I thank the Minister for being here. This is a success story that the Minister will be glad to hear about. The question is how we are going to support and expand the service that exists at Roscommon University Hospital. The reconfiguration of the hospital, which caused huge controversy at the time, has turned out to be a great success, with many innovative departments and many new services for people, especially the elderly, being developed. In the past 15 years, a plastic surgery unit that uses a see-and-treat model has been developed under Dr. Deirdre Jones, who is a plastic surgeon. In 2025, the unit received 8,000 GP referrals from Donegal, Leitrim, Sligo, east Mayo, east Galway, Westmeath and Offaly. The unit developed a photographic referral system in order the GPs could take photographs of skin lesions include them with referral letters. That happened during Covid. Of the 8,000 referrals, 2,000 were able to be triaged and referred back to the relevant general practitioners for appropriate treatment without the need for the patients involved to be seen by the unit. Of the remaining 6,000 patients, 2,000 have had surgery. The unit is also involved in screening for, diagnosing and treating skin cancers. The 2,000 surgeries to which I refer were carried out by one plastic surgeon, one part-time plastic surgeon and eight advanced nurse practitioners working over different periods. This unit is hugely productive. It is located in an area where there is a high prevalence of skin cancer. The west of Ireland has one of the highest prevalences of skin cancer, not just in Ireland but internationally. There is no plastic surgeon from the tip of Malin Head in Donegal right down to Roscommon. We have patients travelling from Sligo, Donegal and the other areas to which I referred to this unit in Roscommon, which is providing an exemplary service. In addition, 10% of all cases of melanoma, which is a deadly skin cancer, are treated at the unit. The problem for the unit is that it is treating approximately 50 patients per week. From a staff point of view, it has the capacity to treat 150 per week. This is really important, because those in the unit are constrained by the environment in which they are working. They are working out of two small treatment rooms and they have an area in which they assess patients. Will the Minister urge the HSE and the Department to consider the expansion of the physical infrastructure in which this unit operates in order that it can operate with maximum efficiency and to its maximum potential? As already stated, this is a success story. It is a story of productivity. It is a story of Sláintecare. It is a story of a hospital which has reimagined itself but which needs ongoing support. The hospital also has a tremendous endoscopy unit, which serves the region, and has developed services for elderly patients. We know that the population is getting older and that, as a result, there will be a need for frailty clinics, falls clinics, memory clinics and a range of outpatient services. This really is something worth supporting. I urge the Minister and her Department to intervene with the HSE to support this unit in any way it can.

Sentiment score: 0.12

I thank the Minister for her comprehensive answer, which I appreciate. The important thing is the innovation that has happened at this particular unit in terms of the "see and treat" model, where patients are referred for photo triage before they attend. The service is led by a consultant but delivered by specialist advanced nurse practitioners, ANPs, in dermatology, who are trained in the screening and diagnosis of skin cancers and other skin lesions. These may not turn out to be skin cancers but it is important that this work is done. We need to support the advanced nurse practitioner model in this unit and develop it further. It needs more physical capacity. I have spoken to the HSE. I spoke to Mr. McCallion last week after the health committee meeting, and he said the HSE is going to look into that. It is worth supporting. The whole issue about Roscommon is that the public in the west, in particular in Roscommon and east Galway, were promised that with the reconfiguration of Roscommon University Hospital, it would be supported in all its endeavours to provide appropriate services, such as day services. It is important that we keep an eye on the replacement acute psychiatric unit, the car parking services and the outpatients unit, which does not have disabled toilet facilities or a ramp for disabled patients to use. We need to develop the endoscopy service. If the Minister can expand that, we would be delighted and would support her in that. There are so many good things happening in Roscommon University Hospital but it takes commitment. For example, Roscommon University Hospital was promised a neurological rehab unit in 2015, with an attached budget of €8 million. That was taken off the capital plan twice, and only after an intervention by me and my office has it been placed back on the plan. There is a dearth of neurological rehabilitation places in the west of Ireland. I urge the Minister to support Roscommon University Hospital in every way she can. This is an exemplar for the reconfiguration of that hospital.

Sentiment score: 0.30