Surgeon shortage: The number of plastic surgeons in Ireland must be doubled and services de-centralised to meet growing demand in the sector, a leading Irish plastic surgeon has warned.
Mr Michael Earley, the first Irish president of the British Association of Plastic Surgeons (BAPS) and consultant plastic surgeon at the Mater Hospital, told The Irish Times that demand for plastic surgery "far exceeds" what practitioners were able to provide and people were waiting longer or doing without.
Some 70 per cent of the workload of Irish plastic surgeons revolves around trauma, cancer and congenital deformities, according to Mr Earley, who said the "nip and tuck" phenomenon had "trivialised" plastic surgery.
The increase in demand had been prompted in part by a "major increase in skin cancer throughout the country", which he said was a "very real drain on services". There has also been a shift in public expectations, which means that people now "wish to have specialists doing specialised work". He said people wanted to be treated by a plastic surgeon if they had a facial injury, hand injury or were in need of tendon or nerve repair.
A big rise in tumour work has also happened because of the increased ability in reconstructing defects after either breast cancer or head and neck cancer. "If someone has their jaw removed, it can now be replaced. Women are no longer willing to just have a mastectomy, they want a breast reconstruction as well," he explained.
Pressures in the sector mean that people are waiting longer for treatment or making do without for as long as possible. The already "stretched" service would become all the more apparent with the new EU working time directive, he warned.
There are currently 17 plastic surgeons operating in units in Dublin (10), Cork (3) and Galway (4). Outreach clinics take place in Dundalk, Sligo, Tralee and Castlebar. A doubling of this figure as well as the development of units in other parts of the country was needed to meet service demands, he said.
Mr Earley said clinics and day surgery should be available in Drogheda, Sligo, Letterkenny, Tullamore and Limerick. These services should be set up on a hub and spoke basis, he said, with Cork, Galway and Dublin providing services as a main centre to the peripheral clinics and day care units. To do this, consultant numbers needed to be doubled, which would bring the number of plastic surgeons up to one per 100,000, a figure recommended by the Royal colleges, Mr Earley said. Such a system would "fit in really well" with the Hanly Report, he added.
The 2004 summer meeting of the British Association of Plastic Surgeons opens tomorrow in Dublin. This is the first time the meeting has taken place in Ireland.