Skin conditions: Irish people with severe skin conditions, many of them children, routinely have to wait a year to see a medical specialist, according to new figures.
Dr Gillian Murphy, chairwoman of the Irish Association of Dermatologists and consultant dermatologist at the Mater and Beaumont hospitals, Dublin, told The Irish Times yesterday that it was "utterly unacceptable to have a person waiting for a year to see a skin specialist".
A recommendation by Comhairle na nOspidéal - which regulates consultant appointments - to increase the number of specialists in skin diseases was inadequate and would do little in the short term to help those suffering with chronic skin diseases, Dr Murphy has warned.
Based on population, the number of dermatologists employed in Irish health services is the lowest in Europe. It is believed that several thousand Irish people are waiting to be seen by a dermatologist.
Commenting on figures which show that people with severe eczema and psoriasis are routinely waiting for over a year to see a specialist for assessment and subsequent treatment, Dr Murphy said: "If you have nasty eczema or psoriasis, it can stop you working. Bad itching is worse than pain. Such is their level of distress, patients end up crying."
Dr Murphy said the problem was not only one of discomfort and emotional suffering but one that gave rise to financial problems, including a hidden economic cost to the State.
The Irish Association of Dermatologists (IAD), in a statement, said the current number of approved consultant dermatologist posts, at 19, is "grossly inadequate for a population of four million people". While welcoming Comhairle na nOspidéal's recommendation to increase consultant numbers to 38, it said that would still leave the State with a less that optimal service.
The statutory body's recommendation is based on having one dermatologist per 100,000 population. The IAD wants to see a ratio of one consultant per 85,000 people, in accordance with British guidelines.
The report of the Committee on Dermatology Services follows a formal review initiated by Comhairle in February, 2002. "At that time, dermatology services were acknowledged to be underdeveloped nationally and two health boards - the Midland Health Board and the North Western Health Board - were without a locally-based permanent consultant dermatologist," it notes.
Future development of dermatology services requires collaboration between primary and secondary care, according to the report's recommendations.
It also says there must be regional self-sufficiency in dermatology services. "Each region should have its own regional dermatology centre based in a major regional general hospital where the full range of clinical and laboratory services are provided." The report adds that each dermatology centre should be staffed by a minimum of two consultants.
However, Dr Murphy described the infrastructure of dermatology services as inadequate. She said that even in so-called centres of excellence, such as the Mater and Beaumont, "dermatology clinics are divided into lots of areas. Dermatology nurses even have to borrow rooms from other staff".
"We strongly urge the Department of Health to ringfence dermatology financing so as to enable our hitherto neglected dermatology services to be brought to an acceptable level," she said.