On a grey and overcast day, it may not seem appropriate to raise the issue of skin cancer, which is a topic I am somewhat obsessed with. However, because I see on a daily basis tragedies that result from late diagnosis of skin cancers, I was extremely distressed when one of my dermatology colleagues called during the past week to mark my card about a procedure in the HSE's special delivery unit which will have negative consequences for the delivery of care and which must be seen as a mechanism for obscuring the true scope of the deficiencies in our health system. I stand to be corrected on this and I would be grateful if the Leader could get clarification from the Minster for Health. The State has 30 dermatologists but the old Comhairle na nOispidéal recommended many years ago that we should have 45, which equates to one per 100,000 of population. The UK ratio is one per 60,000, which is one of the lowest in Europe. Even if this recommendation was fully implemented, we would have one dermatologist or skin specialist per 100,000 of population, which would still be among the lowest in Europe. Between 1998 and 2008, the incidence of potentially lethal malignant melanoma in this country doubled from 400 to 800 per year while the number of potentially fatal cases also doubled from approximately 100 to 200 per year. How are we dealing with this problem?

Has the Senator a question for the Leader?

Yes. The special delivery unit is dear to the Minister's heart. It has sent instructions to outpatient clinics around the country, including dermatology departments, where traditionally we have absurd waiting lists of up to a year. It is much more than a year in some parts of the country, particularly outside Dublin. However, the SDU has told staff in outpatient scheduling divisions to no longer notify patients who have been on a waiting list for more than six months what the date of their appointment will be. Instead, they are to write a letter noting that the patient is seeking an appointment and stating that closer to the date he or she will be given a date for the appointment. The net effect of this is that people are in an amorphous area until a few months before the appointment, which is perhaps a year hence-----

The Senator is way over time.

-----and are told only two months beforehand that they have an appointment. This makes it look as if the waiting list is only two months long. It is a fudge. Will the Leader seek clarification from the Minister about what is going on in the SDU? The unit is massaging the statistics and, instead of dealing with the problem, which is the shortage of skin doctors who can diagnose early skin cancers, we are attempting to obscure the truth in the matter.