I thank the Deputy for raising this really important issue and giving me the opportunity to provide an update to the House on paediatric dermatology services in the HSE south west. Those services are provided through primary care services, regional dermatology services and specialist dermatology services based in Children's Health Ireland, CHI, in Dublin. Paediatric dermatology services in the south-west region are primarily provided in Cork from the South Infirmary Victoria University Hospital, which serves as the regional hub for the specialty. As the regional centre, it treats a wide range of conditions in infants, children and adolescents, including eczema, psoriasis, acne and rare genetic skin disorders. While SIVUH is the regional hub, Cork University Hospital also hosts outreach clinics and integrated care for children with complex needs. Public dermatology services from the regional hub centre also extend to Bantry General Hospital and University Hospital Kerry. In addition, CHI manages and delivers paediatric dermatology services across the three paediatric hospitals in Dublin. CHI is currently focused on reducing the numbers waiting, as well as reducing the waiting times, on the dermatology outpatient lists. I acknowledge the impact on patients and their families who have to travel to Dublin. I am not sure whether those having to do so are those accessing the specialist dermatology services based in CHI. I assure the Deputy that the delivery of high-quality patient-centred care and best practice remains at the centre of all hospital activity. Having said that, I see exactly the point he is making. I checked this morning and the waiting lists are extremely high, especially for children seeking dermatology supports. There has been a small reduction in the waiting list of 58 young children and adolescents. In January 2026, there were 227 people waiting between six and 12 months and 601 waiting from nought to six months. That shows the massive demand for this service. On the Deputy’s question regarding the recruitment of paediatric dermatology consultants to the south-west region, the HSE has advised that while it currently has no plan in this regard for 2026, the matter will be kept under consideration for the future. That seems to be at odds with what the Deputy has said. I certainly will look into it. Obviously, the HSE will use waiting-list initiative funding to take some of this list down. I will bring back to the regional executive officer, Dr. Andy Phillips, and the Minister for Health the Deputy's contention that there are no plans to hire an additional paediatric dermatology consultant given that it is clear that this waiting list is forever too high, especially for young children.
Sentiment score: 0.18
I have a briefing note here that states that CHI has a staffing complement of 8.8 whole-time consultant dermatologists. These are 8.8 whole-time equivalent, or funded recurring consultant dermatologists, across three CHI sites but it is currently operating within 6.3 whole-time equivalents. That is the information I have. I also know from my own area, and Deputy Michael Murphy will be aware of this as well, that in the old CHO 5 area, for example, dermatology consultants are scarce and it is difficult to recruit them. To return to what the Deputy said about the letter only being submitted last night, I can follow up on that in relation to the additional dermatologist posts that have been sought. Thankfully, with the new regional structure, the six regional executive officers have received their cohort of staffing numbers. There were 3,300 this year: 300 for mental health and 3,000 for all other definitions. They are able to decide and determine whether they want to prioritise a certain speciality. I will certainly follow up on this for the Deputy because it is very difficult for young children with eczema, psoriasis or acne, or teenagers with acne. Looking at the waiting lists, they are quite long. I thank the Deputy for raising this matter; it is a really important one first thing this morning.
Sentiment score: 0.10
On behalf of the Minister for Health, I thank the Deputy for raising this important matter. I acknowledge the number of times he has raised it. I have answered him several times in relation to this. As I go through the answer, for anyone listening in, it will become very clear that every effort has been made to try to recruit staff, but the HSE just has not been able to do so. As the Deputy knows, the HSE provides optical services free of charge to preschool children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate optical care, which will continue to be provided until the child has reached the age of 16 years. The community ophthalmic services scheme, COSS, is a national fee-per-item scheme which was introduced in 1979. Under the COSS, medical card holders aged over 16 years can be seen by local ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians who have entered into a contract with the HSE to provide services. The HSE has advised that the community ophthalmologist physician post, as the Deputy has referred to many times, became vacant in October 2024 due to a retirement. As he knows, our constituencies border each other and this has been raised with me as well. I met one of the nurses while I was out and about one day in west Waterford, close to Clonmel, and it was raised with me. I just happened to come across the nurse working in the services and she explained to me how difficult it had become. In line with the national clinical programme for ophthalmology model of eye care and the modernised eye care pathway - this is important - the community ophthalmologist physician post has been upgraded to the position of consultant medical ophthalmologist. Following a recruitment process to fill the post in south Tipperary, an interim appointment was made in July 2025. Unfortunately, the successful candidate subsequently declined the post prior to the commencement date. I am telling the Deputy everything he knows, but I want to put it on the record. Unfortunately, a second recruitment campaign in late 2025 resulted in no candidates being shortlisted. The HSE acknowledges the impact on patients, both children and adults, caused by the current vacancy and has further advised that it readvertised this position in the Irish College of Ophthalmologists with a closing date of 21 January 2026 and, positively, several eligible candidates have applied. Shortlistings will commence on 27 February with interviews anticipated in mid-March 2026. The HSE expects to fill the role in the near future. The HSE has also confirmed that a clinical optometrist and orthoptist post were also advertised, with a closing date of 19 January. The recruitment of these positions will ensure the resumption of optical services for those living in the south Tipperary region. The HSE has advised that patients from the Tipperary south area who have been unable to receive eye care due to this vacancy may, for urgent eye care issues, be referred to the eye service via the emergency department in University Hospital Waterford and that all patients have been notified of this additional referral pathway but I acknowledge that is not a suitable pathway for children. It is difficult presenting to a hospital like that. The HSE has also engaged with the Royal Victoria Ear and Eye Hospital in Dublin with a view to supporting Tipperary south. It has undertaken discussions with a private agency and a scoping exercise has been conducted in this regard. Personally, I would much prefer to see the consultant in place and services resume. I know that the Deputy wants that as well. For emergencies, a scoping exercise is under way. I am actually pleased to hear that there were several applications which we did not have previously.
Sentiment score: 0.16
I can confirm that the post was upgraded to that of consultant medical ophthalmologist and obviously that may be one of the reasons it was not as sought after as it was. Several recruitment campaigns have been run and to date the HSE has been unable to fill the post. The post is funded as well, so it is not a financial issue. Several eligible candidates have applied in the latest recruitment campaign, which closed on 21 January. Shortlisting will commence on 27 February, with interviews anticipated to take place in mid-March 2026. The HSE has also engaged with the Royal Victoria Ear and Eye Hospital in Dublin with a view to supporting Tipperary south. It has undertaken discussions with a private agency and a scoping exercise is being conducted in this regard, acknowledging the long waiting list and the likes of the two kids the Deputy mentioned who have been waiting two years which is simply not good enough. I thank the Deputy and I will follow up on this again.
Sentiment score: 0.18
I hope I will be able to give the Deputy some clarity. I thank him for asking the question, which I am answering on behalf of the Minister for Health. I acknowledge the Deputy's dedication to the people of Galway and beyond on raising these important health issues. I can assure him that the Government is committed to increasing elective-only day case capacity through the elective ambulatory care programme. This is being delivered in two phases, a national network of surgical hubs in the first instance to meet medium-term demand and capacity and, in the longer term, a national network of elective treatment centres in Galway, Cork and Dublin. In relation to the surgical hubs, developments are well under way and a new hub is due to become operational at Merlin Park later this year, along with hubs in Cork, north Dublin, Limerick and Waterford. This will build on the success of the two hubs already opened, namely, the Reeves Day Surgery Centre in Tallaght and Mount Carmel surgical hub facility in south Dublin, which have reduced waiting times. The Galway hub will deliver thousands of procedures and treatments every year. As announced last July, surgical hubs are also in development for Sligo and Letterkenny to provide additional day theatre capacity in the west and north west. In relation to the elective treatment centres, also known as elective hospitals, we remain committed to developing these in Cork, Galway and Dublin. As the programme has developed and evolved, the HSE has determined the most appropriate design for the new facilities. The introduction of the surgical hubs was not originally envisaged when elective hospitals were first proposed. The significant additional capacity being provided by these hubs has been an important factor in determining the model for the centres going forward. I understand the HSE has been considering how best to deliver elective care at Merlin Park. As the Deputy is aware, the HSE is considering extending the surgical hub. I understand that the design team is working through this and further details will be available in due course. The HSE expects to be in a position to apply for planning permission in the middle of this year. The new elective treatment centre in Merlin Park will have six operating theatres - I think the Deputy referred to two - five endoscopy procedure rooms and ten minor operation procedure rooms. This is a significant addition of capacity and will make a real difference to patients. This is not a reduction in ambition. I want to be clear about that. As the Deputy knows, there are no beds at elective facilities and there is no intention to provide them. These are not for inpatient care. These are for people to get the procedure they want and to get them home to their own beds in a timely manner - in and out the same day. The intention is for the elective facilities to provide day case procedures and treatments, for example, those which do not require an overnight stay. Patients will arrive at and leave the facility on the same day. The development of the elective-only facilities I have outlined will also mean that capacity is freed up in existing hospitals for more complex or emergency acute cases. I understand where the Deputy might have had confusion in relation to how many theatres there are. When the surgical hub was proposed for Waterford, it was designed to have two. It has since been upgraded to four. It will be operational by the end of the year. There is a real push for these surgical hubs. Two of them are open in Dublin. They are being built around the country to take pressure off the acute hospitals. These will be staffed separately. Sometimes elective surgeries are cancelled. This will not be the case. I hope the Deputy can see that we are committed to improving elective care in Ireland. The plans we have in place are already making a real difference and helping to drive down waiting times. I look forward to the Deputy’s continued engagement on these issues.
Sentiment score: 0.13
I thank the Deputy. In relation to the elective treatment centres, known as elective hospitals, the HSE and the Minister remain committed to developing these in Cork, Galway and Dublin. They will take longer to develop. In the short term, as the programme has developed and evolved, the HSE has determined the most appropriate design for the new facilities. The introduction of the surgical hubs was not originally envisaged when elective hospitals were first proposed. The significant additional capacity being provided by those hubs has been an important factor in determining the model for the centres going forward. I am not in a position to answer the Deputy's question. I have been in Merlin Park previously visiting mental health services but I cannot answer the Deputy's question in relation to where it will be located. I would be of the mind that if you are going to have an elective hospital with overnight beds, that colocation is important beside a model 4 hospital. Maybe that is the reason behind it but I am only thinking out loud. This is my sixth year in the Department of Health. I understand that decisions are made at times. A lot of people are on waiting lists for elective surgery. We have already delivered two new surgical hubs that are operational. A couple more will come on stream this year. I think what is being proposed for Galway is both. This states clearly that the Minister remains committed to developing the elective hospitals in Cork, Galway and Dublin but while we await those, the surgical hubs will be in place. That will take down a huge amount of capacity for his constituents who are waiting for treatment.
Sentiment score: 0.13