Living with a skin disorder or disease can be costly, may profoundly affect your quality of life and psychological well-being. Our advocacy work aims to improve quality of life for people with skin disease by influencing public policy and services.
At least one third of the population is affected by a skin condition¹ and between 15-20% of GP consultations specifically relate to the skin². This represents between 3.5 and 4.7 million GP consultations in Ireland each year ³. Waiting times for a hospital dermatology appointments can be quite long; perhaps as much as a year. Skin diseases can be very distressing and cause over 180 deaths each year in Ireland, including 113 deaths due to malignant melanoma⁴. Conditions like psoriasis, eczema, acne, rosacea and hidradenitis suppurativa (HS) significantly impair quality of life, often to an extent that is as great as some life-threatening conditions such as cancer⁵.
Getting timely access to dermatology services is a challenge and demand is growing. Routine waiting times can be very long; people with skin disease need improved and convenient access to better-resourced services and affordable treatment options.
In 2016 we made our first submission to government about policy changes that are needed to help people with skin disease.
Tackling skin cancer
Sun-safe practices lead to a reduction in skin cancer incidence. To tackle the increasing prevalence of skin cancer, a long-term strategy to change public attitudes about prevention and early detection is required.
Changes to legislation are needed to place a duty of care on local authorities, schools, recreation / sporting clubs and employers to protect the public, children and employees from ultraviolet (UV) damage. Sunbeds should be banned, completely, for public and private use.
Reducing out-of-pocket expenses
Living with a long-term skin condition can be extremely expensive. The ISF has called for a reduction in the cost of moisturisers, emollients, bandages, dressings, specialist clothing and sunscreens by eliminating VAT on these products.
We have also called on the HSE to expand the limited choice of products available via medical card and Drug Payments Scheme (DPS) for preventing, treating and managing skin disease. This includes the provision of sunscreens for those at particular risk of sun damage and skin cancer (e.g. immunosuppressed patients, such as transplant recipients).
Support at GP level
People with skin disease need more support at GP level. More resources are needed for dermatology training for all GPs, to provide universal access to the widest range of dermatology care to all patients in Ireland. As a patient organisation, we want policy makers to examine options to support patients at GP level in consultation with all healthcare professional representative bodies and other stakeholders.
Support in our hospitals
Increased funding for secondary care dermatology should include an increase in consultant dermatologist numbers, and must include greater investment in the infrastructure, equipment, specialist nursing and support staffing in dermatology departments.
Service planning and development must provide sustained investment for consultant dermatology posts (to increase numbers of consultant dermatologists from 46 to 74, i.e. from 1 per 100,000 population, to 1 post per 62,500), dermatology clinical nurse specialist (CNS) and advanced nurse practitioner (ANP) roles, along with the necessary administrative support.
Medical and nursing education
Universities and training centres must ensure that medical, nursing and GP training (undergraduate and postgraduate) is sufficient so that doctors have a basic knowledge of dermatology for common and important diagnoses. Basic nurse and pharmacist training must include dermatology and those specialising in dermatology should have easy access to training in Ireland. This will widen the pool of doctors and nurses with some dermatology expertise and allow for earlier diagnosis and treatment.
1: Hay et al, The Global Burden of Skin Disease in 2010: An Analysis of the Prevalence and Impact of Skin Conditions, Society for Investigative Dermatology, (2014) 134, 1527-1534.
2: Reported by the Primary Care Dermatology Society of Ireland (2015).
3: The Irish Medical Organisation estimates that there are 25 million GP consultations each year, www.imo.ie and the National Association of General Practitioners (NAGP) estimates that in 2014 23,308,910 GP consultations (comprising GMS patients and private patients) were held in Ireland (NAGP: Pre-Budget Submission 2016).
4: In Ireland between 2003-10 an average of 181 people died each year as a result of diseases of the skin and subcutaneous tissue (68 deaths) and melanoma (113 deaths); figures from the OECD.
5: Skin Conditions in the UK: a Health Care Needs Assessment, NHS, 2009.