the enormous impact on quality of life a skin condition can have, Dr Buckley said.

“The impact can be as severe as cancer, heart disease, diabetes. People will not take part in team sports, they won’t use the swimming pool, they’re too embarrassed to take their children to the beach.

“Those with scabs can suffer psychosexual problems, even with their spouse, there are huge body image problems,” said Dr Buckley.

In addition, Dr Buckley said a “considerable number” of people felt they were passed over for jobs because of skin conditions.

“For example they feel prospective employers don’t want them handling money in a retail setting. Subconsciously, interviewers can develop negative thoughts as a result of a skin condition,” Dr Buckley said.

Children with severe eczema and ache, which can scar, can end up with lifelong psychological problems if not treated in time.

Yet Dr Buckley said he was “effectively seeing urgent cases” only, such as skin cancer, and the service was “finger in the dyke stuff”.

Six years ago, a Comhairle na n-Ospideal report recommended one dermatologist per 100,000 population but there are only approximately 35 for the whole country. Dr Buckley said in addition to requiring an additional dermatologist in the south-east, they needed a new department, that the existing infrastructure is too small.

Labour TD for Waterford, Brian O’Shea, who raised the issue in a Dáil adjournment debate recently, said some GPs in the south-east were now referring patients to Cork, Limerick and Dublin but “these centres increasingly refuse to accept referrals from outside their regions which adds to the pressure on the inadequate provision in the south-east”.

He described the situation as “appalling”. He said no suitable locum dermatologist has been available in recent years to provide cover for the annual and study leave of Dr Buckley.

Fianna Fáil TD Billy Kelleher, who responded to Mr O’Shea on behalf of Health Minister Mary Harney, said posts in vascular surgery and orthopaedics had been given priority this year in the south-east. He also said decisions on the services of any hospital will not be taken before 2010.

Dermatology services in the mid-west are equally dire. The Health Service Executive recently confirmed a patient has been on a waiting list for eight years for an appointment with a consultant dermatologist.