Dermatology service in 'utter collapse' with 4,000 on waiting list in NW

Healthcare professionals including GPs and consultants have described dermatology services in Donegal as ‘in crisis’ and ‘in utter collapse.’

Amidst grave concerns expressed about the shortfall in dermatology services in the north west, Saolta has stressed that recruitment is underway. However, no indication has been given as to when posts are expected to be filled - or why steps were not taken to appointment a consultant in anticipation of an expected retirement. 

One Donegal GP said the retirement of Dr Patricia Podmore from dermatology services in Letterkenny University Hospital (LUH) as ‘another tale of appalling shortfall in management of retirement.’

In a strongly worded letter seen by the Donegal Post, Dr Dermot McKenna MD MRCPI DCH Consultant Dermatologist at Sligo University Hospital informed GPs that his service was already under immense stress. And he did hold back in his criticism of Saolta, the organisation which manages a number of hospitals including LUH and SUH, and the impact their actions would have on patients. 

“Delayed diagnosis impacting melanoma survival, acne teenagers scarred, eczema/psoriasis patients' lives destroyed because of an inability to gain access to care rests on management's shoulders,” he said. 

“Donegal patients already make treatment decisions based on distance to travel.”

The consultant drew attention to a past potential appointment that was never completed despite funding being available, and that Galway University Hospital was allowed to withdraw dermatology service from Roscommon and Ballina, a decision which inevitably had an adverse impact on the service in the north west.

He continued: “I have less nursing hours now than when I started 20 years ago, I have lost half my secretarial office space, I can't get adequate secretarial support and I had no secretary in Sligo for an entire month last October. 

“I can't even get an examination light installed to properly examine patients after two years of trying. All this in the context of being single handed with thousands of patients awaiting their first appointment, a wait time of over four years, 4,000 patients. Only urgent cases are coming off that list. 

“This has made recruitment into the region very difficult.”

Dr McKenna said it was simply not possible for him to absorb Dr Podmore’s patients.

He expressed grave concern in particular for patients who required skin cancer follow up treatment, patients on specific drug treatments that required monitoring, and those who needed prescriptions that could only be written by a consultant.

Saolta has responded to the Donegal Post’s query, saying: “The model for Dermatology care in the north west has always been a service based from Sligo University Hospital and this remains the case.

“Historically this service was supplemented by a consultant from Northern Ireland who ran a weekly clinic in Letterkenny, funded by LUH. Regrettably this consultant is no longer in a position to continue running this weekly clinic. 

“However, the consultant has agreed to continue a monthly clinic to provide clinical care for existing patients who are currently on treatment regimes or in surveillance programmes that require on-going monitoring.”

Regarding recruitment, the Saolta spokesperson said: “Saolta has secured funding for two new consultant dermatology posts for the north west and LUH management have identified a requirement that the appointment of these posts would deliver two clinics per week in Letterkenny.

“Recruitment for these posts is currently underway.”

One of the south Donegal GPs who raised concerns about what they describe as the ‘utter collapse’ of the service said: “Dermatology services are already grossly inadequate. Dr Podmore’s retirement has not come as a surprise. Saolta could have and should have ensured that a replacement would be in place when she stepped back from her Letterkenny clinics. 

“We are constantly telling people to put on sunscreen, to cover up in the sun, to get any changes to their skin checked out. And yet, when people come to us with concerns, we are sending them through a system where consultants are doing their very best but are simply swamped by the numbers of patients on their lists. 

“Have no doubt, we are talking about the difference between life and death here.”